Page 22 - HME Business, August/September 2019

use Glooko to do so.
“So it really arose out of the necessity and
the need created in the clinics to kind of have that platform and then companies deciding, ‘Hey, it makes sense, we’ll get better distribu- tion when we can make it easier for our clinics and care teams to have access to the data that we’re looking at,’” he explains. “So that is the genesis.”
On the patient side, Glooko offers a mobile application to let patients see their data for self- management, and then they can also push that data to the clinic and care team from afar.
“They can upload that data when they’re not in the office, and then they can also use it, again, for true remote patient monitoring where a clinic or a clinician is looking at that data in between visits,” Johannesson notes.
“As a practitioner in a large center where we’ve got 11 different sites, we used to have to manage six different software platforms and over a dozen different cables and connected devices,” says Mark Clements, MD, PhD, CPI, FAAP, the Chief Medical Officer of Glooko. Also, Dr. Clements
is also Associate Professor of Pediatrics at the University of Missouri-Kansas City School of Medicine, and is also a pediatric endocrinolo- gist at Children’s Mercy Kansas City, where he serves as Director of Pediatric Endocrine/ Diabetes Clinical Research and Medical Director for the Pediatric Clinical Research Unit. “Glooko has really simplified that. As you can imagine, with well over a hundred devices in use in the U.S. market, just in pediatrics where I work, the knowledgebase and maintaining the knowledge base for how to interact with all those devices is certainly a challenge that centers have.”
Clements adds this is a real boon to patients who sometimes have to deal with limited device choices because of the RPM systems their clini- cians prefer.
“If you’re a person with diabetes or parents of a child with diabetes and you have two different devices that you think are right for you that you would like to use, it can be really frustrating to not have the ability to have those devices talk to the same system so you can see all your data in one place,” he explains. “That’s the real-world problem that Glooko is solving for.”
Given that many diabetes patients have prefer- ences for particular devices, a unified monitoring system that lets them retain those devices is a real boon, according to Clements.
“There are some people who really do prefer a particular device and being able to get that device onto a common platform with their other devices and with their diabetes center is important,” he says. “... Whatever device they’re using, it reduces
friction in the care system if they can easily commu- nicate information about their self-management and their outcomes to their provider.”
THE UPSHOT
Let’s review: First, we know that sleep therapy has developed a very successful RPM model that helps patients better manage and adhere to their care and that helps physicians show outcomes to their payers. In fact, it’s been so successful that payers are essentially demanding it at this point and HME providers, with their vendors’ help, are there to provide the entire RPM system. They are in the perfect position to make the entire dynamic happen.
Next, we know that in the oxygen care
arena, things are playing out a little differently. Providers and vendors alike see the opportuni- ties to remotely monitor devices in order to trou- bleshoot devices and help patients use them. That said they are stopping short of collecting usage data and connecting that to actual care because it doesn’t necessarily translate and
it might involve reimbursement in ways that could run counter to effective long-term oxygen therapy models both from a care and business standpoint.
And we know that when it comes to diabetes care, both models are probably going to get exploded as users take great ownership over their care and the types of devices they want. Whatever closed loops any provider is trying to establish are probably going to wind up turning into weak links as we see connected care models continue to proliferate across global healthcare.
Think about it: in a world where apps are constantly being developed to collect and share data on literally everything single activity they engage in – sometimes entirely unbeknownst
to us – is there really going to be tolerance for proprietary systems over the long haul? Nearly everyone with a smartphone and wearable is collecting all sort of health metrics and probably happy to share them with physicians.
As a medical professional, Glooko’s Clements wants more data; not less. It comes down to the best way to manage care.
“I think the business insights and the actionable evidence that will be created by remote patient monitoring are going to help me as a clinician
not just manage one family at a time, but they’re going to help our diabetes center to differentiate our care across an entire population by identifying — I hope in the near future — the remote inter- ventions that are best matched to the needs of individual groups or cohorts within our center so that we can deliver smarter care faster.”
So, we can likely expect increased demand for RPM across more corners of care: the physicians, the patients, and, yes, the payers. Equipment providers can try and manage that demand, but it will come. There’s an insatiable hunger for it at an economic level.
“I do think that the payers, whether it’s govern- ment payers or whether it’s private payers, are going to continue to see the improved outcomes when there is more consistent and ongoing treatment through outpatient monitoring and visibility and I think the demand will continue to increase on that side,” Johannesson says. “I think the technology will continue to expand and keep up with it. The amount and volume of data that’s coming is increasing exponentially and I think the ability to use that to drive actionable insights and decision support between visits is going to continue to increase.”
That means the loop will break open. Growing demand for patient use metrics won’t tolerate a closed data environment.
Should a lack of a closed data loop or increased demands for RPM from payers worry any provider? ResMed’s Dench says no. Loop or no, HME providers still sit in the catbird seat.
“As equipment providers, HMEs are still in
the best position to provide patients with a comprehensive and seamless therapy experi- ence by helping them receive both equipment and support,” he emphasizes. “HMEs know their prescriptions and other needs, most likely set them up on their equipment, ideally help resupply them when needed, and can leverage remote monitoring to give them peace of mind as they achieve long-term adherence, or jump in to help get them back on track.” n
22 HMEBusiness | August/September 2019 | hme-business.com
Management Solutions | Technology | Products
“The ability to monitor and then, more importantly, efficiently manage patients by leveraging remote patient, or technology-based tools, is really becoming the standard of care.”
—Tim Murphy, Philips Sleep and Respiratory Care