Toward Connected Health: How Patient-Generated Health Data Is Posed To Transform Healthcare

A growing universe of wearables and other digital health devices is creating powerful new opportunities to enhance patient-centered care by improving clinical decision-making, strengthening patient engagement, and expanding research opportunities.

Integrating patient-generated health data (PGHD) with artificial intelligence and big data can further refine and personalize diagnostic and therapeutic care. However, challenges persist around data interoperability, reimbursement, equitable access to digital devices (techquity), and patient digital literacy.

Common PGHD usages

PGHD includes information created, recorded, and gathered by patients, typically via wearable devices, such as mobile health apps, watches and phones, and through patient portals. Information can include physiological data, like heart rate or blood pressure, and patient-reported information, such as health histories, outcomes, sleep or mood diaries, and medication use.

By providing insight into a patient's health outside the hospital or exam room, PGHD gives clinicians a more holistic view of health and disease progression in support of data-driven decisions and timely interventions. The process of engaging PGHD can also help clinicians identify barriers that may be undermining patient self-management, such as health or digital literacy and education.

PGHD today is being harnessed in areas ranging from chronic disease management and metabolic and gastrointestinal conditions to musculoskeletal/progressive functional conditions, cognitive symptoms, perioperative care, and pain management.

Many devices now offer data collection related to behavioral health

PGHD is also creating significant opportunities in therapeutic areas like behavioral health. Patients with behavioral disorders can identify and measure incremental progress via their devices and establish short-term goals. Conversely, subjective information on mood, anxiety, and sleep patterns can be combined with objective data like weight, heart rate, and steps to generate automated alerts that notify providers about possible risks to the patient's mental health.

Remote patient monitoring is a trusted PGHD application

Remote patient monitoring (RPM) in the home is an important tool for managing chronic disease and arguably stands as the most mature application of PGHD. Studies have shown RPM can result in improved outcomes and fewer complications for patients with diabetes, hypertension, cancer, and chronic obstructive pulmonary disease (COPD).

During the height of the pandemic, RPM played a key role in supporting care for COVID-19 patients as hospitals reached capacity limits. A 2021 study of remote pulse-oximetry monitoring of patients with COVID-19 calculated that patients with at-home monitoring experienced a substantially reduced mortality rate compared to those without home monitoring. The study also determined that remote monitoring was potentially associated with 87% fewer COVID hospitalizations, 77% fewer deaths, and reduced per-patient costs of $11,472 over standard care.

AI can support patient data analysis

Incorporating artificial intelligence can bolster the utility of PGHD. Researchers recently applied machine learning to step counts and other biometric data from patients undergoing radiation treatment to predict the likelihood of an unplanned hospitalization during treatment. Between 10-20% of patients receiving outpatient radiation therapy require emergency department care or a hospital admission during their care, and early identification of those at risk could reduce complications and resulting hospital stays.

PGHD paving the way for more precise data collection

Clinical research likewise can benefit from PGHD due to more efficient data collection processes. Patient-generated data can also expand the diversity of study populations and improve understanding of the patient journey with a greater volume of contextual information, from granular physiological data to social determinants of health.

Digital health devices facilitate improved patient engagement

From a patient perspective, the act of tracking health information can enhance health awareness, inform goal setting, and help motivate positive behaviors. One study found that two-thirds of patients believed PGHD made them feel more engaged in the care process. Other research suggests PGHD gives patients greater confidence when communicating with providers by engendering a belief that they'll be taken more seriously than had they simply shared verbal descriptions or anecdotal symptoms.

Decentralized data collection poses integration barriers

For all of patient-generated health data's prospective benefits, utilization remains sharply constrained by significant challenges ;surrounding the integration and management of patient-collected information. Disparate data types and formats pose major integration and interoperability problems for provider organizations. Additionally, the time and resources required to incorporate patient-generated health data may lead some already hard-pressed clinicians to disregard or discount patient-collected information.

Developing a standardized ecosystem that can seamlessly integrate PGHD into both the electronic medical record and clinician workflows in support of evidence-based pathways will help optimize the benefits of patient-generated information and foster true patient-centered, connected care.

Current health plans offer limited reimbursement options

Along with technical issues, PGHD adoption is also hindered by a lack of financial incentives and supporting policies. With the exception of remote patient monitoring services, reimbursement for PGHD integration is largely non-existent. That said, any tools that help strengthen patient compliance, improve outcomes, and enhance efficiency theoretically can contribute to higher reimbursement in many value-based care models.

Separately, ethical concerns exist around who can afford to purchase and use wearable devices and who cannot: a study found that remote patient monitoring devices were largely out of reach for historically under-resourced populations. Low health literacy, language challenges, and cultural competence can similarly undermine the utility of PGHD for groups that are economically or socially marginalized.

The future of patient-generated health data

Realizing the full potential of PGHD will depend upon the continued development of technical standards and infrastructure that can enable the seamless capture, integration and sharing of PGHD. Key to these efforts will be finding ways to ensure that the data collected is presented at the right time and place in the clinician workflow. Ultimately, automated capabilities that can simplify data integration through templates or other shortcuts may prove optimal for mitigating provider burden.

Guidelines to leveraging PGHD resources

Although significant questions remain, provider organizations don't need to wait to begin capturing the benefits of PGHD. A recent report by the Agency for Healthcare Research and Quality (AHRQ) offers a practical roadmap for clinicians to plan, implement and support PGHD initiatives in an ambulatory setting.

The systematic approach provides detailed guidance for each phase of the planning and rollout process and is designed to be used by physician practices, outpatient departments, community health centers, ambulatory surgery centers, urgent care clinics, and specialty clinics.

Refining real-world PGHD implementation

From deploying the proper scientific methods to quantifying programmatic value, integrating mobile health apps and software, to AI technologies and new data sources that support clinical decision making, our people and solutions support your care goals. Contact RTI today.