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T ere is huge opportunity in the mobile space to innovate on the edges. Apps are where it’s at. Surprisingly, there still are no apps for most of the medical verticals out there, and the opportunities are endless for developers. T e coming of age of “millennials” and the increased cost shifting onto patients means those who can be effi cient and innovative will reap rewards. We’ve already started to see the birth of diagnostic tools on the iPhone (to do an EKG, for example), and I think we’ll start to see more wireless care delivery and health management tools prescribed by physicians as a result of the innovation happening in this space. By acknowledging the value of mobile health solutions, the FDA has taken a major step in encouraging innovation. In September 2013, the FDA issued fi nal guidance on what it classifi es as a mobile medi- cal app and requires regulatory approval. T is openness in healthcare technology is something we at athenahealth have been advocating for heavily in Washington, D.C. If you look at FDA-cleared apps for diabetes like LifeScan’s OneTouch Reveal (glucose monitoring), Glooko (diabetes data management) and WellDoc’s DiabetesManager (logging and coaching), you see how data collection and tracking are a big piece of the puzzle for apps. While these apps won’t likely replace all of the medical testing being off ered in hospitals and physi- cians’ offi ces, they may inspire a change in how people manage their own care and coordinate that care with their physicians. Similarly, physicians will have access to better tools to obtain information on patients between visits. T is is where interoperability comes into play. T ere is a need for


new technologies to “talk” to one another so that the valuable infor- mation that technology enables us to obtain is shared with the right people, at the right places and at the right time. T at’s something a lot of us are focused on right now, particularly with meaningful use Stage 2. It is our view that getting to the point of interoperability with all EHRs will be a huge accomplishment for the entire industry — a win for patients and physicians. T is will replace a massive amount of faxing, emailing and paper mailing, not to mention save an im- measurable amount of administrative burden.


Pallav Sharda, M.D., Director of Product an


Strategy, Omnicell Inc. 1. Big data infrastructure technology. T e foun- dational stack needed to handle high-volume, variety and velocity of data in healthcare will be in wide use.


T is will include the types of technology tools that can perform at the needed scale for managing information generated by billions of individual care delivery events. In most cases, this will end up being replacement technology because the needed changes in areas like computing, architecture, storage, etc., are too radical for traditional technology infrastructure. 2. Health information exchange technology. T e fundamental tools for health information exchange (HIE – the verb) are going to reach critical adoption. T e accountable care model will drive various healthcare participants to start exchanging information using common standards. Meaningful use will force health IT vendors to provide a baseline set of functionality for such exchange. In most cases, these will probably be enhancements because much of the needed change has been gradually taking place with federal initiatives around HIE (the noun). Also, the tools being developed (such as Master Patient Index) are primarily designed to work in conjunction with incumbent EHR technology.


Juergen Fritsch, Chief Scientist, M*Modal It is already becoming clear that today’s electronic


health record (EHR) systems with their focus on episodic care are not very well-suited to the emerging needs around population health management for value- based reimbursement models. At the same time, many healthcare organizations have sunk multimillion-dollar investments into their EHR systems and they will continue to use them in the foreseeable


g www.healthmgttech.com


future, but will try to augment them with additional systems to ad- dress the needs they’ll face in fi ve to six years. I believe that we will see new technologies emerging that will focus on information-enabled longitudinal patient care in a way that will enhance existing systems. T ese technologies will accumulate and analyze large quantities of evidential data in order to identify and execute the most appropriate, most personalized treatment plans for each individual patient. Another development will be an acceleration of mobile and


Web-based applications that will seamlessly connect patients, family members, care providers and insurance plan managers. Patients will be able to perform most diagnostic and laboratory tests in the comfort of their home using their mobile devices with medical add-ons. Care providers will be connected to each other and to their patients and will be able to communicate, coordinate and share information securely. Most importantly, intelligent reasoning and abstraction technologies will become available that will summarize the right information for the right care provider at the right time, thereby preventing medical professionals from drowning in the sea of data that will be generated by 2020.


Ronald Razmi, CEO, Acupera fu


Remote monitoring of patients with chronic dis- eases and population health management tools will become critical for healthcare organizations in the future. As providers become increasingly responsible for


managing the cost of care, they will need to proactively identify and manage high-cost patients. Medical care will transcend the walls of the provider’s offi ce.


Healthcare organizations will start monitoring and engaging pa- tients outside of the clinical environment more frequently. To do so, healthcare providers will need to embrace emerging technologies and monitor patients in their home environment, allowing them to intervene before those patients start on a downward spiral toward costly end-care. In order to better manage costs and improve overall quality of care,


providers must embrace population health tools. T ese technologies enable healthcare organizations to segment patients based on their risk levels and organize the most intensive resources around those who are at the highest risk, resulting in a shift to a more patient-centric, team-care model. T is evolution of care will also require analytic tools along with intelligent workfl ows that ensure effi cient collaboration between care team members.


John Glaser, Ph.D., CEO, Health Services,


Siemens Healthcare First, if recent history tells us anything, it’s that we


cannot predict with complete accuracy where technol- ogy will take us. No one could have predicted the rapid development of cell phones into smartphones and, more importantly, their meteoric rise in society. However, in the next fi ve to six years, we can predict that mobile solutions will take center stage in health to enhance today’s care models and technology. As healthcare organizations evolve from the acute focus, providers will need ways to connect with other clinicians and with patients. Patients are becoming more engaged in their own care, and the


- d


industry is just beginning to capitalize on this potential. We’re already witnessing growth in patient portals, which facilitate appointment scheduling, test results and patient/physician communication. Today, patients with chronic conditions, such as diabetes, can upload blood glucose levels into a system for monitoring by a care provider. T at will evolve and we’ll see diabetics and people with hyperten- sion, for example, with home-based devices that measure blood levels and blood pressure and automatically transmit that information to care providers. Secondly, HIT systems will become more “intelligent” in order to create personalized care plans and guidance – the fi rst phase of


HEALTH MANAGEMENT TECHNOLOGY January 2014 9

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