Achieving Anywhere Care 

Written by Guest Blogger, Tamara StClaire, chief innovation officer, Xerox Healthcare

The New Paradigm of Health Care Delivery

Imagine for a moment, a day in the life of a type 2 diabetic: While her efforts to stay physically active, maintain a balanced diet and monitor stress levels are currently analog and disjointed, we’re approaching an era in which they will be digital and connected.

Soon, her alarm clock (on her phone) will wake her up at 5:30 a.m. and give her a personalized exercise routine - 30 minutes of cardio and 15 minutes of strength training. Then stepping on her Wi-Fi-enabled scale while checking her blood glucose level using an attachment on her smartphone. Both of these readings go straight into the fitness dashboard on her smartphone and to her physician.

Afterwards, she goes to her refrigerator and receives a notification that her weight is 0.5 pounds higher than the day before, and that she should consider a green smoothie for breakfast – the recipe for which her nutritionist provided. The refrigerator then places an order with a local supermarket to have the ingredients re-stocked.

When she arrives at work, a sensor embedded in her watch detects a higher than usual heart rate – most likely due to the big presentation she’s scheduled to lead later that afternoon. Her smartphone suggests a nearby yoga class during her lunch break instead of her recorded habit of stress-eating at In-N-Out Burger.

While this may seem like a scenario from a science-fiction movie, the reality is that most of these technologies already exist today. Internet bandwidth and Wi-Fi connections are already strong enough in much of the world for this type of connected experience. Integrating disparate systems into a common platform and making the data available and useful is the key to realizing improved care and reduced costs associated with “the future.”

We need to prepare for a new healthcare paradigm – one typically delivered outside the four walls of a hospital.

How did we get here?

The biggest technological growth enabling this futuristic healthcare landscape has been the Internet of Things (IoT) and more specifically, advancements in printed electronics that can make everyday objects “smart” at a very low cost.

For instance, imagine a temperature sensor on a bottle of vaccine to ensure it maintains quality during shipping. At a $100 price point, it wouldn’t be logical to use, but at a 50 cent price point, it becomes a cost-effective solution for guaranteed quality. According to my colleague Steve Hoover, Chief Executive Officer of PARC, smart labels will allow us to turn every-day objects like shirts, bandages and hospital beds into sources of incredibly useful information.

Paired with robust analytics techniques, the Internet of Things becomes transformative. Artificial Intelligence (AI) and machine learning allow us to develop unique insights and contextual understanding, such as creating algorithms for determining cost-effective clinical interventions.

Five Remaining Challenges to This Future

  • Interoperability and data integration. As more devices collect data and deliver proactive care, they need to share the data with each other as well as with relevant healthcare providers EMR/EHR’s and payers. Beyond this, it’s important to integrate weight scales, refrigerators, “smart” shirts, fitness trackers and all the other passive devices that collect data to “connect the islands to the mainland.”
  • Unique patient identification and patient integrity. After years of debate and discussion we still haven’t landed on a standard solution that ensures we recognize a patient as the same person across different systems (how many Smith’s/Johnson’s live in one town?) and electronic health records regardless of minor differences, like the format of the birthdate entered. Anywhere Care will depend on every patient being universally recognized at every interaction across the variety of EMR and EHR systems.
  • Regulations and reimbursement. Without proper alignment and incentives, Anywhere Care will always be fragmented and not show a cost-effectiveness for both the provider and patient.
  • Security and privacy. As we collect and store larger amounts of data it’s even more important that it remains secure and safe. I’m particularly interested in the conversation around distributed trust and using Blockchain in healthcare - Leonard Kish provides a fantastic overview.
  • Understanding the role of caregivers. While the relationship between patient and physician has traditionally been paternalistic, the connected healthcare experience and Anywhere Care paradigm questions if that model is still the best. Dr. Eric Topol has long been a champion of a more collaborative relationship in which patients have full access to their medical data and engage in two-way dialogue to make their healthcare decisions with their provider.

In some ways Anywhere Care is enabled by telemedicine and telehealth solutions now. With the explosion of fitness trackers and wearables new methods of care and sources of data are converging and we’re finally starting to separate the wheat from the chaff.

With the advent of ubiquitous connectivity health and wellness will soon surround us from the time our refrigerator suggests the best breakfast for us to the time our bedsheets monitor our sleep patterns. As people take more ownership of their own care and data, they will also tell us if we’re getting the new healthcare experience right, and they’ll have the data to prove it.