Patients want remote health monitoring and providers should adapt


Remote retinal imaging system placed in a primary care physician's office to screen for diabetic retinopathy

Fueled by billions of dollars of venture capital, new technology continues to invigorate the healthcare sector. From heart rates and steps to calorie counts and sleep patterns, people are creating data each day at an exponential rate and uploading them to databases through their smartphones and other digital devices. New mobile platforms are revolutionizing how doctors communicate with and treat our patients.

As a retina specialist in private practice whose most common patient population has been receiving AARP mailings for several years now, I thought, “Surely my patientswouldn’t be interested in these new-fangled devices. These are for kids (or at least millennials), right?!?!”

Though I was asking, “Why should I have to worry about these devices penetrating my clinic?” the real question should have been: “Do I really know what my patients want?” To answer these questions, this past summer my undergraduate student (1) and I decided to survey (2) the exact patient population in question: MY PATIENTS.

We wanted to find out how many of my patients were currently using or were interested in using web-based technology to manage their health care in the future. How many of them have already used a either a smartphone, tablet or personal computer (PC) to schedule a doctor’s appointment online, pay a medical bill, read an online review or research a medical condition?

Which of my patients are interested in using telemedicine?

How many have already used or are interested in a wearable device to track health data?

And lastly, how many would be interested in an at home monitoring device for their eye condition?

Here’s what we found:

Using the responses of the 200 patients surveyed, our patient population was broken down into four age groups: Age <35 (13%), ages 35-49 (23%), ages 50-64 (25%), and age greater than 65 (39%).

As expected, nearly 95% of the younger age groups (<35 and 35-49) have a smartphone, tablet, or PC. Only 85% of our age 50-64 patients and just under half of our 65+ patients use them.

As of the summer of 2015, by far, our younger patients aged <35 used web-based technology the most: nearly three-fourths of them have scheduled a doctor’s appointment online, read online reviews of doctors, or researched a medical condition. Conversely, only 40% of our 35-49 did so and rarely did patients over 50 managed their healthcare online.

So far, my initial assumptions were correct. But this is where it gets really interesting!

Not only did 80-90% of my under 65 year old patients, but nearly 60% of my medicare aged patients have already used or are interested in using telemedicine in lieu of a doctor’s visit as part of their healthcare.

With wearables, Over 90% of our younger (<35) and middle aged patients (age 35-49) and over half of our older patients have already used or were interested in using them in the future to track their health status. Clearly, it seemed that my patients are becoming just as excited about this healthcare technology craze as the venture capitalists!

Lastly, we surveyed our patients regarding their interest in a newly available at-home monitor device for their ocular condition. Here’s the most interesting piece of data we discovered.

My medicare-aged patients wanted this technology just as much as my younger patients!

A whopping 62% of my patients aged 65 and older were interested in an at-home monitoring system for early detection of vision changes. In fact, the majority of patients in each age group seemed to want this.

At first I was surprised by this, but after thinking about it for a moment, it made perfect sense. Most of these older patients are seeing me because they are at risk for a potentially blinding condition called macular degeneration. Many of them have seen a relative or friend lose their central vision to this and would do almost anything possible to prevent this from affecting them.

Because we can treat it, early detection is vital to preserving long-term vision. Of course, they would want this!

Patient using Foresee At Home monitoring device

Sure the survey results confirmed my initial inkling that younger patients are quicker to adapt to healthcare technology, but I was surprised to find that, to a lesser degree, my older patients are too.

More importantly, my patients in the 50-64 year old group are the ones who are very tech savvy and will be hitting medicare age and all the ailments that come with it. They’re the ones who we as retina specialists need to prepare for and it’s only a few years away. As time goes on, this population will only continue to increase.

Since this survey, my practice has incorporated telemedicine to help identify patients with diabetic retinopathy and has begun to offer an at-home monitoring device for our patients with AMD.

Prior to this survey, we already had an online portal system in place so patients can access their health records remotely and we’re currently upgrading our online bill payment system. We are currently discussing the best way to accommodate online appointment booking.

As a doctor, we took an oath to do what’s in the best interest for our patients. Decades of training have given us the ability to identify and treat human disease and for the most part, we are pretty good at it.

However, as healthcare technology advances and our patients’ expectation from us change, we as healthcare providers must too evolve. The first step, is figuring out what our patients want. The simplest way is to ask.

1 Special Thanks to Mackenzie Franklin, BS candidate, Yale University Department of Molecular, Cellular & Developmental Biology / Neuroscience.

2 Manuscript in preparation

#telemedicine #wearables #digitalhealth #fitbit #maculardegeneration #athomemonitoring #healthcare #sunshineact #telehealth #mHealth #mobilehealth

Robert Wong, MD
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