According to Roth, accelerating that progress will be a $1 billion Center for Medicare & Medicaid Innovation initiative announced in May 2013. CMS is seeking proposals for models that are designed to rapidly reduce Medicare, Medicaid, or Children's Health Insurance Program costs in outpatient or postacute settings.
"It's a great opportunity to improve quality and ensure that patient preference and patient choice in the postacute care realm is preserved, but that you can add in these efficiencies that allow for better care coordination," Roth says.
Dignity Health "has a very purposeful strategy" for mobility technology, working with three to five companies at any given time, Roth says. One example is AirStrip OB, which offers an app that runs on iPads and enables nurses to share heart rhythm waveforms collected by traditional ICU monitoring equipment with obstetricians who call up those waveforms in the AirStrip OB app running remotely on their iPads.
This takes the place of trying to describe the waveform over a phone call, which, Roth says, is "like describing a sunset to somebody." The AirStrip OB app instead ensures that "caregivers can make appropriate and right decisions at a very critical moment with all the information that they need to ensure the health and safety of the mother and the child," Roth says.
So far, Dignity Health has monitored 15,000 babies with the AirStrip OB app. As part of the Hospital Engagement Network, a joint effort with the Centers for Medicare & Medicaid Services and CMMI, Dignity Health has put in significant processes incorporating AirStrip OB to lower costs and save lives.
"The country has got to make these great improvements in quality and safety," Roth says. "We've got to figure out ways to take advantage of technology as a healthcare system to improve our own operations, become more efficient, and ultimately achieve the clinical goals and the cost-reduction goals that the system needs to achieve."
Mobile monitoring of asthma symptoms is another technology being tested now at Dignity Health. Patients use an inhaler paired with the Asthmapolis sensor device, which records the type and amount of medication dispensed, as well as date, time, and GPS-enabled location of the self-treatment. "If patients are using their inhaler too often, or not using it, we can ping them and get them into the clinic and adjust their medication or help with patient education so they can better self-manage," Roth says.
The cost of controlled asthma conditions versus uncontrolled asthma is a difference of $3,000 per Dignity Health member per year, and early stage data of the trial has been significant enough to prompt Dignity Health to expand the technology's use in the greater Sacramento, Calif. area, Roth says.