| | July 20199UTLOOK Healthcare Tech connected devices represent deeper and richer data on critical health-related data. Wearable devices, such as glucose meters download blood glucose data for rapid review and interpretation. Digital scales, blood pressure cuffs, and other biometric devices significantly improve the ways that smartphone tools can be used. We have implemented retinal photography at many of our Family Health Centers sites and the improvement in diabetic retinopathy monitoring using this technology has been profound. The proliferation of new data points has required new workflows, but the overall experience has been excellent. Frequent monitoring of data such as retinal images, blood pressure, and blood glucose has required new workflows and training for staff to manage, providers to interpret and patients to understand. In particular, making meaningful treatment decisions based on this data is a skill that must be developed over time. Monitoring all this patient data is the final and most challenging aspect of the explosion of new technology. Patient monitoring workflows in electronic health records (EHRs) are critical. Since EHRs are now widely accepted and patient portals are in place for most medical offices in the US, the interface between existing EHRs and smartphone app data must take off. Portals provide access to information previously primarily accessed by providers. Patients can now view and ask questions about lab, radiology and other test results.In some cases, they can see the notes written by their providers. Patients can request refills, seek help with new symptoms and can also submit information regarding their health that the provider does not have access. With planning and a well-developed workflow, the patient portal can become a vital tool for better patient monitoring, allowing connected providers to follow up on patient symptoms and make sure patients achieve desired treatment goals. This onslaught of information is daunting and requires workflows for receiving, reviewing and collating that information. A clear understanding of staff roles in this setting is critical. Although most people have smartphones today, there is still a significant population for whom technology can be intimidating and underused. People struggling with limited literacy, poverty, educational attainment, distrust of the healthcare delivery system, developmental disabilities, and other factors, do not make use of technology at the same rate as others. The Primary Care Plus program, a home visiting program recently initiated at the Family Health Centers at NYU Langone, makes use of in-home community health worker intervention coupled with a physician and nurse practitioner providing both in-home and telehealth encounters. The key to success in this predominantly Medicaid population is helping to facilitate telehealth encounters through the use of in-home staff intervention. The staff work with patients in their homes to specifically contribute to promoting the use of these new technologies by helping patients to set up EHR portal access, make use of glucometers and facilitate app related monitoring. Devices that record biophysical data are now in the pockets of most people. Monitoring patient outcomes is now in the hands of patients, the people for whom it makes a real difference. At NYU Langone, we'rebuilding upon on our initial experience with these new tools when working with patients who have a chronic illness, helping them to take ownership of their medical conditions through monitoring. As providers, we understand the importance of engaging with our patients when those measures of health are uncontrolled, which is key to improving their overall health. HTAccess to information is empowering and the proliferation of new ways to see, understand, communicate and monitor health-related data has really opened new doors for patients, as well as for their physicians"
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