MEDS Magazine has contacted the leaders: Philips, the Medical Device Innovation, Safety and Security Consortium (MDISS), West Health, and Continua to hear what they have to say. Philips’s interview by MEDS will be followed by input from other industry leaders.
MEDS Magazine Interviews Dr. Brian Rosenfeld, VP and Chief Medical Officer for Telehealth, Philips Healthcare
MEDS: The medical technology market is evolving rapidly in many areas especially in telehealth, technology use in hospitals and independent living. We would like to learn about Philips’ perspective in each of these areas, and what should developers and users expect to see in 2013 and beyond?
Dr. Rosenfeld: Philips connects care across the continuum from the hospital to home, focusing on critical transition points and risks. Advanced Philips technology includes telehealth in the emergency department (ED), intensive care unit (ICU), hospital ward and skilled nursing facility (SNF), and in home health monitoring and risk-based solutions to ensure that treatment is seamlessly provided throughout the care cycle.
In an era of unlimited access and universal connectivity, monitors must go anywhere that care is delivered whether it’s the ICU, hospital transport or the home. Philips monitoring technology provides immediate actionable patient data that supports predictive and preventive care.
In the hospital, it is important that clinicians are able to monitor their patients wherever they are, in order to intervene before complications occur. Philips’ cable-less sensors allow greater freedom of movement and more proactive monitoring of patients in the hospital environment, while Philips’ Intellivue Guardian Software detects patient deterioration and routes alert notifications to either the care team member’s mobile device or to a central telehealth team.
Additionally, Philips’ Enterprise Inpatient Telehealth eICU program enables 24/7 patient access to an intensivist-led care team allowing the care team to detect problems before they become complications, leverage limited clinical resources (intensivists and seasoned critical care nurses), and extend patient access to remote specialists.
Philips understands that healthcare delivery shouldn’t end when the patient leaves the hospital. Studies show that remote patient monitoring leads to better clinical care and reduced long-term healthcare costs due to fewer hospitalizations. Philips’ telehealth solutions enable experts to remotely monitor patient symptoms and vital signs to provide timely, focused interventions. Philips also offers a wide range of solutions that help patients live independently, including medical alert and medication dispensing services, as well as sleep apnea and respiratory solutions.
Philips will continue advancing technology across the continuum of care, bridging the gap from the hospital to the home. Philips’ goal is to create solutions that are “high tech in disguise”—easy for patients and care providers to use, but built upon Philips’ robust technologies.
MEDS: What are the greatest challenges the medical technology market faces today and what does it need to do to overcome them?
Dr. Rosenfeld: The path our current healthcare system is heading down is largely unsustainable—and we have no choice but to improve. Our rapidly aging population and rising demand for medical services contribute to soaring costs (56% of our 2.6 trillion dollars spent annually is for personnel) and ever more pronounced gaps in care. Physician and nurse shortages only add to the challenge. The reality is that health systems are struggling to develop care models that leverage care providers enabling them to accommodate the expanding needs.
Gaps in care are also a serious health concern, especially for patients with chronic conditions. Poor communication between patients and doctors, and the technology that supports them, are both health and cost hazards.
In order to overcome the challenges of today’s healthcare landscape, technology must help providers deliver more efficient and effective care, reducing and preventing errors of omission and redundancy, both of which hamper clinical operations. Medical technology must close the gaps in care and connect patient care from the hospital to the home, all the while helping providers simplify workflow, communicate more effectively and increase the efficiency of their clinical teams.
MEDS: How will the safety (FDA clearance) and security aspects impact the development of medical technologies and applications?
Dr. Rosenfeld: Philips continues to work with industry and regulatory partners to put their solutions through rigorous tests and quality measures. Philips is proud of the longstanding relationships cultivated with agencies such as the FDA, and will keep collaborating in order to make sure that technology meets patients and healthcare consumers needs and is as safe and secure as possible.
MEDS: How will networked medical devices interact with medical records systems in the future?
Dr. Rosenfeld: Philips understands that medical device interoperability with electronic medical records (EMR) is a key component of improving clinical workflow and enhancing the quality of care. Philips’ solutions bring key information to patients and providers, facilitating enhanced data collection and information sharing to eliminate gaps in care. Philips hospital monitors export data to all EMRs through HL7, which is a standard convention that Philips was a leader in establishing years ago. Another way we accomplish this is by providing interoperability through IntelliBridge, a single, standards-based integration solution. IntelliBridge supports interoperability between Philips solutions and hospitals’ EMRs and other multivendor enterprise systems. Beyond bridging and transporting data, some of our solutions also actively integrate and process the data and alarms before forwarding.
In the future, there will be additional data coming from myriad devices and these will include monitors worn with continuous data input from ambulatory patients. We are actively working to lead in promoting new technology (Medical Body Area Networks – MBANs) for acquiring this data so that they can be seamlessly acted on and then downloaded to the EMR. Our goal is to enable advanced clinical intelligence with a simplified way to access complete patient clinical data.
MEDS: Are future telehealth devices likely to be worn constantly (and comfortably) by the patient or will they consist more of home terminals and devices that the patient uses on a regular basis to send data into a medical center?
Dr. Rosenfeld: Philips telehealth solutions will comprise devices that are constantly worn by the patient and terminals used in the home to send data to the telehealth center.
Philips currently offers the Lifeline with AutoAlert, which can be worn comfortably 24/7 and comes in the form of a small pendant or a wristband that is designed to detect motion and any fall, automatically calling for help. Philips is continuing to innovate in wearable devices that remotely send data to clinicians allowing them to catch early signs of deteriorating conditions and provide timely, focused interventions.
Philips also believes that patient interaction remains necessary for optimal care. Telehealth Solutions consist of home terminals that enable clinicians to remotely monitor patient symptoms and send short health status surveys and reminders. Philips Personal Healthbook promotes patient and family engagement and helps patient consumers take an active role in their health and wellness. The Philips Lifeline call center provides a “high touch” linkage to patients to facilitate aging in place and minimize loneliness, while providing necessary patient touchpoints.
MEDS: What will the medical technology ecosystem look like in 2013 and beyond?
Dr. Rosenfeld: In today’s environment of rising costs, an aging population and changes brought about by healthcare reform, the focus on accountability and efficiency has never been more important. Technology is expediting the evolution of the care delivery model from a traditional inpatient/outpatient model for episodic illness management to a comprehensive program-based approach to keeping patients healthy.
The new health reality requires technology and process redesign that helps providers reach beyond the walls of the hospital or physician office and into patients’ homes, managing care transitions and enabling patients, families and providers to be true partners in health and healthcare, engaging and informing patients with the tools for better management. Leaders in true patient-centered care will excel in care coordination, better discharge planning and reduced readmissions, early detection and chronic condition management.
MEDS: What is Philips doing in these segments to prepare for the future?
Dr. Rosenfeld: Philips offers health systems the technology and process redesign for “end-to-end solutions” that enable connected care, managing patients from the hospital to the home and at each transition point across the care continuum.
The Philips Healthcare Hospital to Home initiative builds a bridge across care settings and transition points with technology and redesigned workflows for seamless continuity, making it easier to treat and manage patients with chronic diseases, reduce hospital readmissions and costs, and increase provider efficiency.
Dr. Brian Rosenfeld, MD
Dr. Rosenfeld is an internationally recognized intensive care specialist and healthcare entrepreneur who pioneered and developed the concept of remote intensive care unit management. He co-founded VISICU Inc. in 1998, and after its being acquired by Royal Philips Electronics, presently serves as Chief Medical Officer for Telehealth. Prior to founding VISICU, Dr. Rosenfeld was an Associate Professor of Anesthesiology and Critical Care Medicine, Medicine and Surgery at the Johns Hopkins University School of Medicine. While at Hopkins he was Director of two critical care units and received the Shannon Award from the National Institutes of Health. He founded and directed the Perioperative Research Center—a government and industry funded research group, and he implemented the first-ever smart monitoring system for hospital-wide management of patients with myocardial ischemia. He was Principal Investigator on numerous research trials and has published over 50 peer-reviewed articles and book chapters. Dr Rosenfeld has been an invited lecturer at international and national meetings and is a Fellow in both the American College of Critical Care Medicine and the College of Chest Physicians. Dr. Rosenfeld has over 20 U.S. and international patents around remote patient management and has a strategic role in Philips Healthcare’s telehealth direction. He graduated magna cum laude, special honors-biology from the University of Pittsburgh in 1975. He graduated from Temple University School of Medicine in 1980 followed by post-graduate training in internal medicine, pulmonary medicine, anesthesiology, and critical care. He currently serves on the Board of The New England Healthcare Institute and Visual Telehealth Systems.
Medical Device Innovation, Safety and Security Consortium
“Medical devices are a critical component of our nation’s health care system. As medical devices are increasingly becoming networked computing devices, they are now organically forming a national biomedical device network that is a foundational component of our health care system’s infrastructure. MDISS has built a public-private partnership to establish the collaborations necessary to better understand the security risks associated with medical devices and to collaboratively develop strategies and solutions to mitigate these risks.”
About Dr. Dale Nordenberg
Dr. Nordenberg is CEO of Novasano Health and Science, a company that delivers services and products to accelerate innovation in healthcare and life sciences with a particular focus on leveraging the strategic application of information resources. He is the co-founder and Executive Director for the Medical Device Innovation, Safety, and Security Consortium (MDISS). Prior to Novasano, Dr. Nordenberg was a managing director in the health care practice of PricewaterhouseCoopers. From 2002 through 2007, Dr. Nordenberg held various positions at CDC including Chief Information Officer (CIO) and Associate Director, National Center for Infectious Diseases (NCID), CDC. He was detailed part time to the Office of the National Coordinator for Health Information Technology at HHS in 2004-5 to catalyze the development of a national strategy for children’s health information technology. Dr. Nordenberg has been a member of the Science and Technology Review Subcommittee of the Science Advisory Board of the FDA, 2007 and 2009 and provided Congressional testimony on findings. Prior to CDC, Dr. Nordenberg was a founding executive of a company that launched VeriSign affiliates in Latin America and Asia and prior to that he was faculty in the Emory School of Medicine where he founded and directed the Office of Medical Informatics for the Emory University Children’s Center. Dr. Nordenberg has served on the boards of multiple companies. Dr. Nordenberg is a board certified pediatrician, received a BS in Microbiology from the University of Michigan, his medical degree from Northwestern University, completed his training in pediatrics at McGill University, Montreal Children’s Hospital, and his fellowship in epidemiology and public health in the Epidemic Intelligence Services Program at the Centers for Disease Control.
Healthcare providers in the U.S. are acutely aware of the importance of having ready access to reliable, safe and secure systems and medical devices for use during the hundreds of millions of patient encounters that occur each year. These encounters, as estimated by the Centers for Disease Control and Prevention, include 35 million hospital discharges, 100 million hospital outpatient visits and 900 million physician office visits.
Securing and monitoring the nation’s health care systems, medical devices, and associated bio-device networks is an integral ingredient for the safe, effective, patient centered, timely and equitable delivery of care defined by the Institute of Medicine. The adoption of technology and safe computing is vital to the current U.S. government administration’s health care reform strategies. The government, including leadership in Congress and the Food and Drug Administration, is engaged in legislation and regulatory activities that will acutely impact health care technology and medical devices.
Our consortium is focused on optimizing the relationship between the quality of health care and the process of assessing and ensuring that devices and systems are secure and functioning in a safe and efficacious manner.
“Today, the clinical enterprise struggles with the inefficiency resultant from the needlessly fragmented and obstructed flow of critical clinical information. Medical devices capable of delivering life-saving interventions are often blinded to otherwise available information that could either enable improved outcomes or prevent adverse events. Underlying all of this inefficiency is the lack of true, functional, plug-and-play interoperability. If we can work on improving interoperability in health care, we can unleash the value of medical devices and information technology, while we simultaneously lower the costs of health care delivery. West Health is dedicated to solving this problem”
About Dr. Joe Smith, MD, Ph.D, FACC
In his role as Chief Medical and Science Officer of West Health, Dr. Joseph M. Smith brings strategic, engineering and clinical expertise to advance the unique, one-of-a-kind initiative’s mission to lower health care costs through the West Health Institute, West Health Policy Center, West Health Investment Fund and West Health Incubator. All of these entities focus on lowering costs by creating innovative, patient-centered solutions that deliver the right care at the right place at the right time. Dr. Smith’s role encompasses directing the West Health Institute’s medical and clinical research, managing the West Health Investment Fund and leading the policy efforts of the West Health Policy Center.
Dr. Smith has an extensive career at the intersection of clinical medicine and engineering. Prior to joining the Institute, he was most recently Vice President of Emerging Technologies for Johnson & Johnson in their Corporate Office of Science and Technology. He also served as Senior Vice President and Chief Medical Officer of Guidant / Boston Scientific, Cardiac Rhythm Management. In 2010, Dr. Smith was named by HealthLeaders Magazine as one of the “20 People Who Make Healthcare Better.” He is on the faculty of the University of Southern California, and currently serves as an advisor to Johns Hopkins Biomedical Engineering, the Harvard-MIT Division of Health Science and Technology, Case-Western Reserve University, the Wellcome Trust, and a number of innovative health care and technology start-up companies. He has testified before Congress on the value of health care technology, and most recently, on the potential of wireless health technology to dramatically lower health care costs.
Dr. Smith holds a B.E.S from The Johns Hopkins University; a Ph.D. in medical engineering and medical physics from the Harvard-MIT Division of Health Sciences and Technology; and, an M.D. from Harvard Medical School. He is a Fellow of the American College of Cardiology, the American Heart Association, and the American Institute for Medical and Biological Engineering.
About the West Health Institute
The West Health Institute is an independent, non-profit 501(c)(3) medical research organization whose mission is to lower health care costs by developing innovative patient-centered solutions that deliver the right care at the right place at the right time. This is accomplished by conducting innovative medical research, educating key stakeholders and advocating on behalf of patients. Solely funded by pioneering philanthropists Gary and Mary West, the Institute is part of West Health, an initiative combining four separate organizations – the West Health Institute, the West Health Policy Center, the West Health Investment Fund, and the West Health Incubator. The Institute is located in San Diego, California, the global center for health care innovation. For more information, find us at www.westhealth.org and follow us @westhealth.
“Mobile health technologies are becoming an integral part of healthcare delivery and self-management of health and wellness. Standards-based interoperability, defined by end-to-end, plug-and-play connectivity, facilitates time and cost savings, and user convenience, necessary to a thriving mhealth market. Further, by eliminating complicated technology integration and implementation, as well as costly maintenance of legacy systems, interoperability encourages mhealth investment and innovation. Adopting plug-and-play standards for mhealth is the key to a thriving market as well as efficient, effective healthcare delivery for individual and population health. An acknowledged leader in health technology, Denmark recently adopted Continua Health Alliance’s guidelines for interoperability into its national health program, demonstrating the value of this approach.”
About Mr. Clint McClellan
Clint McClellan is Senior Director of Strategic Marketing for Qualcomm Life, where he has served in business development roles and established the Global Industry Analyst and Global Market Intelligence programs. He is also President of Continua Health Alliance, an industry non-profit promoting plug-and-play connectivity of personal health devices and services. Previously, Clint was a senior analyst for Gartner Group/Dataquest’s Telecommunications Group in the personal communications wireless program. During his time at Dataquest, he served as a technology news analyst for two years on Good Morning San Jose at KNTV, an ABC affiliate, where he presented analysis and commentary on daily news events affecting high-technology industries. Previously, he worked as a marketing specialist at Telephone House Nippo in Kobe, Japan and for CH2M Hill Consulting Engineers in Oakland, California. Clint holds a B.S. degree in Economics from the University of California, Berkeley.
Continua Health Alliance is an international not-for-profit industry organization enabling end-to-end, plug-and-play connectivity of devices and services for personal health management and healthcare delivery. Its mission is to empower information-driven health management and facilitate the incorporation of health and wellness into the day-to-day lives of consumers. Continua is a pioneer in establishing standards-based guidelines and security for connected health technologies such as smart phones, gateways and remote monitoring devices. Its activities include a certification and brand support program, events and collaborations to support technology and clinical innovation, as well as outreach to employers, payers, governments and care providers. With nearly 250 member companies reaching across the globe, Continua is comprised of technology, medical device and healthcare industry leaders and service providers dedicated to making personal connected health a reality. For more information visit www.continuaalliance.org.