Connected Health: Extending the Continuum of Care to Improve Medication Compliance

According to an August 2009 report from the New England Healthcare Institute (NEHI), one-third to one-half of all patients do not take their medications properly and this noncompliance costs the U.S. healthcare system an estimated $290 billion each year.1 Medication noncompliance is especially prevalent among patients with chronic diseases, such as asthma, heart disease and diabetes, since they may forget to take their medications, discontinue them due to cost or believe that they are unnecessary.2

Contained in the NEHI report were recommendations on improving patient medication compliance, including the use of health information technology, such as electronic health records, e-prescribing and clinical decision support systems, to ensure usage data is shared among patients, physicians and pharmacists. Other recommendations included patient engagement and education, payment reform and the creation of support teams comprised of nurses, care managers, pharmacists and other clinicians to encourage patients to remain compliant over the long term.

The concept of Connected Health has emerged as a potential means to address poor medication compliance and facilitate some of the above recommendations. It relates to the use of technologies to extend care beyond traditional healthcare settings (hospitals, physician’s offices) to reach patients in their daily lives (at home, at work, at school). The technologies can be used to not only facilitate patient engagement and support, but to also capture health data and transmit it among those that have a vested interest in the patient’s care (caregivers, physicians, nurses, insurers, employers, pharmaceutical companies, etc.).

Vaishali Kamat, Group Manager for Medical Technology at CambridgeConsultants demonstrates a blood pressure monitor developed with A&D Medical, which utilizes the Cambridge Consultants' Vena technology, at recent Innovation Day event.

According to Vaishali Kamat, group manager for medical technology at Cambridge Consultants, a Boston-based technology and innovation company, Connected Health is not a new concept, but it is one that is gaining momentum due to the current focus on electronic health records and their central role in healthcare reform.

“Connected Health is about delivering a continuum of care from the clinical setting to the home and supporting the patient through regular monitoring and feedback,” said Kamat. “It involves different ways to encourage people to live healthier lifestyles, be proactive with their care and take action to monitor and manage chronic conditions rather than letting these conditions take over their lives. What it brings to the table is the ability to manage patients while they’re already healthy as opposed to waiting for adverse events, thereby improving outcomes and reducing costs.”

Cambridge Consultants has been active in the Connected Health arena and recently developed a prototype device to improve patient compliance with asthma medication. Called the Vena-enabled Inhaler, it is based on the design of a standard asthma inhaler but it is equipped with the company’s Bluetooth wireless platform (the Vena platform), which is compatible with the Continua Health Alliance standard. The device flashes a light to alert the patient that it is time to take his/her dose of medication. Once the dose is taken, the device wirelessly communicates this information to a Vena-enabled computer or smart phone, which in turn transmits the data to any number of back-end Internet portals such as Google Health. The patient then logs into these portals to view and track their dosage activity. (A demonstration of the device can be viewed on You Tube:

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Kamat notes that this simple connectivity presents a wide range of opportunities for the patient and other key stakeholders. For example, patients could enroll in an incentive program through an employer or insurer that rewards them for maintaining compliance, or a social media outlet where a network of peers, family and friends could monitor the patient’s medication usage and provide encouragement and support.

On the industry front, pharmaceutical manufacturers could use the Vena platform to monitor medication compliance among clinical trial participants in real-time, correlate this data with efficacy data and share this combined data with regulatory agencies to prove product efficacy. Kamat also notes that the technology could be used to facilitate post-market surveillance of drug usage among patients.

When asked about the potential patient privacy and “Big Brother” issues surrounding the transmission of personal health data in this manner, Kamat points out that industry initiatives and social factors are converging to facilitate this level of electronic information sharing.

“As the use of electronic data in healthcare expands, security has been implemented to protect patients and will continue to be implemented as adoption increases. For example, HIPAA laws are being amended to account for encryption in electronic personal health records,” said Kamat. “As for the Big Brother aspect, this generation is increasingly willing to be open with their lives – look at the popularity of social networking sites like Facebook – we’re pouring our lives into them. So the barrier is moving with respect to people being more open about these things.”

For more information on Cambridge Consultants’ Connected Health activities, contact Vaishali Kamat in the company’s US office at 617-532-4700 or Paul Williamson in the UK office at +44 (0)1223 420024 or email info@CambridgeConsultants.com.

About the author:

Kara Nadeau Della Vecchia, founder of KDV Communications, Inc., USA, is a healthcare communications consultant and freelance writer. Visit http://www.kdvcommunications.com or contact her directly at kara@kdvcommunications.com .