Robin Farmanfarmaian is a Silicon Valley entrepreneur working in technology and artificial intelligence. She has been involved with more than 20 early-stage biotechnology and healthcare startups, including those working on medical devices and digital health.
With over 180 speakers in 15 countries, she has educated audiences on many aspects of healthcare-related technology, including artificial intelligence and change in service delivery. health care to the patient’s home.
She has written four books, including Patients are CEOs: How technology empowers healthcare consumers and most recently, How AI can democratize healthcare: The rise of digital care.
IT news about healthcare spoke with Farmanfarmaian to discuss where AI is influencing remote patient monitoring today and how AI can democratize healthcare.
Q. Where is remote patient monitoring now? Where do you see RPM in the next 5 and 10 years?
ONE. Remote patient monitoring is still being used in its first five years of adoption and integration into healthcare systems, and the pandemic has fueled this trend by illustrating the need and value of RPM. . Currently, there are many clinical-grade devices that patients can purchase or use to measure and monitor various vital signs, including electrocardiogram, heart rate, heart rate variability, blood pressure, and blood pressure. oxygen level in the blood.
The Centers for Medicare and Medicaid Services is one of the standards-setting organizations in the U.S. healthcare system, and CMS introduced the CPT code for remote physiological monitoring more than four years ago. CMS has expanded its scope and specialization over the past few years with additional and updated CPT codes.
In 2022, CMS released CPT codes for telemedicine monitoring (RTM). These codes include RTMs for respiratory and musculoskeletal conditions (MSKs), such as telemedicine and COPD inhaler monitoring. Considering that most healthcare takes place in a patient’s daily life, not the occasional visit to the clinic, this is a huge step forward in helping patients use tailored treatments. the best possible way everyday.
Many mainstream corporations have launched their own FDA-approved wearables, blurring the lines between healthcare companies and consumer-facing tech companies. Apple, Amazon, Google, and Samsung are some of the giants that can change consumer habits on a national scale, and they’ve all hit the smart wearable market.
For example, the Apple Watch has outsold the entire Swiss watch industry for several years in a row, and a device with an EKG display has been FDA-approved for use by people over the age of 22 with no history of the disorder. heartbeat.
This trend is great news because many people may already be tracking something about their health, whether it’s blood pressure monitoring, continuous sugar monitoring, or even a simple accelerometer. to count steps. That makes it significantly more likely that a patient will continue using the device if their healthcare professional recommends it and has access to the data.
In 10 years, remote patient monitoring will be mainstream and likely to be reimbursed by all major payers. We’ve seen that RPM has the ability to get the hospital checked every day before they happen. The healthcare industry is experiencing a revolution in vital signs devices, with many companies innovating on how vital signs are collected.
New innovations include identifying vital signs using a smartwatch, using only a smartphone or laptop camera, breathing apparatus for standard vital signs such as BP and Sp02, in-clothes sensor, epidermal sensor and subcutaneous sensor.
Within 10 years, monitoring of vital signs will be made possible in ways that are more seamless and easier for patients, such as a 5-year lifespan subcutaneous sensor. Eversense already has an FDA-approved implantable sensor for continuous glucose monitoring, passively recording blood glucose levels 24/7.
Q. How did Artificial Intelligence first come into the picture with RPM? What is connection?
ONE. Some of these new FDA-approved devices measure vital signs continuously, which means they are collecting thousands of data points per day per patient. BiolntelliSense has a medical-grade rechargeable sensor that attaches to the chest and passively measures over 20 vital signs, recording 1,440 measurements per day.
Humans are incapable of analyzing and interpreting thousands of data points per day for each patient. That’s why these clinical-grade wearables and sensors feature an AI software component to manage, monitor, analyze, and interpret thousands of data points daily per patient. AI software typically flags or alerts the healthcare team and patients when vital signs are out of predefined ranges, personalized to each individual.
While this trend is still in its infancy, there are examples of new innovations that exist only through continuous, personalized data collection. January AI uses data from the previous three days from continuous blood glucose monitors combined with vital sign data to predict real-time blood glucose response to individual foods, educating patients at the time of making the decision.
This helps manage diabetes in a more predictable and personalized way, instead of the current standard reactive diabetes treatment. But the January AI isn’t just for people with diabetes. They work with athletes, people with prediabetes or metabolic syndrome, and people who just want to be as healthy as possible.
This education in real time doesn’t just assume that the standard diabetes diet is right for everyone, or that any healthy diet works for everyone. People don’t react to food the same way as other people, or even to themselves.
Everyone has a unique glucose response to food based on many factors, including activity level during the day, sleep, fiber intake, stress, weight, age, and many other data points. AI-based software combined with RPM enables 24/7 personalized care.
Q. How does AI work with RPM today to improve patient care and outcomes?
ONE. When RPM is used for severe conditions, it can be the difference between life and death. VitalConnect did a study on their one-headed VitalPatch EKG and was able to predict hospital admissions for heart patients 6.5 days in advance.
Alacrity Care is working on RPM for cancer that combines vital signs performed with FDA-approved devices, including Omron blood pressure monitors and Oxitone pulse oximeters with routine checks. Oncologist day and blood lab done at home.
This is to detect serious, life-threatening problems such as leukopenia, sepsis, and cytokine storm days before cancer patients have serious medical problems. Catching these three conditions early can be the difference between life and death.
New AI-based software tools are clearing the FDA, including one earlier this year for TytoCare that analyzes lung sounds for patients and clinicians remotely using a connected stethoscope. indoor connection.
There are other companies working on sensors on Medicare-covered clothing. SirenCare is available with prescription socks to monitor the temperature of the soles of the feet.
For diabetics, a hot spot on the bottom of the foot can lead to skin ulcers, which can eventually lead to amputation if the wound doesn’t heal. With access to continuous data, the software can alert patients and clinicians when there is a problem so it can be treated before the skin breaks.
RPM’s promise and goal is to keep patients safe in their homes and detect problems early before they become serious problems or emergencies.
Q. You have a new book with Michael Ferro, “How AI Can Democratize Healthcare.” How does that theme fit the mix of AI and RPM?
ONE. When it comes to AI, life begins at a billion data points. There are some major problems with the traditional healthcare dataset that exist today for software training. Most healthcare data is locked in silos, whether it’s EHR, fax, payer, or in clinical notes.
In fact, when I receive a test result from my doctor through the hospital patient portal, it is uploaded as a scanned fax and saved as a PDF which cannot be read by the machine and sometimes humans can’t even read. While we are seeing interoperability moving forward, there is still a long way to go.
Typical healthcare data is collected on people at one point in time such as their annual fitness or if they are hospitalized. Typically, that means data that doesn’t include an individual’s baseline, taken in their day-to-day environment. It also means that most clinical-level vital sign data is based on people who have become ill enough to require hospitalization.
By moving data collection to patients’ daily lives, RPM has the ability to capture clinical-grade data for people of all health stages and ages. When collected continuously in machine-readable databases, once RPMs are more fully applied, those databases have the potential to collapse EHR data from hospitals or health systems .
It’s the kind of training data that can give healthcare providers greater insight and insight into normal vital signs across ages, genders, and genetics.
RPM helps democratize healthcare like never before. Many people don’t live within easy reach of a doctor or clinic. Trying to get to a clinic during their opening hours can be impossible for some people due to a variety of factors, from not being able to leave work, school, transportation, distance, childcare and other barriers to travel. clinic.
Even for established patients, specialists are often booked one to three months in advance, which gives the medical problem time to progress and potentially get much worse. . That will reduce the success rate when and if the patient has been seen and treated by a healthcare professional.
Instead of trying to get to a clinic, RPM can be used to determine when someone needs to see a healthcare professional and can make a virtual visit much more efficient.
The best health care is the real health care taken. RPM enables passive healthcare in someone’s everyday environment, 24/7.
Twitter: @SiwickiHealthIT
Email the writer: [email protected]
Healthcare IT News is a publication of HIMSS Media.
