Cisco exec: Home monitoring needs standards, financial incentives

We report elsewhere in today's newsletter that the Continua Health Alliance is creating a library of source code to connect wireless medical devices with smartphones. Such developments are welcome in the immature but rapidly expanding field of home health monitoring, says Dr. Daniel Z. Sands, director in the healthcare practice of Cisco Systems' Internet Business Solutions Group and a primary care physician at Beth Israel Deaconess Medical Center in Boston.

Writing in the June issue of Hospitals & Health Networks, Sands makes the case for certification and standards for such technologies as the growth of the patient-centered medical home and the desire for chronically ill elderly patients to live independently drive demand. "There are numerous vendors and countless, overlapping products from which to choose, and very little in the way of consumer or physician guidelines for understanding the products' features and availability," says Sands, himself a pioneer in patient-physician communications. "Additionally, there are no established design guidelines that ensure consistent quality and interoperability among electronic home healthcare devices."

Sands specifically lauds Continua for working with other industry collaboratives to create interoperability in telehealth and monitoring device, but says there need to be major changes in healthcare payment mechanisms to encourage physicians use the vast stores of data such devices generate and soon will be pumping into EMRs. (Medicare currently doesn't cover most wireless monitors.)

"Unfortunately, there is little reason for [physicians] to analyze and act on this information," Sands contends. "Doing so requires incentives, such as global payment models for longitudinal care and pay-for-performance programs. Physicians will also require intelligent information systems that filter data, look for trends, provide alerts and information to physicians or their proxies, and integrate this information into the EMR."

To learn more:
- check out Sands' commentary in Hospitals & Health Networks