Wireless Health Blog

Admit to Home

04 September 2015

Can you remember the last time you had an enjoyable experience at a hospital beyond the moment you are discharged? If you can’t, you’d be in the majority. At #QualcommConnect, CareCentrix CEO John Driscoll explained that a whopping 82 percent of patients prefer to receive their care at home, rather than at a hospital or other care facility. The health care industry should prefer this as well, because billions of dollars ($17 billion, to be precise) are wasted every year on preventable hospital readmissions, and $4 billion is spent on the more than 700,000 hospital-acquired infections in US acute care facilities.

One of five households are involved in caregiving to persons aged 18 or over, and by 2030 we’ll see a 37 percent increase in Americans with chronic conditions. 26 percent of all patients waited at least six days to see their physician; 40 percent were discharged from the emergency department without fully understanding what the doctors told them; and over 18 percent of Medicare patients are readmitted to a hospital within 30 days of discharge. All of this translates into skyrocketing health care costs and crowded hospitals unless something is done.

While we think of these primary care facilities as the only option for taking care of our chronically ill relatives, a large number of patients can easily be cared for right at home. Driscoll’s company, CareCentrix, is focused on providing a comprehensive network of home-based health services, and therefore, high-quality alternatives to facility-based care. Driscoll gave the example of Kyle, an 8-year-old patient who lives three hours from an infusion center and has to miss a day of school every other week to receive a 2-hour infusion. Moving his infusion to home saves his health plan $75,000 every year.

“Healing at home is both possible and preferable,” Driscoll said. “Future technology will propel more at-home care.” Fortunately, current solutions are gaining traction, which will open the window of opportunity for even better innovations down the road. Consumer wearables, passive sensors, telehealth, mobile connectivity and smartphone apps are all current options that make it easier to take care of patients in the home and wherever else they go.

By finding more opportunities to move patient care to digital platforms and the home, Driscoll believes the deeply flawed health care system – which Driscoll jokes is the reason fax machines still exist -- will begin improving and more money can be saved. “In order for us to be successful,” he argues, “we all need to work together to try to find solutions. Together, we can compassionately and successfully address the needs of patients and families at home.” It’s also essential for health care companies to involve patients in critical decisions, use technology to create personalized approaches that alleviate fear and confusion, and make sure connected technology is available so all involved parties can collaborate toward the patient’s recovery.

So far, CareCentrix’s efforts appear to be having a positive impact. Driscoll reported a 40 percent savings in the first six months of managing infusions to a home setting compared to a facility; the ROI for managing facility sleep tests to the home is 4 to 1; and his company has seen a 36 percent year-over-year reduction in 90-day readmissions. Certainly, the hospital is not always the best option for the patient – or even the health care industry as a whole – and there’s a significant opportunity for companies to provide new solutions to help aid the recovery process and save a lot of money for everyone in the process.

How to Deliver the Internet of Medical Things™ to Millions

01 September 2015

The theme at this year’s #QualcommConnect is the Internet of Medical Things™, and unsurprisingly many of the conversations taking place at the conference are centered on how the tech industry can help make connected health services and devices frictionless and accessible to the masses. Dr. James Mault, VP and Chief Medical Officer for Qualcomm Life, discussed that one of the big challenges facing the industry right now is figuring out how to scale these devices. “When we talk about scale, we’re talking about millions of patients interacting with the health care system using technology on a routine basis.”

What’s preventing the health care industry from adopting the IoMT on a massive scale? Dr. Mault points out that one of the biggest obstacles getting in the way isn’t technology, but rather the fee-for-service systems used by the vast majority of health providers, which is based on the number of visits and length of time. The more times you visit the hospital, the more money that hospital makes.

Slowly, the industry is shifting towards a values-based system, in which clinicians, pharmaceutical companies and other aspects of the industry are rewarded for patient outcomes: fewer hospital visits and readmissions, higher patient adherence and compliance with medications, lower rates of chronic disease and many more. “By 2019, 90 percent of the industry’s payment programs will be value-based in one way or another,” Dr. Mault said. Most health care companies are aware of this, and recognize that they have no choice but to go digital or die.

Dr. Mault closed his discussion by highlighting a few accelerators that will drive higher adoption of the Internet of Medical Things in the coming years. First, the tech industry needs to start thinking less about the technology (which exists) and a lot more about how we can help providers adopt and use that tech. If the tech isn’t effortless for the patient, it won’t be used. Second, there needs to be a viable fabric for the IoMT from hospital to home and everywhere in-between. Predictive, intelligent care needs to be everywhere.

The third accelerator is medical-grade apps and devices. In order to scale, everything needs to be medical-grade. It must be secure, as clinicians will need to make life-and-death decisions based on the data collected and shared. Doctors have to trust the information coming in, and must trust the systems used to deliver that data.

Also required is a change in provider behavior. For centuries, doctors have been taught that the only way to help the patient is to see them face-to-face. In fact, “until January 2015 it was a felony for a physician to bill medical care without seeing the patient,” Dr. Mault said. This is slowly changing with value-based care solutions which don’t require face-to-face visits but still provide management of the patient’s chronic diseases.

The final accelerator, according to Dr. Mault, is clinical workflow and outcomes data. Certainly, this tech isn’t going to do any good if doctors and nurses can’t figure out how to make it fit into what they need to do on a regular basis. Old habits are difficult to change; “right now you’re hearing a lot of kicking and screaming,” Mault said.

This seems like a long way away, and nobody seems to agree on exactly how long it will take to make technology scalable to millions of patients. But one thing is clear: it’s not only possible, it’s inevitable. These accelerators should be viewed as opportunities for tech companies to take advantage of, rather than barriers that get in the way.

From Device to Doctor: Shifting to a Consumer Focus on Health

01 September 2015

Slowly but surely, the health care industry is evolving its approach from a patient-based focus to that of the consumer. This may sound like a very subtle difference – all patients are consumers, after all – but in the past, people only had access to data when they were at a doctor’s appointment. With the proliferation of consumer devices like heart rate monitors, fitness trackers and sensor-laden apparel, it’s now easier than ever to collect data and share it in any way we see fit.

That’s wonderful, but now that we can essentially create a journal of our health history, what can we do with it? How does this information get utilized in a meaningful way? Dr. Harry Greenspun, Director of the Deloitte Center for Health Solutions, explained at #QualcommConnect that in our regulated society, all of this new technology is the digital equivalent of supplements: it’s only able to make claims on improving health until it can actually provide a measurable impact to health and quality of life. “There’s a tension back and forth between the ability to do stuff and not having evidence that it does the stuff that it’s supposed to do,” Greenspun said.

What’s more, doctors don’t have the capacity to continuously monitor your Fitbit data; and despite having more access to our personal health information than ever before, we don’t want to share it. Nobody likes to discuss a rash they received in Vegas, nor do they want others to make assumptions about their prescriptions or other potential concerns.

Additionally, a primary opportunity for the health care industry is to start reaching out to patients like the rest of the world reaches out to consumers. In the US, we are better connected to Chipotle via its mobile phone app than we are to our primary medical care facility. Many hospitals still lack many of the most basic technological amenities that you can find in an app for your local hair salon, such as the ability to make appointments, send data digitally instead of over fax, and so on.+

This shift from patient-centric care to consumer-centric isn’t something that takes place overnight. We now have to figure out what to do with all of this new data, how to ensure that it gets to the right people, and how to determine the tangible benefit new consumer technology can have on our health without impacting the wallets of those in the health care industry.

The Future of Connected Health is Filled with Optimism

01 September 2015

In the last few years, we’ve seen a tremendous surge in the rate of innovation in technology, which continues to evolve at an ever-increasing pace. Smartphones and smart wearables are being sold by the millions, and more of our lives will be integrated into this mobile world. This presents many opportunities to make health care more connected, efficient and cost-effective, but the industry’s traditional business models have resulted in painfully slow adoption of these new innovations.

It’s a struggle that Qualcomm Life SVP/GM Rick Valencia is intimately aware of. Speaking to a group of innovators and visionaries at Qualcomm Connect 2015 in San Diego, Valencia acknowledged that the process of bringing health care and technology into alignment is still early on. “There are a lot of pieces of the puzzle that don’t always fit together well,” Valencia said. “We’re at that stage where people are showing up not just with ideas but with business plans, launch plans, and general go-to-market strategy. We’re figuring this out as we go.”

Valencia insists, however, the existing challenges are actually a reason to be optimistic about our connected future. “It feels like a healthy sign of an industry that’s starting to mature. It’s a thrilling, exciting time for all of us because we get to experience the next problems that you don’t normally get until you start getting into the marketplace and talking to actual patients and doctors.”

There are certainly plenty of hurdles to jump over before the health care industry is entirely on board with the latest and greatest innovations, but this can be achieved when the best and brightest minds work together to come up with – and act upon – solutions. Stay tuned at #QualcommConnect as we put our heads together to help the health care industry continue its journey into the 21st century.

Health Care is a 3D Journey: Welcome to the Internet of Medical Things™ Health Care is a 3D Journey: Welcome to the Internet of Medical Things™

25 August 2015, Written by Rick Valencia, President

With the rise of smart mobile devices and cloud computing, the “Internet of Everything” (IoE) has exploded – and now, in the health care space, the “Internet of Medical Things” (IoMT) is also gaining traction. mHealth apps, activity trackers like FitBit, and connected medical devices such as weight scales or blood pressure monitors are creating a mainstream push for this connected movement. Yet the Internet of Medical Things still differs from the Internet of Everything in that it affects our health, our longevity and our quality of life – as well as that of our families. The challenges and rewards are higher on many levels for this very reason.

There are a myriad of challenges surrounding the IoMT. As consumer-driven health care takes hold, the IoMT has to have a draw for consumers – an instant and ongoing gratification. The reality is that health is often neglected; we let our busy lives get in the way of wellness, prevention and the opportunity for early diagnosis. The average consumer will invest more time setting up their smart device or TV than on a connected medical device. Additionally, all stakeholders are looking for net incremental value from the IoMT – providers and payors will challenge IoMT to improve outcomes and supplant existing health care encounters. For those that recognize and tackle these challenges head-on, the promise of the IoMT is immense. In fact, this health care Internet of Things is expected to reach $117 billion by 2020 and health care will be the highest segment for the IoT growth.[1]

While still a fairly nascent category, we define the Internet of Medical Things as a digital ecosystem of connected and diverse, medically-related things that enable transfer, sharing, and use of data over a network with a goal of optimizing care pathways and delivering the right care, at the right time, at the right location. The fabric of this ecosystem will integrate stakeholders and create a connected interdependent environment for exchanging services and knowledge. This integration and recent advances in natural human interfaces, wearable devices, sensors, and smart medical devices will allow machines to be an integral team member in the delivery of care to a consumer.

The IoMT has the potential to make “care anywhere” a reality by connecting and integrating a wide range of devices, wearables, sensors and implantables, which will generate an enormous amount of personalized ‘small data’. The IoMT pioneers are demonstrating how embedded analytics outside the traditional enterprise (a hospital) will be able to collect, cleanse, classify, and synthesize data to reveal big insights. These insights will enable providers and patients to see patterns and trends. At Qualcomm Life we have been designing and engineering for this concept of ‘Intelligent Care Everywhere’, which is powered by the IoMT. Historically care has been very linear – from cradle to cane we move in and out of acute care settings along a very linear patient journey. Now, with the advent of IoMT, care will be everywhere. And it will be intelligent.

All “things” health related will be connected – from your DNA sequence to your electronic medical record to your FitBit data – your health care will no longer be a linear journey, but care will become three-dimensional, delivered to patients in a personalized, convenient manner, anytime, anywhere. The IoMT will know you, and it will allow for cognitive learning of the IoMT through the small personalized data that is collected and analyzed near real-time. This hyper-personalization will help make care more dynamic and treatments and therapies more specific and efficacious.

The positive impacts that the Internet of Medical Things will have on patients, providers, and health care system globally are vast. Ultimately, the need for physical clinics or hospitals will be reduced. There will be less dependence on physician visits and consults as data can flag exceptions and recommend patient-activated or machine interventions. It will bring better care for seniors and people in remote areas with improved care access, and will address health care inequality by reducing costs associated with in-person visits, hospitalizations and medication errors. Ultimately the IoMT will allow patients to heal and age while at home, reduce the burden on the health care system and unlock the power of self-care where patients will be informed and engaged in their own care.

So how do we realize this vision for the Internet of Medical Things in a historically siloed, disconnected industry? Simply put, we must embrace a new business culture. The success of IoMT will hinge on leaders and their companies embracing a cooperative, interdependent way of developing connected solutions. Companies will quickly realize that success in the new ecosystem depends on how well we can co-create value. We will be focusing on the IoMT – and other topics – at our upcoming Connect conference next week – where we will be welcoming a roster of industry thought leaders from our own Qualcomm Life Ecosystem for a compelling two day knowledge sharing and networking session.

At Connect 2015, we will be sharing live video and blogs from the conference. Follow here and on Twitter, @QualcommLife and #qualcommconnect.

[1] Big Data in Internet of Things (IoT): Key Trends, Opportunities and Market Forecasts 2015 –2020 http://www.marketresearch.com/Mind-Commerce-Publishing-v3122/Big-Data-Internet-Things-IoT-8926222/

From Discharge Planning to Admit to Home: Bridging to a Truly Connected Health Care System

20 March 2015, Written by James R. Mault, M.D., F.A.C.S., Senior VP and Chief Medical Officer



There has been a lot of buzz in the industry about a connected health care system.  Rightly so, as we have made significant strides towards taking archaic paperwork to a digital state that will better maintain health records and improve the quality and effectiveness of care.  Advancements in electronic health records and health information exchanges have led to a number of improvements in our health care system and have undoubtedly made it more “connected.”  This connectivity, however, breaks down when a patient leaves the hospital.  If we are aiming for a truly connected health care system, we need to ensure that the tools are in place to allow health care providers, patients and caregivers to actually connect, especially as care is shifting from the hospital to the home. 

With more than 35 million Americans discharged annually, the home is the fastest growing health care setting in the U.S.1  Yet when a patient is discharged from the hospital, the communications process immediately breaks down.  Care becomes disconnected and disparate.  Discharge planning entails a series of one-to-one or synchronous communications:  patient with a case manager; patient with a pharmacist; case manager with a doctor.  Information is communicated via phone, fax or not at all.  It is slow, time consuming, expensive and not scalable.  
Even with a focus on reimbursement models created for transitional care management, CMS estimates that $17B is spent on preventable readmissions annually2.  Nearly 20 percent of Medicare beneficiaries are re-hospitalized within 30 days of discharge3 Ineffective transitional care plans can also lead to medication errors, non-adherence, increased readmission rates and even deaths.   

We need to change the way we view this process.  Instead of discharging and sending patients away to a disconnected system, let’s admit to home and use technology to help create a truly connected, continuous care plan.  It starts with shifting from synchronous to asynchronous communications, where many people are communicating and sharing vital information to make informed care decisions.  This continuous, team-based care enables providers to more effectively manage resources, make decisions and provide care with near real-time data, leading to better accountability and reduced costs.  This approach keeps family and care team members connected and apprised of a patient’s health status.

But how do we get there? We need to engineer care models where free-flowing data is securely and asynchronously shared between the care team and the patient, enabling coordinated team-based care. The only way to achieve this is through mobile technology that is interoperable and back-end data platforms that mange by exception. We have watched it reshape other industries like banking and travel where interactions were once conducted face-to-face or telephonically and are now done in the convenience of a mobile app.  And health care is next up for this digital transformation.

We know communication among health care team members influences the quality of working relationships, job satisfaction and profoundly impacts patient safety4.   As the home is the new care setting, connected continuous, team-based care is a necessity for providing hospitals the confidence to admit to home, and for patients and caregivers the tools to get well. 

1 CDC, National Hospital Discharge Survey, number and rate of hospital discharge, 2010

2 Centers for Medicare and Medicaid Services. Real-Time Reporting of Medicare Readmissions Data. Niall Brennan, Acting Director, Offices of Enterprise Management. February, 2014

3 U.S. Department of Health and Human Services. National Healthy Statistics Reports: National Hospital Discharge Survey. Number 29. October 25, 2010

4 Team strategies and tools to enhance performance and patient safety (TeamSTEPPS), Department of Defense and Agency for Healthcare Research and Quality

Is the Wearable Market about to Explode?
What will the evolution of wearables look like?
Is the Wearable Market about to Explode?

10 June 2014, Written by Rick Valencia, President

Look around. Chances are, someone around you is wearing one right now. I’m not talking about a baseball cap or a pair of minimalist running shoes. I’m talking about a connected device—a “wearable”—a fitness band, a smart watch, a pair of smart glasses…of maybe even connected clothing. Ready or not, the wearable market is about to explode.

Right now, fitness-related wearables dominate the market—about 90 percent according to a February CNET report quoting Accenture. But by 2018, the market will expand, to where three categories—fitness/activity trackers, smart watches and infotainment, health care and medical categories—will take over 70% of the wearable space says ABI Research. In that same year, you also probably won’t have to look too hard for someone with a wearable, research firm IDC says the number of devices out there will be 118 million.

I too think we’re only touching the tip of the iceberg with wearables. There’s a lot of opportunity out there, not just in form factors but what’s possible with function and value.

Consider fitness bands. They give users real-time feedback on performance and, if you can upload the data to the cloud, onto a platform where you can compare your latest event with previous events, they are a great way to gauge progress. In addition, these cloud-based platforms give wearable device makers a place to begin engaging with customers.

These fitness applications are great, but can we go further?

Think beyond the simple fitness band or heart rate monitor. What about leveraging the same concept for all health care monitoring devices—giving yourself and your health care provider a clear view of what’s going on inside you during various situations, environments, temperatures, etc? All that data, coming from all of us? It’s possible. The technology side is coming together.

Think about it: advanced wireless networks, offering speeds and bandwidth that rival “old fashioned” wired networks (I work for a wireless company so I am slightly biased) have been launched all around the world. Moreover, the processing technology is increasingly more powerful, more feature rich and (amazingly) more energy efficient.

With these critical pieces in place, it’s possible to begin building that “Internet of Everything” we’ve all envisioned. The Qualcomm Tricorder XPRIZE could be one of those connected things that has the potential to transform health care—imagine sophisticated sensors integrated into a single device that will literally be used as a home diagnostic kit, as common as a thermometer.

I believe it’s just a matter of the devices maturing and becoming more widespread.

The higher-end devices today are already connected to the cloud in one way or another—giving you and/or your health care professional instant access. It’s only a matter of time before:

  • Nearly all—low to high-end—devices offer the same connectivity
  • Embedded sensors will just be a given, in our jewelry, accessories and clothing
  • Temporary body patches and injectables for the most serious or localized uses, such as in health care facilities. Imagine checking into an urgent care facility at which point the receptionist places a patch on you that takes your vitals and wirelessly transmits them to a secure, centralized repository where the doctor can review before he sees you. (already done by nurse before visit)

Going back to the benefits to the individual, I believe we’re only on the cusp of what’s possible.

Sure, you can currently track some interesting vitals such as resting heart rate, body temp… even locations and moods. And maybe you can upload them into proprietary cloud systems to view past performance. Ideally, you will be able to see all of your health care data across multiple devices, apps and environmental sensors to give you a contextual, actionable and holistic view of your health. That’s the value to individual users.

There’s also value to the wearables manufacturers themselves. Fitness data establishes a beachhead for companies to engage with their key audiences. Imagine, whenever someone uploads information from his or her wearable into a community database, a conversation can be initiated between user and device maker.

Look at it this way: Today’s wearable technology is helping people build a mental model of the possible uses and benefits of digital health.

So if we look at all the potential in front of us, in front of the wearables category, you’ll realize that the category is really in its infancy. In fact, 10 years from now, we’ll look at today’s devices like we look at the 8-track players now. Or the way we look at mobile phones from 10 years ago.

Personally, I'm pretty excited about what's being developed right now and what's to come from wearables.

Pedaling for a Cause
Qualcomm Lifers Pedal for a Cause in San Diego on October 26-27
Pedaling for a Cause

22 August 2013, Written by Rick Valencia, President

Most of my previous blogs have been focused on Qualcomm Life announcements, key industry trends or the latest in mHealth buzz, but this time I wanted to share a health care cause that is a little more personal to me.

Pedal The Cause is a San Diego fundraising organization that is hosting a cycling event, taking place October 26-27, where over a thousand cyclists meet in downtown San Diego and ride together with a single goal: to find a cure for cancer.

Personally, I decided to get involved in memory of friends I have lost to cancer over the years. I was first touched by the devastation of cancer when good friends of mine lost their young daughter to Leukemia. At the time, I was about 30 years old with a 2 year old son, and cancer was just a news story to me because it had never impacted someone close to me. More recently, another close friend was diagnosed with cervical cancer. Although she has sent the cancer into remission twice now, it has basically become a chronic disease for her that she will battle for the rest of her life.

Professionally, I decided to get involved with Pedal The Cause because 100% of all donations stay in San Diego and go directly to a very unique collaboration of cancer research institutes. UC San Diego Moores Cancer Center, Salk Cancer Center and Sanford-Burnham Medical Research Institute are combining efforts to create the San Diego National Cancer Institute Cancer Centers Council, or C3 – to leverage their distinct and combined resources and talents. This new partnership will allow San Diego’s cancer researchers to accelerate the understanding of and innovative treatments for cancer, the nation’s second leading cause of death.

Just a few weeks ago, my friend of over 20 years, and likely a friend to many of you, Duane Roth, passed away in a bicycle accident. Duane was a huge source of influence and support in my life, especially when I had just started my business and was in need, and was also a big supporter of Pedal The Cause.

This year, I’m so happy to share that Qualcomm Corporate Giving has donated $50,000 to Pedal The Cause in honor of Duane.

I have also formed a team, the Qualcomm Lifers, of riders who will be cycling in October in honor of Duane and other loved ones who we have lost to cancer.

I’ve included some links to join me in the ride or make any size donation that you can and so appreciate your support of Pedal for a Cause.

Here is the link if you’d like to join me in the ride: https://sandiego.pedalthecause.org/ride.jsp

Here is the link if you’d just like to make a donation: http://sandiego.pedalthecause.org/riders_profile.jsp?MemberID=67



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