Interoperability in the personal health domain is becoming a reality, thanks to industry collaboration, says David Whitlinger, president of Continua Health Alliance
and director of health care device standards and interoperability in Intel’s
digital health group. Continua is a cross-industry consortium focused on networked devices in telehealth and recently released the first components of what will be a set of technical guidelines for vendors and users.
Early next year, the ad hoc group of more than 130 members also plans to introduce a compliance program and logo based on first-generation standards. Among its many members are IBM, Dell, Intel, GE Healthcare, AstraZeneca, Panasonic, and Pfizer. Digital HealthCare & Productivity recently spoke with Whitlinger about how moving away from proprietary standards and toward open architecture and common interfaces and communication protocols can help connectivity initiatives in medical technology.
DHP: So what’s on Continua’s technology roadmap?
Whitlinger: We’re trying to create an ecosystem of personal telehealth solutions in three fields: chronic disease management, aging, and health and fitness. In 2008, we’ll publish some initial guidelines for device makers, as well as release the details of compliance and testing programs. Our standards will use existing networking technologies, such as Wi-Fi and Bluetooth. Health Level 7 (HL7) will allow integration with standards-based electronic health records (EHR), and there are formats established by the IEEE 11073 for linking medical systems. For example, specific versions of Bluetooth and USB can act as wireless transports linking home health care devices, such as glucose meters, blood pressure monitors, and other monitors and sensors.
Consumers and health care providers will be able to more simply share information through common communication channels such as cell phones, PCs, TV set-top boxes, telephones, and other devices. We think many of our original equipment members will have compliant devices ready to demonstrate at events next year. In addition, we’ve put out a call to member companies for abstracts for second-generation use cases that we’d like to address. In the summer or early fall of next year, we’ll determine requirements for additional standards. Our technical committees will track new wireless transports such as ZigBee, RFID, and ultrawideband, although we currently don’t address them.
DHP: What’s being done to persuade the payer community to acknowledge the value of these devices and services?
Whitlinger: Reimbursement is yet another aspect of the marketplace that Continua is looking to address. We’ve contacted with a research company to gather baseline information, collecting trial data that already exists. We’ll create a digest of telehealth research studies done on remote chronic disease management in the U.S. and Europe over the past five years.
This will help us determine strategies for initiating quality improvement studies and securing reimbursement for devices and services. It will be the cornerstone in a broader strategy, engaging with private and public payers to understand what proof is needed to achieve reimbursement for personal telehealth technologies. But there may be more work coming to prove the reimbursement case for these systems.
DHP: Where’s the biggest bang for the buck, as far as interoperability? One study shows for every million dollars spent on equipment, integration costs can run as high as $400,000.
Whitlinger: Business decisions related to systems acquisition and deployment need to take into account interoperability. Interoperability is about purchasing the best-of-breed systems and knowing they’ll work together in affordable and supportive way. But it’s also about improving safety and quality of care.
If you look at health care providers, they’ll tell you that interoperability affects the ability to integrate different systems from different vendors within their environment, such as being able to integrate PAC systems with electronic health records. If you look at public health systems, you can argue that health care interoperability between them is the higher priority, transferring health records from one hospital system to another. My own belief is that improving efficiency at the patient care level is the biggest bang for the buck in the short term.
DHP: In a little over a year, Continua has grown from 22 members to more than 130. Will this growth continue?
Whitlinger: We’re trying to broaden our membership to include companies involved with electronic medical records, especially as more devices go online and become a significant data source. Membership also can include more insurance and health care providers.
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