Research and Exploration

The potential role of wearable biosensors in value-based payment

David White
Market Research Analyst,
Philips Connected Sensing


Wearable biosensors may provide a strong return on investment (ROI) for healthcare providers as they transition to value-based payment models for both chronic and episodic care.

Management of Chronic Diseases
 

There are many reasons why chronic disease sufferers often bounce between acute and post-acute care facilities. For example, in the acute care hospital, patients are actively cared for by dedicated professionals - their medications are tracked and properly adjusted, diet is followed, and vital signs are monitored. Back in the community, things are often very different. Even with strong support from family and friends, the level of care and understanding of a patient condition can drop off sharply. Managing a chronic disease can be very demanding and depends on lifestyle habits, such as diet, exercise and medication adherence. People are expected to take much more responsibility for managing their own wellbeing.

 

Fortunately, there are things that can be done to help while still in acute care. This includes education, quick access to care after discharge, and proper discharge timing. Ensuring stable vital signs within the patient’s normal range before discharge has been shown to reduce the likelihood for readmission to acute care.¹ Wearable biosensors could help trending this vital sign information over time, and when needed, continue this trending into the home.

 

In conjunction with analytics software, periodic sensing of vital signs can help care providers spot the early signs of patient deterioration, allowing them to intervene more quickly.² Automating measurement can help achieve this in a cost effective way and could prevent a readmission that benefits both the person and the provider. Keeping an eye on a person’s vitals in post-acute care and the home with biosensors can help to reduce the odds of a readmission that is costly for both the person and the healthcare system.³

 

In conjunction with analytics software, periodic sensing of vital signs can help care providers spot the early signs of patient deterioration, allowing them to intervene more quickly.''

Episodic care
 

Many of the virtues of wearable biosensors for managing chronic conditions may also ring true for episodic care. For example, patients are at some degree of risk following a total hip replacement. During immediate post-operative recovery, there is the risk for opioid-induced respiratory depression. This condition, which may ultimately lead to cardiac arrest, is believed to affect a significant number of patients each year.⁴ Imagine if a biosensor could be used to track respiration rate, and software used to intelligently interpret that rate in context for a specific patient. This could potentially trigger a timely intervention from caregivers to prevent the patient’s deterioration into cardiac arrest.

 

Even after discharge from hospital, patients can be at risk. Conditions such as wound infection and the onset of sepsis can occur and remain undetected for some time.⁵ That may be true, whether the patient is discharged to a skilled nursing facility for rehabilitation or directly to their home. Automated, frequent monitoring of vital signs – combined with intelligence algorithms - may help to prompt caregivers to a timely intervention in this scenario.⁶

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[¹] Vital Signs Are Still Vital: Instability on Discharge and the Risk of Post-Discharge Adverse Outcomes
[²] A controlled trial of electronic automated advisory vital signs monitoring in general hospital wards
[³] How to Use Telehealth to Improve Outcomes: Banner Health’s Experience with Patients in its Pioneer ACO
[⁴] Postoperative Respiratory Depression and Opioids, Initiatives in Safe Patient Care
[⁵] Time is tissue: Why emerging evidence on sepsis urges physicians to watch the clock
[⁶] Prospective trial of real-time electronic surveillance to expedite early care of severe sepsis