Healthcare technology is developing faster than ever before. Can we predict which emerging tech will reach the ubiquitous standard of electronic health records? In order to understand what will succeed, we need to understand what already has.
Changing The Status Quo
Imagine it’s your first appointment at a new primary care practice. What are some of your expectations? Filling out prior health information, requesting a transfer of records, and signing up for their electronic record system is likely at the top. You might also wonder what system they use. In the United States three major players hold the nation’s hospital records including Epic, Cerner, and Meditech. Electronic medical records (or EHR) are so commonplace you are more likely to be shocked by a practice that doesn’t use them.
Most people assume the inception of EHR began with the rise of the internet, but it’s actually been around for much longer. As early as 1960, EHR was an expensive, cutting edge technology only available to government institutions. As the world became more computer reliant, EHR adoption continued to rise. As of 2021, 96% of general acute care centers use some sort of electronic record technology— nearing a 100% adoption rate.
Advancements in medical technology since the inception of electronic records have followed suit including; artificial intelligence, 3D printing, telehealth, and remote patient monitoring. Despite promising outcomes within these advancements, financial burdens and resistance to change creates significant roadblocks.
In the case of early EHR systems, computing technology was new and extremely expensive in comparison to paper record keeping. Such a large shift would require a significant amount of time, training, and money. When taking into consideration the importance of streamlining care processes as quickly and efficiently as possible, changing things up can pose real challenges in the minds of stakeholders.
On the other hand, physical record keeping presented enough downsides that made it vulnerable to a replacement. Some downsides of paper record keeping includes security risks, the need to expand office space in order to store expanding records, and the possibility for human clerical errors. Paper record keeping, although perfectly acceptable and efficient for the time being, was just waiting for something more scalable to replace it. Those who did take a risk as early EHR adopters saw a return on investment, establishing themselves as forward-thinking industry leaders.
The years leading up to 9 out of 10 hospitals using some form of electronic record system included fierce competition and legislative action. The final result is improved risk management, preventing adverse effects, and providing an overall higher quality of care. Not to mention the peace of mind patients have knowing their appointments and records are easily accessible.
Blue and Red Oceans
How can we use electronic records as a framework for rising healthcare technology? What can it tell us about the future of another promising new technology: Remote patient monitoring?
A simple way to look at the healthcare industry as a whole is through Chan Kim and Renée Mauborgne’s blue vs red ocean theory where one ocean is composed of blue and red zones. The red zone represents a fiercely competitive market where only the strongest survive. The blue zone represents opportunities within the market; a chance for an organization to change the way business is done in their niche.
Historically the healthcare industry is an overwhelmingly red market. This is where electronic records come in, as the introduction of EHR began as a blue ocean idea.
By solving a problem before it existed, properly representing the value of the solution, and presenting it as a long-term investment, electronic records created a blue ocean. Over time, the demand for an EHR system became so popular that the saturation of companies transformed the market into a red ocean. As competition grew, only the strongest companies remained. Currently, there are less than a dozen major EHR providers who all own large stakes in hospital systems.
Electronic records turned a red ocean into a blue ocean, but the ocean has since returned back to a majority red state. This follows Kim and Mauborgne’s theory that despite markets being composed of both blue and red oceans—they are not separate. The market as a whole is still one single ocean. EHR providers have worked to maintain control of the red ocean, including a fair share of attempts to block competing software.
In the case of any technology succeeding EHR, it will be a challenging road. Instead of transitioning from paper to electronic, new advancements are trying to move through electronic to electronic mediums. This creates a more demanding red ocean scenario, as hospital systems have required over 60 years of time to reach the ubiquitous 96% EHR adoption rate. Despite these challenges, opportunities are continuing to arise. It has been argued that digital health startups aim to fill the gaps left by EHR giants.
The million-dollar question in the modern healthcare red ocean is: which technology is worth creating a new blue ocean?
Remote Patient Monitoring Moves Forward
As the COVID-19 pandemic quickly increased the need for virtual solutions, a sudden shift in the tides occurred, and a new blue ocean was generated overnight. The pandemic quickly began to sweep through hospital systems, and organizations scrambled to provide both HIPAA-compliant and fully remote services.
Nearly three years later, integrated technology beyond digital record keeping has only continued to be desired from both a patient and provider perspective. In fact, the demand is so high that major EHR players are being pushed into adopting solutions for pandemic-era features such as telehealth and remote patient monitoring.
In this climate, one of the strongest contenders to create a new blue ocean is remote patient monitoring, as it has both virtual and in-person functions.
Hybrid settings continue to be predicted as the future of value based care. Remote patient monitoring (or RPM) presents a more comprehensive approach in treating patients.
Patients can use RPM technologies to monitor vitals, track changes in blood pressure, and more. Providers use it to better answer patient questions, monitor those with chronic health conditions, and reduce the possibility of illness transmission. As a highly specific subset of telehealth RPM plays a critical role in moving the value-based care model forward.
RPM can also easily be integrated on an individual and organizational level, making it a promising technology for both emerging companies and long-established hospital systems.
We may begin to see a tightening competition as RPM companies work to integrate with enterprise level hospital systems.
3 Reasons Why RPM Is the Next EHR
What patterns suggest that remote patient monitoring is creating their very own blue ocean? The following outlines three parallels between EHR and RPM.
The Need Has Always Been There
Similar to the downsides presented by paper record keeping, there has always been a need to monitor patient conditions on a regular basis. This is especially true when considering patients living with conditions that change very quickly.
Take for example a patient with diabetes, remote patient monitoring allows for real-time readings of glucose levels in people with diabetes. Remote patient monitoring also extends beyond a need for better traditional care as developing technology continues to drive additional advancements and create new blue oceans.
An important distinction to make within this point; a need doesn’t necessarily guarantee a seamless blue ocean transition. This caveat has been observed in countless tech strategies across industries, where the prediction of fast-paced adoption and acceptance fails to take into account the previous blue and red oceans that make up an industry in the present.
It’s important to ask:
- Are consumers ready for your product?
- Are healthcare organizational leaders willing to integrate?
- Is the use case clear and easy to understand?
In the case of remote patient monitoring, the answer to these questions is yes! As adoption grows among large organizations, the benefits will continue appealing to patients. Individual agency within health and wellness has become more commonplace, and patients will begin to actively seek out organizations that are early adopters of emerging technology such as RPM. We have already seen a demand in healthcare technology to keep patients loyal. Remote patient monitoring has the benefits of being easy for patients to understand, and less invasive to integrate into large organizations. Organizations that fail to adopt technology may fall behind and as a result, lose patients.
Adoption Has Been a Slow Burn
We are still in the early stages of RPM technology. Similar to EHR, remote patient monitoring has been around much longer than you may think. In fact, remote patient monitoring has been around since the 1940s (prior to electronic records).
With EHR, the need to shift from paper to electronic was pushed forward by the introduction and boom of the internet. In the case of remote patient monitoring, the need has been pushed forward by the consumerization of healthcare and the COVID-19 pandemic. More patients are opting for remote/virtual care as the industry increases efforts to close the health equity gap. Remote patient monitoring provides agency for patients, who may find relief in the ability to share vitals with their provider.
Because adoption takes time, we may see a slow and steady shift with more RPM companies appearing and disappearing in the current blue ocean environment.
Eventually, as adoption rates increase, patients will demand remote patient monitoring as part of their daily healthcare experience. New companies may emerge as adoption rises. If RPM follows electronic records, few companies will remain and hold large stakes in key organizations.
Organizations Who Adopt Early See a Higher Patient Satisfaction Rate
Simply put, both EHR and RPM bring a net positive in patient outcomes.
For example, EHRs improve the ability to diagnose diseases and reduce, if not eliminate, medical errors, resulting in better patient outcomes and the global RPM systems market is projected to be worth over $1.7 billion by 2027.
Of course, data and statistics only tell part of the story. It’s important to measure impact on an individual level within your organization. Are your patients happy with remote patient monitoring technology? Does RPM technology help ease workload burdens for your providers?
The importance of choosing the right company to provide this information and more becomes apparent in these questions. As RPM oceans shift from blue to red, companies providing this technology will need to critically assess their devices and how to make integration as simple as possible for hospital systems.
EHR and RPM work so closely that 70% of respondents agreed that EHR integration is extremely important when considering a care-at-home solution, and 78% reported that an enterprise-wide solution is critical to providing care at home.
Ultimately, RPM is a very favorable technology for both sides of the care experience. As observed with the rise of electronic record keeping, hospital systems are looking for highly convincing arguments to change up the status quo. They need a technology that is desired by patients, easy to integrate into legacy systems like Epic, and a financial incentive to invest time and energy into training and implementation. We can use the framework for EHR adoption to closely compare it to current technology trends in the modern healthcare world. Remote patient monitoring has a unique advantage in both patient adoption rates and ease of integration.
Although an exact prediction of what remote patient monitoring (or any technology for that matter) will look like in the next five years is impossible, the parallels between electronic record adoption and remote patient monitoring tell a very important story; moving quickly does not guarantee a universal adoption, especially in the case of large healthcare organizations.
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