Author:

Mastrototaro, John J.

Abstract:

The health care industry is undergoing a major transformation. Despite spending more on health care than any other country, the United States has not seen a commensurate improvement in the quality of care. Chronic disease management puts the greatest burden on the health care system with estimates suggesting that 3 of 4 health care dollars are spent on managing chronic disease. Moreover, the number of older patients with chronic conditions, like diabetes, is rising as expected, which only serves to worsen the physician shortage problem we are currently experiencing, and further increase health care costs. Unless new models of health care are established for these patients, they simply will not be served. Consistent with the message above, there are generally 3 universal health care needs, (1) improved outcomes, (2) expanded access, and (3) optimized cost and efficiency. It is likely the future state will involve value-based health care, with payment based on outcomes, not services rendered, and incentives tied more directly to the value delivered. Medical device providers will be held more accountable for positive outcomes, and to ensure success, they will need to create better solutions with their therapies. Instead of the touch point with patients being solely at the time of a procedure or sale of the device, it is likely companies will need to drive toward a more comprehensive partnership with patients, providers, and payers, extending the scope of services and interactions to provide a continuum of care. In general, companies will need to start to think of their most important customers as people living with a condition, as opposed to patients needing immediate medical devices. In this article, I discuss the challenges of health care today and present some of the opportunities to revamp health care delivery in diabetes by leveraging the pervasive use of mobile technologies and digital data.

Document:

https://journals.sagepub.com/doi/10.1177/1932296815612093

References:
1.Cassak, D . The West Health Institute: is this what the future of health care looks like? INVIVO: Business Medicine Report. 2013:30-40. Available at: http://www.pharmamedtechbi.com/publications/in-vivo?issue=Oct-22-2013.
Google Scholar
2.PricewaterhouseCoopers’ Health Research Institute . Healthcare unwired: New business models delivering care anywhere. September 2010. Available at: http://www.pwc.com/us/en/health-industries/publications/healthcare-unwired.jhtml.
Google Scholar
3.Scripps Translational Science Institute . Digital medicine. 2014. Available at: http://www.stsiweb.org/translational_research/digital_medicine/. Accessed June 2014.
Google Scholar
4.Quinn, CC, Shardell, MD, Terrin, ML, Barr, EA, Ballew, SH, Gruber-Baldini, AL. Cluster-randomized trial of a mobile phone personalized behavioral intervention for blood glucose control. Diabetes Care. 2011;34:1934-1942.
Google Scholar | Crossref | Medline | ISI
5.Javitt, JC, Reese, CS, Derrick, MK. Deployment of an mHealth patient monitoring solution for diabetes—improved glucose monitoring leads to reduction in medical expenditure. US Endocrinol. 2013;9(2):119-123.
Google Scholar | Crossref
6.Tidepool.org. Giving data a home and you the keys . Available at: http://www.tidepool.org/about/.
Google Scholar
7.Glooko.com . Glooko: the unified platform for diabetes management. March 2015. Available at: http://www.glooko.com/products/. Accessed June 2015.
Google Scholar
8.DiaTribe . Joslin and Glooko launch Hypomap software to identify and improve hypoglycemia unawareness. Available at: http://www.diatribe.org/issues/65/new-now-next/6.
Google Scholar
9.Livongo.com . About Livongo. Available at: http://www.livongo.com/about.
Google Scholar
10.Krumholz, HM, Merrill, AR, Schone, EM. Patterns of hospital performance in acute myocardial infarction and heart failure 30-day mortality and readmission. Circ Cardiovasc Qual Outcomes. 2009;2:407-413.
Google Scholar | Crossref | Medline
11.Cardiocom.com . Hospitals. Available at: http://www.cardiocom.com/benefits_hos.asp. Accessed September 2015.
Google Scholar
12.Feldman, B, Martin, EM, Skotnes, T. Big data in healthcare: hype and hope. October 2012. Available at: http://drbonnie360.com.
Google Scholar
13.DCCT Research Group . Epidemiology of severe hypoglycemia in the diabetes control and complications trial. Am J Med. 1991;90:450-459.
Google Scholar | Crossref | Medline | ISI
14.Bergenstal, RM, Tamborlane, WV, Ahmann, A. Effectiveness of sensor-augmented insulin pump therapy in type 1 diabetes. N Engl J Med. 2010;363(4):312-320.
Google Scholar | Crossref | ISI
15.Bergenstal, RM, Klonoff, DC, Garg, SK. Threshold-based insulin-pump interruption for reduction of hypoglycemia. N Engl J Med. 2013;369(3):224-232.
Google Scholar | Crossref | Medline | ISI

The SELF Institute