The Electronic Healthcare Curve: Where the US Stands in Connected Health Technology

According to a recent extensive Accenture healthcare study, the US is ahead of the connected health curve in at least one important respect: More patients can access their health records online than in most of the other countries surveyed.

Specialists and hospital physicians in the US led an Accenture survey in many dimensions of healthcare IT adoption and health information exchange (HIE), particularly for clinical results and electronic patient notes. The US health system has more than double the percentage of doctors providing patients with electronic access to their own medical information compared to their international counterparts (8 percent global average versus 17 percent US average).

However, progress toward remote monitoring of patients with chronic conditions is relatively limited in the US (and indeed across all countries), with only 8 percent of physicians stating that their patients can use telemonitoring devices to monitor and record their own health indicators and remotely inform physicians of their conditions.

While there are pockets of good practice across US health systems—and within specific states—experts suggest that “connected health” capabilities are generally more advanced when it comes to managing or treating specific diseases or conditions such as cancer, diabetes, congestive heart disease, hypertension and asthma―what one executive surveyed called the “low-hanging fruit.” Experts point out that the need—and the business case―for connected health is particularly strong when it comes to managing chronic conditions, which requires a more interactive provider/patient relationship as well as care coordination with other caregivers.

Some HIEs are focusing their initial efforts on chronic care because this is where there are the greatest opportunities to reduce costs, improve the quality of care and demonstrate value (since the data necessary to measure and demonstrate value is being collected and reported at the disease-specific level). Moreover, the focus of innovation is around these chronic diseases.

Connected health refers to healthcare delivery that leverages the systematic application of healthcare IT to facilitate the accessing and sharing of information, as well as subsequent analysis of health data across healthcare systems. Connected health encourages communication and collaboration among all of the various stakeholders involved in a patient’s health. It uses knowledge and technology in new ways for more effective, efficient and affordable healthcare.

As the US population continues to age and people are living longer, healthcare IT-supported care coordination across organizations—and with patients themselves—is particularly critical to manage the rising demand for (and cost of) care. New care delivery models such as patient-centered medical homes and accountable care organizations are thought to hold great potential for improving chronic disease management, while the development of mobile solutions will enable patients to manage their own care.

As is the case in most other countries around the world, the use of data analytics for organizational and public health reporting is still in its early stages in the US, but it is likely to be an important focus of connected health development in the future. Experts welcome this development since they believe that analytics has a huge potential for improving quality of care at the local level, shaping improvements in public health and developing more cost-effective solutions across the system. The meaningful use criteria will, experts believe, drive future progress and accelerate the use of analytics.

The relatively limited use of patients’ clinical data for analytical purposes is largely due to a lack of comprehensive and comparable patient data sets. To enable sophisticated analytics, healthcare professionals need to collect and store individual patient data in a form that is easily accessible and enables interrogation. This in turn, requires physicians and other health professionals to enter data in a structured, ideally coded, way.

A willingness to differentially reward improved quality of care and efficiency is central not only to future sustainability but also to share the benefits from the investments. In many countries, including the US, current physician payment schemes (for example, those based on fee-for-service) do not provide the appropriate incentives.

Accenture’s physician survey shows that approximately only one in five physicians, on average, receives incentives for proactively managing patients with chronic conditions (though the numbers range from just 11 percent in the US to 44 percent in Singapore). Less than 20 percent receives incentives for using healthcare IT to achieve clinical quality of care targets or enhanced preventive care, and only 10 percent or less for coordinating care with other organizations or for conducting non-face-to-face consultations.

However, the majority of physicians surveyed said that they would be more likely to use healthcare IT if they were motivated to do so—for example:

• Coordinating care with other health providers (70 percent of respondents said they were very or fairly likely to use healthcare IT to do this).

• Providing preventive care (64 percent).

• Proactively managing patients with chronic conditions (62 percent).

• Offering non-face-to-face interactions with patients, for example via email or telephone (57 percent).