Connected technology can improve care

An explosion of connected devices, from bathroom scales to wearable fitness trackers, sits poised to revolutionize health and how healthcare is delivered. Navigating that new landscape presents enormous opportunities, as well as some challenges, for rheumatologists and their patients.

Joseph Kvedar, MD

“By 2020, there will be 20 billion everyday objects that we think of as inanimate that will be connected,” said Joseph Kvedar, MD, a dermatologist and Vice President of Connected Health at Partners HealthCare in Boston. “These objects will have sensors in them that are picking up things from the environment, they’ll be processing information, and they’ll be communicating back and forth with the cloud and with each other.”

Kvedar will deliver the Annual Meeting’s Opening Lecture on this topic, based in large part on his 2015 book, “The Internet of Healthy Things.” As part of the Lecture and Awards Session that takes place at 4:30 pm Saturday, Dr. Kvedar will discuss the new types of sensors and devices that are or will be available, how the data they generate might be used to help manage chronic health conditions, and some of the areas that need work before this field can truly make a difference in healthcare.

Early examples of the more general “internet of things” include the “learning” thermostats or city trash receptacles that can track when waste needs to be collected. In healthcare and personal fitness, wrist devices have become immensely popular, and other wearable devices that attach to a belt or bra and measure respiratory rate and monitor stress also are gaining steam. New devices capable of tracking virtually every aspect of health are being developed every day.

At present, Dr. Kvedar said, there are already massive streams of health-related data available without a way of normalizing them. For example, wrist-worn personal fitness devices can provide a calorie output, using certain apps meticulously can provide calorie input, and smart scales can track your weight, but those numbers on their own don’t tell a story. Ideally, the wearables and associated software will eventually tell the user that based on recent trends, the user is likely to gain or lose some number of pounds over some amount of time. That sort of output could be useful both for individuals and for healthcare providers.

Many of the potential applications for connected technology apply across healthcare fields, but Dr. Kvedar said there are obvious rheumatology-specific avenues.

“For many people with rheumatologic conditions, getting them moving is important,” he said. “We can now measure whether they are moving, how they are moving, give them feedback on that, and keep track of it better.”

Some companies have begun using devices to do remote physical therapy and other related activities, and various technologies may be leveraged to improve adherence to medications, a crucial aspect of managing some chronic conditions.

There are, to be sure, challenges and barriers to the integration of this nascent stream of patient data. One such challenge is in the integration with electronic health records. EHR use is now ubiquitous, but incorporating all the data from patients’ wearable or home-based devices won’t happen automatically.

Other challenges relate to the logistical practice of medicine, from reimbursement and liability issues to changes in deeply ingrained workflow practices. Generally, physicians are used to coming into the office and seeing patients and making decisions, but with remotely connected patients that may not be as necessary in the future.

Dr. Kvedar said that progress is already being made on many of them. The more fundamental challenge and most exciting opportunity comes in analytics: How healthcare providers will actually use the data streams coming in.

“In the same way geneticists can get a unique genotype, we can get a unique phenotype, based on all this interesting data about you,” he said. “This is going to change the way we provide care.”

Harnessing the Internet of Healthy Things: How Connected Health Can Advance Rheumatology
4:30 – 6:15 pm Saturday – Hall D