Jennifer DeFrancesco: The Rise of Sustained Chronic Disease Modalities and Why HTM Should Be Watching

During a recent trip to South America, I was taken with the fresh fruit that street vendors sold all day. I couldn’t wait to run into one of the pineapple vendors to get a slice. That week it dawned on me that I’ve never seen a street fruit vendor in the United States. Furthermore, the prevalence and demand for highly processed foods as well as advancements in healthcare technology have lead Americans to have long lengths of their lives in sustained chronic disease modes, such as is the case with diabetes or high blood pressure.

This shift in disease models requires healthcare systems to change. Healthcare technology management (HTM) must have a broad view of these trends and changes in healthcare technology to adapt our service delivery models to address the changing landscape. By proactively addressing the needs of our organizations, not only can we support operations, but we can prove ourselves to be valuable resources to our leadership in understanding innovations and the needs of our patients.

The proliferation of wearable technology as well as point-of-care technology that can be used in the home or within the healthcare facility is changing the availability and access to primary care and is creating a shift in how hospitals function. More primary care is being pushed to local communities or at home with remote support and hospitals are increasingly becoming places where only the very sick or those in need of diagnostic care go. This shift empowers our patients to take a more active role in their health in a more convenient and private way.

So what does this mean for HTM? With all current indications, there is going to be a growing need for HTM to support hybrid healthcare data collection and translation. Organizations will need to develop a service delivery model to support wearables and point-of-care technology in a more mature and robust way than we have seen. HTM also may be required to develop or support homegrown applications and their integration with existing hospital systems and electronic medical records (EMRs). The clinical applications piece has been an area where HTM has been having growing pains. This transition will require HTM professionals to understand traditional clinical informatics principles, as well as medical instrumentation and basic information technology. HTM departments also will need to develop enhanced remote support capabilities for satellite primary care offices and patients calling from home to troubleshoot their devices or integration into the organization’s systems. The utilization of “consumer devices” outside the traditional care paradigm will inevitably place stress on existing service delivery models.

Additionally, we can expect to see the prevalence of sustained chronic disease states increase our bed-days-of-care annually for these items. For example, studies have shown that, on average, individuals with diabetes now may live into their late 60s, with some reaching 85, due to advances in medicine and disease management. Those patients may have several stints which require specialty care or inpatient hospital stays due to situations that have been proactively identified to manage their symptoms. Such scenarios increase the need for HTM resources devoted to specialty care modalities and inpatient support equipment.

With a higher level of understanding of the emerging healthcare trends, HTM can partner with their organization’s leadership to engage in meaningful conversations on how to best meet the changing needs of our patients living with sustained chronic diseases.

Jennifer DeFrancesco is the chief biomedical engineer for the Indianapolis Veterans Affairs (VA) Medical Center and the lead biomedical engineer for the Veterans Integrated service Network (VISN) 10, which supports 11 hospitals in the Midwest.

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