Remote patient monitoring is transforming episodic care to continuous care.

A confluence of events – the aging baby boomers, rising healthcare costs, the strain placed on a limited number of skilled care professionals and facilities, and the availability of smaller, cheaper and smarter technologies – has resulted in the emergence of what is being called “pervasive healthcare.”

Pervasive healthcare, using technologies like miniaturized sensors, wireless networks and mobile devices, allows for a broad range of tele-health applications that are always on, always active and always aware. Able to interface wirelessly with home computers, cell phones or even remote Internet applications, they provide a look at the near future of healthcare.

By using emerging technologies such as wearable health devices, researchers have been demonstrating how the remote, continuous monitoring of patients has the potential to transform healthcare.

Prototypes showcase “next generation” care management, creating a new healthcare vision for key stakeholders: insurance companies, employers, government, clinicians and patients. By assessing patients virtually, in real time, these technologies can prevent expensive hospitalization, empower the patient and produce better outcomes. It’s transforming “episodic” care, as we presently know healthcare – a doctor’s visit, a trip to the emergency room, a stay in the hospital – into “continuous” care.

Pervasive Healthcare
Take the case of a fictional patient named Sarabeth Mitchell, a 78-year-old woman with a history of chronic heart failure. Sarabeth wears a device called a LifeShirt developed by Accenture Technology Labs that monitors more than 30 of her physiological signs in real time. Once it becomes apparent that her depth of respiration has risen, accompanied by some weight gain, the application sends an alert signal to a cardiac nurse at a remote call center. 

On her computer screen, the nurse selects a tab that reveals a list of detailed options about Sarabeth. This includes a more complete summary of cardiac data from the device Sarabeth is wearing. The default window displays a day’s worth of data, but the nurse can also look back as far as six months.

Compare this kind of real-time data with the way it is now, where Sarabeth might call her doctor to make an appointment. If she does, the doctor could suggest tests, which may not be for a day or two and may not offer results for several days after that, with the final result showing just a snapshot. Here, the technology takes a continuous movie of Sarabeth’s health for the current week or past six months. Having this rich and ongoing visibility to the patient can lead to the timely detection of early warning signs and intervention.

Back to the scenario, the nurse can call Sarabeth to see how she feels and ask her appropriate questions. She can also bring in a specialist to look at the data virtually and decide the right course of action to take. This could mean an immediate doctor’s visit, a decision to call an EMT to take her to a hospital, or the ability to resolve the problem right there without the patient leaving her home.

Compare this to the present model of healthcare, which focuses on treating patients with acute problems, and is ill-equipped to handle the number of patients who will suffer from those chronic conditions commonly associated with an elderly population. That’s why there is so much interest in the advent of pervasive healthcare, which effectively manages patients at any location, reduces costs, and makes better use of scarce professional care resources. This empowers patients to engage in self-care and provides ongoing education and proactive interventions from providers.

The Benefits
Evidence shows that pervasive healthcare offers great potential in the following ways:

• Cutting the skyrocketing cost of health care by reducing ER visits and hospitalizations – For example, a 2004 analysis by the New England Healthcare Institute found that using remote monitoring for healthcare patients reduced the readmission rate by 32 percent following hospitalization. This resulted in a net savings of nearly $2,000 per patient.

• Improving provider organizations’ productivity improvements that address the increasing shortages of healthcare professionals – The most visible example is the worldwide nursing shortage, which is especially prevalent in long-term care. By allowing homebound patients to take their own vital signs via pervasive healthcare technology, visits with healthcare professionals can be shortened.

• Enhancing the quality of patient care – Hospital discharge often results in a drop in the quality of care because most patients lack the means, information, discipline and oversight to properly care for themselves. The current situation often results in non-compliance behaviors – such as failing to take the proper medication – that can lead to delayed recoveries, complications and hospital readmission. A continuous care environment can help prevent this.

• Reducing healthcare costs by increasing patient visibility and enabling care providers to take early action – This also has the potential to reduce insurance premiums and payouts by ensuring that patients receive proactive treatment.

In addition, pervasive healthcare represents a business opportunity for technology companies. The demand for innovative wearable and home health devices continues to grow, with some retailers even opening separate stores to sell these devices.

The Challenges
The promise of pervasive healthcare notwithstanding, a number of major challenges still lie ahead. These will need to be remedied in order for pervasive healthcare to meet its potential in the near future.

These barriers include the following:

• The question of reimbursement – Doctors and hospitals will expect to be paid, yet health plans and insurers tend to be slow in providing coverage for new technologies. 

• The resistance from both practitioners and patients to change – Doctors will need to change their mindset. Patients, meanwhile, particularly the elderly, may continue to prefer having doctors and nurses present rather than deal with technology.

• Technology obstacles – Early adopters will be discouraged because standards still need to be developed to achieve interdisciplinary cooperation and seamless delivery of services. As of now, none exists for wireless communication among home and wearable devices, data privacy and data formats governing the sharing of information among patients, practitioners and health plans. This means that healthcare organizations will need to choose among the incompatible solutions that currently exist without knowing what standards will be and which devices will meet them.

• Usability – Will elderly patients with chronic illnesses be able to learn new technologies? That’s why user-friendly devices will be essential.

Challenges notwithstanding, the pressures of healthcare today will be the driving force behind the adoption of the more patient-centered pervasive healthcare. With the continued need for change in the healthcare system from both cost and care perspectives, accompanied by the growth of consumer electronics and the maturation of sensory devices, the promise of pervasive healthcare is fast approaching.

Luis Taveras, Ph.D., is a partner in Accenture's Health & Life Sciences practice in Florham Park, N.J., and can be reached at This e-mail address is being protected from spam bots, you need JavaScript enabled to view it

Dadong Wan, Ph.D., is a senior research scientist at the Accenture Technology Labs in Chicago. He can be reached at This e-mail address is being protected from spam bots, you need JavaScript enabled to view it