eHealth: a remedy for what ails doctors… and U.S. healthcare

Bob Schmidt thinks he has an answer for the mega trends of rising healthcare costs, fewer doctors to treat more patients, and provider pay-cuts by the federal government: eHealth.

“eHealth” means different things to different organizations, though for most it means using the Internet or electronic means to lower the cost of delivering healthcare.

For the National eHealth Collaborative, it’s “driving the grassroots development of a secure, interoperable, nationwide health information system.” For insurer UnitedHealth Group, it’s telehealth. For Mayo Clinic, it’s electronic health records.

And for Schmidt’s Cleveland Medical Devices (CleveMed), it’s dreaming up diagnostic devices for sleep and movement disorders that can cut up to 90 percent of the cost of traditional tests — and even help primary care physicians find new revenue sources.

How’s that?

“The way one saves money is, you use less resources. You use fewer or less expensive people, and you reduce facility and equipment costs,” said Schmidt, the inventor and patent attorney who founded and chairs CleveMed, the Cleveland, Ohio, medical devices developer.

“In transportation, we can have a people mover without a bus driver,” he said. “In the military, we can fly planes without people.”

And in healthcare? We can enable primary care physicians to treat more people with equal or fewer resources.

Here’s how that looks for CleveMed and its obstructive sleep apnea line of products and services:

First, a primary care doctor buys into the idea that untreated obstructive sleep apnea can subtract 10 good years from a patient’s lifespan. “When you’ve starved your body for 20 or 30 or 40 years of oxygen, that’s not good,” Schmidt said of the disorder that can lead to organ damage and the diseases that come with it.

Then the doctor buys CleveMed’s SleepView diagnostic system — a small, light sleep monitor that comes with accessories like a respiration belt to measure chest breathing, a pulse oximeter to measure blood oxygen levels, and a cannula to detect sinus or mouth breathing. (The system even tells the doctor whether you sleep on your back, side or stomach.)

The doctor gives the system to a patient to take home and use. No overnight stay at an exclusive facility ($4,000 a night) or sleep center ($2,000 a night) while sleeping in somebody else’s bed, hooked up to a dozen electrodes.

SleepView works only for obstructive sleep apnea. Patients should go to sleep centers if they need diagnoses for other types of sleep apnea or disorders. That said, sleep centers could use the home test for obstructive sleep apnea, too.

The patient returns the SleepView to the doctor, who uses a personal computer to upload its measurements at a Web portal. The doctor gets a detailed but easy-to-read report that’s been vetted by a certified sleep doctor.

Then the doctor gets reimbursed by the Centers for Medicare & Medicaid Services (for about $200) or a private insurer (between $250 and $350) for doing the SleepView test. The Medicare reimbursement for a sleep center test is about $870, Schmidt said.

Meanwhile, the doctor has used less resources (a home test system that can be reused), fewer or less expensive people, and reduced equipment and facility costs (no dedicated equipment at a brick-and-mortar sleep center).

What can Washington do to help? Encourage home testing with laws and reimbursement policies. Until two years ago, doctors got no reimbursement for home sleep tests, Schmidt said.

And remember: if a doctor has to fight to get paid to do a home sleep test, consider the alternative. The government pays four times as much for sleep center studies.

“We just spent a huge amount of political capital getting a healthcare bill that was based on saving money,” Schmidt said. So, how are we going to save money?

“You’ve got to take out the cost to save money,” Schmidt said.