Vice President of Communications, Association for the Advancement of Medical Instrumentation
In health care, the walls are tumbling down. One crucial aspect of “connected health” is that health care services can be provided remotely. No longer are patients necessarily confined to hospitals to recover. Aided by impressive advances in technology, individuals recovering from medical procedures or those with chronic conditions increasingly have the ability to recover at home, or even while on the move. From the vantage points of personal freedom and health care costs, that’s a development worth cheering.
Weighing the risks
But there are new risks to consider. Chief among them is a lack of understanding about the scope, complexity and variability surrounding the use of medical device and health care technology that’s moving outside hospitals walls into new and less-than-controlled settings.
Lane Desborough, a medical device engineer who spoke at an Association for the Advancement of Medical Instrumentation (AAMI) and Food and Drug Administration (FDA) summit on health care technology in nonclinical settings, put it this way: “If you thought hospitals were complex, varying and high consequence, try the real world.”
Asking the right questions
There are a host of tough questions to consider when health care technology moves beyond hospitals. Among them are: How are medical devices being designed for use by lay people outside clinical walls? Who is coordinating the transitions in care between hospital and home, with an emphasis on understanding devices and technology? In short, who will teach the patients? Who services and maintains medical devices when they are outside formal clinical settings?
These questions are being tackled by stakeholders from various backgrounds. At the AAMI and FDA summit in 2013, industry leaders joined doctors, nurses, regulators, patient safety advocates, clinical engineers, equipment technicians and other professionals who service and maintain medical devices to consider how they could best realize the vision for “anywhere, everywhere health care.”
They agreed on five overriding goals or “clarion themes.” First, deepen all stakeholders’ understanding of use environments — and their remarkable variability. Second, coordinate multiple and recurring transitions in care to improve patient safety. Third, adopt a systems approach — encompassing people, workflows, therapies, technology and payment — to redesign the full spectrum of health care in nonclinical settings. Fourth, standardize and simplify. Fifth, design with empathy.
Within each of those goals are a host of challenges. For example, the idea of designing with empathy speaks to the fact that the needs and experiences of the final user — and the environment in which the devices will be used — must be front and center. Device designers and manufacturers have a responsibility to integrate feedback and preferences from users so that they can deliver products that can be used safely and effectively. Seeing the growth in the home health care market, many device designers are already doing just that.
As the delivery of health care spreads out, the development, use and training of related technology (and the instructions that come with it) must evolve as well, so that risks are minimized and the full benefits of connected health are realized.
If you have a health need that involves the use of a medical device or technology, be sure to talk to your health care provider to make sure you understand its use.