Patient-generated data: Re-evaluating the possibilities and necessities

It has been anointed as the next key frontier in healthcare. Patient-generated data, that is. A recent FierceHealthIT post featuring John Halamka, CIO at Beth Israel Deaconess Medical Center in Boston, focused on this important topic and highlighted the ease-of-use of the devices, the financial support that likely will be provided by Meaningful Use legislation, and acceptance of health monitoring devices as a necessity between episodes of care.

Health monitoring devices that passively provide patient generated data are proliferating at an exponential rate. Devices that record weight, O2 sats, blood sugar, heart rate, blood pressure, asthma medication compliance, and steps taken now are mainstream. Apple's recent full-fledged entry into the market will surely only accelerate the pace of product development by other companies.

The parameters measured by these devices are important. They are vital to health. Measuring compliance with medication and exercise regimens is now a reality. (However, there is skepticism that these devices will be used predominantly by the "worried-well" in wealthy, educated sectors of the population. Perhaps mandates and economic incentives will influence the adoption of these technologies in unhealthy populations.)

But health-related parameters are not the only data that can be generated by patients. While these data are important, they do little to maximize efficiency or define capacity--particularly with use of inpatient resources. In addition to blood sugar and heart rate data points, I believe that patients can generate data that can help us optimize the manner in which we utilize healthcare resources.

There are various parameters we currently track in a hospital, such as turn-around-times for imaging reports, time blood samples are obtained and times drugs are administered. We track times that orders are placed and times of first incisions during surgery. And although some of these parameters are tracked with technological tools, such as bar-code scanning, many of these "times" are retrospectively charted based on the best recollection of the overworked healthcare employee charged with serving as a recorder/scribe.

If we really want to improve the way we provide care for patients and actually embrace "patient-centeredness" (not just recording various parameters required to meet mandates from accreditation bodies), then we need to rethink what data we collect and how patients can help us collect it.

Using radio-frequency identification technology, we can find out how long a patient actually has to wait in a holding area prior to a procedure. Using mobile devices, patients can generate time-stamps for when blood tests were actually drawn (not sent to the lab after the phlebotomist draws blood from 4 or 5 more patients). How long from when a patient is told that they will get a CT does the imaging test actually happen?  (This is different than how long after the order is placed--after the care-team completes rounding--is the imaging test completed.) 

How long do patients get to spend speaking with physicians during their convalescence in the hospital? When we tell a patient that the pathology results will be available in three to five days, are we right? Is it three days, or is it five days? Patients can tell us. Constantly collecting this kind of data will provide information for healthcare teams as to whether they are improving, getting worse, or maintaining their performance. This type of patient-generated data will identify new ways to improve how we interact with patients, maximize our capacity, and utilize our resources. The resources required to measure this data are relatively inexpensive--particularly in light of the savings, efficiency, and customer satisfaction that can be realized.

While passively generated patient-centric data from health-monitoring devices has garnered a vast amount of attention in the popular press, patients can and will also generate data that will aide in improving the operations within the healthcare enterprise. Let our patients help us. I am certain that they are more than willing to do so.

Matt Hawkins is a pediatric interventional radiologist and an assistant professor in the department of radiology and imaging sciences at Emory University in Atlanta. He also serves on FierceHealthIT's Editorial Advisory Board.

Prior articles by the author:
Walmart and its implications for imaging
Re-recognizing the importance of radiology's professional community
H.R. 4302: Duct tape, delays and decision support
Reimbursement in medicine: One radiologist's perspective
Keeping score with revenue: The 2-step-back feedback
It's time to end diagnosis fragmentation
RSNA13: Business analytics, clinical decision support take center stage for radiologists