Following the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and its necessitation of electronic health records (EHR) and electronic medical records (EMR), EHR and EMR continue to transform how we record and store patient medical data.
Today there is a lack of integration between EHR and EMR records and the new Internet of Things (IoT) devices being introduced to healthcare, creating a gap between the creation of these records and the networks that store them at nursing homes, continuing care retirement communities (CCRCs) and other facilities with skilled nurses. Mending this gap would lead to better outcomes, improve access to therapies and lower the cost of care for patients.
Even “technologically advanced” facilities that have deployed medical devices to improve care still need to take the next step of integrating their medical devices, as many that record patient activity and progress electronically must still upload their EHR or EMR using human therapists, hindering useful contextualization in real time. Allowing IoT medical devices to both create real-time medical records and upload those records to the health systems’ networks immediately can close these gaps.
Tailoring to individual facility needs
Some technology providers are developing solutions to these problems, but many of them lack the customization needed by today’s healthcare networks and providers, rendering them inadequate. U.S. healthcare networks can contain more than 185 unique hospitals or facilities and with many of those facilities deploying individual information exchange standards, the solution must be tailored on a case-by-case basis.
The presence of multiple standards, like HL7 (with different versions) and Direct, is also a significant roadblock to integrating. For example, one nursing home system may have 10 nursing homes that each have their own standards and processes, preventing inter-facility connectivity. The solution must be customizable and flexible for all the standards used at all the nursing home facilities in order for that nursing home system to implement one information exchange solution. Without this the marketplace will become significantly fragmented, making it difficult for any one vendor to collect meaningful feedback from customers to refine their products and make an impact.
Quality of data and actionable intelligence
Each patient yields data produced by medical devices, and this data enriched with significant context provides useful information for healthcare pracitioners, enabling them to make smarter decisions. With a device’s data, healthcare pracitioners are empowered to make significant differences for every patient in their networks. Currently, data’s lack of integration makes it difficult for practitioners to gain actionable knowledge.
Improved data quality with IoT-integrated robotics is crucial, from the patient level to the health system level. For patients, robots are by nature less biased than human caregivers and give neutral patient evaluations, resulting in more reliable and consistent updates on patient progress. For health systems, robotics and the IoT can generate quality data on patients performance to improve their delivery of care.
This also allows caregivers to monitor equipment productivity, allowing the same departments in different facilities to compare the data across time. This data also provides insights into patient cost, which helps providers increase productivity by reducing unnecessary expenses and care for patients. It is a way to support the clinical teams on their adoption curve for the new technology, by monitoring the technology impact, and the asset productivity. By integrating to upload results instantly, care facilities will have access to the most recent and accurate data, allowing practioners to make more informed decisions on a real time basis.
HIPAA
According to the U.S. Department of Health and Human Services (HHS), HIPAA required the secretary of HHS to develop regulations to protect certain health information’s security and privacy, specifically information that is transferred or stored electronically. As EHR and EMR continue to be adopted, security risks also grow, making HIPAA compliance vital. Because HIPAA is American healthcare’s security standard, any electronic record solutions must comply.
Major roadblocks
Medical device manufacturers know of all the issues and have developed integration solutions to address them. Unfortunately, there are not yet enough solutions that solve all of the issues in play. Even though it’s a long list of demands, providers must not compromise on solving any of these problems.
While the first step of implementing robotic devices, supported by evidence-based medicine, has been taken by many facilities, most still need to integrate with their robotic devices to maximize the returns on their initial investments. The lack of adoption can be partially attributed to a reluctance to invest in new technologies, as well as a lack of education on the technology’s benefits.
Developing fully compliant, patient-facing robotic devices has been challenging for medical device manufacturers but that is beginning to change, and the new challenge is helping the long-term care industry understand that the use of robotics will not only improve their bottom lines, but also patient care.
We have seen information technology investment in the healthcare industry steadily increase, reaching $7.1 billion in 2017 (for the entire healthcare industry, not only nursing care), but it is far from commensurate with the industry revenues, such as the nursing care industry’s revenues, which reached $139 billion in 2019. The money is there and even with the COVID-19 pandemic’s impact on hospitals’ finances, investing in integrated technologies further improving patient outcomes and reducing the administrative burden on healthcare professionals’ shoulders is worth considering.
Conclusion
Medical devices must integrate in order for providers to invest in them, and that integration must be able to do many different things to provide practioners with actionable intelligence, improve patient results and access, and reduce costs, which is especially key at a time healthcare facilities are facing the impact of the pandemic. Manufacturers are already working to develop technology that can do it all for nursing homes and health systems, and solve all of their customers’ major issues, make their facilities faster, communicative and more intelligent. Care systems recognize their challenges at this point, but they must increase their adoption.
Eric Dusseux, M.D., MSc, MBA, is chief executive officer of BIONIK Laboratories, a robotics company focused on providing rehabilitation and mobility solutions to individuals with neurological and mobility challenges.
