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Healthcare

Cable’s Role in the Future of Connected Healthcare

Ralph Brown
SVP & CTO, R&D

Sep 26, 2017

A version of this article appeared in S&P Global Market Intelligence in August 2017. You can find the original here.

The connection between cable and healthcare may not be immediately obvious to the casual observer. CableLabs has a vision of the potential future of healthcare in five to ten years’ time that is based on the massive and ubiquitous broadband connectivity that will be available in this time frame. This vision is captured in our video that you can watch at The Near Future Network. After reflecting on this vision, the connection becomes more evident.

Today, in addition to connecting hospitals and clinics, the cable network infrastructure reaches 93% of U.S. homes. This enables cable services to contribute in an increasingly important role in healthcare. Cable operators are able to deliver a cost-effective bundle of broadband, telephone, and television services that meet the connectivity and business needs of hospitals and clinics. In addition to connecting hospitals and clinics, cable companies are offering gigabit speeds to residential customers, completing the connection to the home. Connected healthcare is very important for areas of the country that lack medical resources. For example, GCI, the largest Internet provider in Alaska, is taking the lead in connected healthcare by providing remote Alaskan villages with telemedicine through their ConnectedMD program.

Connecting hospitals and clinics is only the beginning. Remote patient monitoring is becoming an increasingly important aspect in addressing the growing costs of healthcare. The results of a year-long remote patient monitoring pilot from Geneia showed a savings of over $8,000 per monitored patient annually. This kind of remote patient monitoring relies on a robust broadband connection to the home. In September 2015 Cox Communications acquired Trapollo to offer remote patient monitoring significantly reducing the cost of delivering care to patients with chronic ailments.  Also in September 2015, Kaiser Permanente announced a pilot of My Pregnancy. A TV app on the Xfinity X1 platform; the app provides timely information for expectant mothers to access clinically validated Kaiser Permanente content.

The demand for healthcare services continues to grow thanks to the reality of an increasing demographic of individuals over the age of sixty-five. Currently, that group makes up 15% of our population, but by 2040 it will be nearly 22%.  Coupled with the rising cost of providing healthcare services in hospitals, connected healthcare makes more sense and “cents” than ever. It is well known that treating chronic conditions comprises the highest percentage (as much as 80%) of U.S. healthcare expenditures. Using remote patient monitoring to stay on top of chronic conditions and anticipating potential crises avoids unnecessary ER visits and improves patient outcomes.

Connectivity transcends industries and the issues faced by healthcare are massive, therefore the time for collaboration has arrived. One example of this kind of collaboration with the healthcare industry is cable’s work with the Center for Medical Interoperability (CMI). The West Health Institute studyThe Value Of Medical Device Interoperability, estimated that more than $30 billion in annual health care savings could be realized by solving medical device interoperability. CMI was formed to address this problem and is modeled after the CableLabs centralized research and development laboratory. Cable brings its expertise in device interoperability, device security, and certification to the healthcare industry through its participation in CMI’s specification development efforts.

Another example of industry-wide collaboration is our participation in the Open Connectivity Foundation (OCF) which is spearheading network security and interoperability standards for IoT devices. Through OCF, CableLabs and the cable industry is working to increase IoT security to address the associated risks to both the network as well as the privacy of subscribers. CableLabs not only has a board position at OCF, we chair the OCF Security Working group.

The cable industry will have an increasing role in the future of connected healthcare due to their high-capacity, fiber-rich networks that are able to connect patients and providers. CableLabs recognizes this and on April 12th and 13th we produced two back-to-back Inform[ED] Conferences that brought together cable industry technologists with health information management professionals to continue the conversation. Although healthcare IT will become increasingly complex in the future, cable’s solutions are simple, easy to deploy and scalable across the entire healthcare system.

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Subscribe to our blog to read more about connected healthcare and the innovations we are working on. We hope to inspire the healthcare industry to help us make our vision a reality.

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Healthcare

Cable Connects with Healthcare

Ralph Brown
SVP & CTO, R&D

Mar 15, 2017

The connection between cable and healthcare may not be immediately obvious to the casual observer.  However, upon further reflection, this connection becomes more evident.  Cable companies have been expanding their commercial services to focus on the healthcare vertical.[1]  Cable operators are able to deliver a cost-effective bundle of broadband, telephone, and television services that meet the connectivity and business needs of hospitals and clinics.[2] Connected healthcare is very important for areas of the country that lack medical resources.  For example, GCI, the largest Internet provider in Alaska, is taking a lead in connected healthcare by providing remote Alaskan villages with telemedicine through their ConnectedMD program.

Connecting hospitals and clinics is only the beginning. Remote patient monitoring is becoming an increasingly important aspect in addressing the growing costs of healthcare.  The results of a year-long remote patient monitoring pilot from Geneia showed a savings of over $8,000 per monitored patient annually.[3] This kind of remote patient monitoring relies on a robust broadband connection to the home.

Today, in addition to connecting hospitals and clinics, the cable network infrastructure reaches 93% of U.S. homes.[4]  This enables cable services to contribute in an increasingly important role toward healthcare.

The demand for healthcare services continues to grow thanks to the reality of an increasing demographic of individuals over the age of sixty-five: currently that group makes up 15% of our population, but by 2040 it will be nearly 22%.[5]  Coupled with the rising cost of providing healthcare services in hospitals, connected healthcare makes more sense and “cents” than ever.  It is well known that treating chronic conditions comprises the highest percentage (as much as 80%) of U.S. healthcare expenditures.  Using remote patient monitoring to stay on top of chronic conditions and anticipating potential crises avoids unnecessary ER visits and improves patient outcomes.

Connectivity transcends industries and the issues faced by healthcare are massive, therefore the time for collaboration has arrived.  One example of this kind of collaboration with the healthcare industry is our work with the Center for Medical Interoperability (CMI).  The West Health Institute study, The Value Of Medical Device Interoperability, estimated that more than $30 billion in annual health care savings could be realized by solving medical device interoperability.[6]  CMI was formed to address this problem and is modeled after the CableLabs centralized research and development laboratory.  CableLabs brings its expertise in device interoperability, device security, and certification to the healthcare industry through its participation in CMI’s specification development efforts.

Another example of industry-wide collaboration is our participation in the Open Connectivity Foundation (OCF) which is spearheading network security and interoperability standards for IoT devices.  CableLabs not only has a board position at OCF, we chair the OCF Security Working group. Through OCF, we are working to drive increased IoT security to address the associated risks to both the network as well as the privacy of subscribers.

The organization that I represent, CableLabs, recognizes the increased role that the cable industry will contribute to the healthcare industry of the future.  We are producing two back-to-back Inform[ED] Conferences to bring together cable industry technologists with health information management professionals.  April 12 will focus on IoT Security and April 13 will cover Connected Healthcare.  Please join us in New York City and we look forward to having you join us in this important conversation.

 

 

Inform[ED] Connected Healthcare
Event Details

Thursday, April 13, 2017
8:00am to 6:00pm

InterContinental Times Square New York
300 W 44th St.
New York, NY 10036

REGISTER NOW

Footnotes

[1] Comcast - https://business.comcast.com/enterprise/industry-solutions/healthcare
Cox - https://www.cox.com/business/industry-expertise/healthcare.html
Charter - https://enterprise.spectrum.com/solutions/healthcare.html

[2] https://www.ncta.com/platform/broadband-internet/gci-makes-telehealth-as-easy-as-regular-healthcare-in-rural-alaska

[3] https://www.geneia.com/news-events/press-releases/2016/june/geneia-study-finds-remote-patient-monitoring-could-save-more-than-8000-dollars-per-patient-annually

[4] NCTA -  https://www.ncta.com/industry-data; Source:  NCTA Analysis of SNL Kagan and Census Bureau Estimates

[5] https://aoa.acl.gov/Aging_Statistics/Index.aspx

[6] http://www.westhealth.org/resources/value-of-io-analysis/

 

By Ralph Brown, Chief Technology Officer, CableLabs.

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Consumer

Insights from the 50th Consumer Electronics Show #CES2017

Steve Goeringer
Distinguished Technologist, Security

Jan 11, 2017

This year’s CES was another record breaking event and was well attended by cable industry representatives. The event staff reports over 177,000 people attended to view nearly 2.5 million square feet of exhibit space. Over the next several weeks, analysts and pundits will contemplate the trends and shifts that are ongoing in the industry. In the meantime, here are some thoughts on a few key areas.

Everything is being connected in dozens of ways. Connected everything is going to drive huge bandwidth consumption while also presenting interesting challenges. Wireless connectivity options abound, from traditional WiFi and Bluetooth to a plethora of ecosystem scale consortia options such as ZigBee, ZWave, Thread, and ULE Alliance. Cellular based connectivity is expanding with companies using lightweight modems to easily connect new products such as health device hubs and pet monitors to cloud services. With so many options, however, providing a consistent and securable home and business environment will remain challenging — no one hub will seamlessly connect all the devices and services that are out there, and no one security appliance will keep consumer networks safe.

There is a huge focus on health and wellness, with several hundred companies exhibiting in the Health & Wellness and Fitness & Technology Marketplaces. These focus areas were well exhibited by the large manufacturers such as Samsung, Sony, Intel, and Qualcomm as well. In discussions with product managers, however, it’s clear that we might not have learned too many lessons about the need to secure medical and fitness devices and services. Many vendors continue to integrate minimal security, relying on unsecured Bluetooth connectivity to a hub that often does not leverage any form of strong identity for authentication. Fortunately, the Open Connectivity Foundation will continue to provide a path for addressing this shortfall, and membership in the Foundation significantly increased this week. Moreover, several vendors are leveraging IoTivity which will provide clean paths to secure implementations for connected environments.

Smart, highly connected homes were also a major theme, again with hundreds of vendors showing completely integrated solutions, hubs, and thousands of end devices. Connected lightbulbs remained a continuous and omnipresent idea, as were security systems. However, it’s clear there is not any winning market strategy here yet. With dozens of vendors offering complete solutions and even more offering different controllers, it seems the market is fragmented! On the other hand, Brian Markwalter of CTA advises they expect to see 63% CAGR for the smart home market in 2017. It seems this is a great opportunity for service providers to pave the way to some convergence and integration simplification for home owners.

It’s hard to go to CES and not leave very optimistic about the future. There is so much good stuff coming that is going to impact all of us. From better screens to more agile and secure health care devices to safer cars to anything else you can imagine. And, there are so many ways to add value to mundane items just by connecting them to a network. Given Metcalfe’s law (“the value of a telecommunications network is proportional to the square of the number of connected users of the system”), the value of the cable network appears to be headed for much higher with the growth of so many connected devices. And, it’s clear that we’re going to need all the bandwidth to the home that DOCSIS can bring! Our challenge is ensuring easy and flexible use through good strategies and standards for interoperability and security.

As a member of the Open Connectivity Foundation, CableLabs is guiding the interests of the cable industry with major manufacturers whose devices will connect to the cable network. Additionally, Kyrio provides OCF certification testing services, making it possible for companies to securely connect IoT ecosystems in an interoperable manner.

 

 

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Technology

Healthcare and the Role of Cable

Feb 12, 2015

Advances in nanotechnology, internet of things, 3D printing, personalized medicine, genomics, and big data are creating a convergence that will allow lower-cost, more effective, and more convenient medical practices to become the norm over the next few years. These advances will change the medical landscape significantly, and create large opportunities for those who can integrate enabling and underlying technologies.

Environmental and Demographic Challenges

Now is a very interesting time in medical technology. Researchers at McGill University and the UCLA Fielding School of Public Health analyzed the efficacy of health care systems across the world and found the U.S. ranks 22nd out of 27 high income nations when it comes to increasing life expectancy (per dollar spent), meaning the US health care market is especially inefficient. In addition, in the next twenty years, due to an aging population, for the first time the US health care system will have fewer payers than payees – more people will be on Medicare and Medicaid than paying into the system. An aged population requires different (and frequently more expensive) services, which will add additional economic pressure on the system. For this reason, the next few years will see a shift towards demonstrable value in services, as well as shifts in the technological and entrepreneurial landscape, with a goal of providing more services at a lower cost (also called medical efficiency) – and thanks to technological innovation, this should come without compromising healthcare outcomes. Although the landscape may appear dismal, technological opportunities may save American society.

Technological Factors at Work

Several technological factors are at work right now that should help make this a reality:

  • Nanotechnology is becoming mature, especially as applied to in-the-field testing.   Several technologies are currently being developed and tested, including a portable dengue fever test and HIV test. By 2020, most blood tests that previously required a trip to a regional lab may be available from anywhere, at a very low cost.
  • The Internet of Things (IoT) and 3D Printing are creating an innovation environment for devices where the cost of prototyping a new device has dropped over 75% in the last 3 years, with a similar drop in cost of end user healthcare devices. 3D printing has also allowed for the creation of customized health care, such as custom prosthetics.
  • Lower costs due to the above should make possible near-continuous testing of such things as blood pressure, blood glucose and hormone levels, leading to significantly better well-care outcomes for patients with diabetes, high blood pressure, and hormonal issues – the three most common chronic issues in the population.
  • In addition, low cost remote devices will allow better follow-up and post-procedure compliance on the part of patients. A recent study showed that average compliance after hospital stays is less than 50%, mostly because of inability to remember or follow post-care instructions. Several companies are developing software that is used both in-hospital and once the patient is home (for example, GetWell Networks), and will be integrating these systems with home care products that provide reporting and alerting on everything from outpatient activity levels to pharmaceutical consumption, allowing for far more comprehensive and effective follow-up care and significantly better outcomes.
  • Electronic Health Records (EHR) are rapidly getting standardized, and devices are beginning to interoperate more effectively with these systems. This allows big data analysis and patient monitoring automation at levels not previously seen.
  • Genomic testing is becoming available, allowing “personalized medicine” – testing against a user’s genetic information to determine whether a treatment is likely to work for an individual (rather than statistically across a broader swatch of the general population).

These technological factors will enable more efficient analysis of patient records. More efficient analysis of patient records allows allows for “continuous analysis” of medical device, pharmaceutical, treatment, and procedural effectiveness across a broad population – a continuous clinical trial for existing and emerging treatments. This would allow innovative entrepreneurial and reimbursement and treatment models on the part of the medical insurance industry – keying reimbursement rates and copayments to the efficacy of treatments in the general population. These potential reimbursement and treatment models can lower one of the key factors that increase the cost of health care adapting the standard of care based on what’s new and more effective for only a minority of the population. These technical advances also allow for personalization of medicine potentially providing incentives for pharmaceutical companies to develop test that indicate the efficacy of a medicine for a particular patient. Big data models can also help in fraud detection, approval process, and detection of cross-indicators that define populations at high risk of complication, all additional causes of inefficiency in the health care system.

Where Cable Adds Value to the Healthcare Equation

There are a number of opportunities for the Cable industry regarding these developments:

  • Network Services: Remote testing and monitoring requires a highly secure, private backbone for data transmission, as well as the ability to transmit large quantities of imaging data.
  • Inter-Clinic Connectivity: As data interoperability standards mature for medical devices, it should allow independent remote “clinics” that can interconnect with any hospital – these could exist in caregiver facilities, offices, or neighborhoods. These clinics should be able to “dial-up” to a larger care facility and interoperate securely for the duration of a care visit, without having to be a part of that facilities’ network. Again, these clinics need secure, private, high-bandwidth services.
  • Data Centers: Big data and machine learning requirements of healthcare will require huge amounts of data and compute, an opportunity for large-scale datacenters. In addition, these services may require the ability to anonymize data for remote application consumption, and this will be a new class of cloud service.

By Ken Fricklas —

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