Want Coverage? We’ll Need to See Your Digital Watch First

“There’s a foreseeable future where people who [don’t agree to digital monitoring of their cardiovascular health] won’t be able to buy insurance,” Geoff McCleary, the Global Head of Connected Health at Capgemini, told a session at HLTH Europe in Amsterdam, today.

Filippo Maria Stefania of Generali thought consent would always be needed, but it would become a cultural norm. “A decade ago, if you took a picture of your main course in a restaurant, the owner would come out to ask what was wrong,” he said. Agreeing to share health data with insurers and providers will be part of an overall move toward individuals taking more responsibility for their health. That cultural shift will be supported by incentives, discounts, and nudges based on behavioral economics.

The technology is ready. Inge Thijs, a remote clinical monitoring coordinator, explained that a hybrid care system is already in place for heart failure patients in northwestern Belgium. They tend to have repeat admittances to the hospital. Health professionals can intervene before hospital care is needed by tracking measurements such as the build-up of fluids. This not only improves patient outcomes but also reduces the financial burden on the healthcare system. Belgium has a new pathway for reimbursement of M Health, and one of the first areas to be considered was heart failure.

The same technology can be used for rehabilitation after major surgery, reducing hospital stays while improving outcomes — data clearly show that patients recover better at home.

Elie Lobel, the CEO of RDS, a company that develops biosensor technology that can be worn comfortably at home, said that just discharging patients a day or two early can make an enormous difference to hospitals’ viability. Most hospitals in Europe are paid for the procedure performed, not the days spent in the hospital, and most have waiting lists. Discharging each patient even a little earlier will control costs and improve access.

Technology may also make prevention more cost-effective and better targeted, said Todor Jeliaskov, the CEO of In Heart. At the moment, for example, most implanted defibrillators – designed to restore the regular rhythm of the heart after an abnormal heartbeat – are never used. Large data sets may predict who should receive them better than current clinical guidelines can. Those same data sets may be able to target patients most at risk for a blood clot in the heart; these clots cause about a third of strokes, many of which can be prevented by medicines if health systems can identify who needs treatment.

This progress depends not just on wearables and sensors to collect data but on massive computational power to detect patterns unrelated to the disease. Some of these digital biomarkers will seem improbable: in multiple sclerosis, for example, symptoms of depression are predictive of a disease flare-up. It may well be that speech patterns or subtle shifts in activity can warn of cardiovascular problems. Risk factors may be synergistic, too, Dr Nathan Malka said. As a cardiologist, he could never accumulate the data to see which risk factors might augment others, but quantum computer power can unveil these patterns.

Remember the human factor, cautions care coordinator Inge Thijs. The same patients reluctant to come to clinics in hospitals are resistant to home rehabilitation monitoring and help. The technology will require health professionals who can turn its findings into advice that patients will follow. This transition may not be easy, and it’s important to acknowledge and address these concerns to ensure a smooth integration of digital monitoring in healthcare.