The Time I Backed The Volkswagen Into The Electric Pole

So new restrictions on remote monitoring caught my attention late last year if only because I rely on it for my folks and my wife relies on it to keep track of my questionable decisions, like that time I brought a running chainsaw into the kitchen or nearly killed Aunt Nancy with that uncooked chicken. UnitedHealthcare covers remote monitoring but for a time planned to curtail its use. It changed its mind, sort of like my wife did about the outfit I planned to wear to dinner last night - "Again with the sweats huh," she said. "You know the message you're sending out to the world. Try again." Her real-time monitoring is not unlike what social workers do all the time. Like back in 2014, Cindy Zydel had this idea to remotely monitor seniors on Medicaid in western Pennsylvania, those living with depression and diabetes. “We’d use iPhone 6s (yes kids, 6s) to check on vitals, weight changes, falls waiting to happen – and jump in if needed.” The kicker was the group got a data feed from Gateway Health Plan – those who had cost the Medicaid managed care company a boatload of money every year, at least $40,000 in falls and hospital care. The ~$3,000 a year Gateway paid the social worker’s company per patient was peanuts and made an impact, using a misfit bracelet to transmit data through an apple product called the cloud. The patients stopped falling. The social workers showed up, singing, monitoring. The patients smiled a bit more. This was the infancy of this stuff and of course it worked because it was first, it was low-hanging fruit.  Which in value based care is the easiest time to make a dent, particularly because this was the first time these patients had people care for them like this in a long time. That was both sad, but also  hopeful for me to hear as a journalist running around seeing mostly sickness, morbidity.  We all don't have to age that way. Maybe there is a place for tech if paired with people like Cindy Zydel. Of course paying for that care and tech is complicated. What happens when the baseline moves - when that $40,000 a year goes to $5,000? How do we change what we pay the remote monitor - or do we? Who actually is keeping total cost of care down in that case?  My wife likes to say she saves the healthcare system a lot of money monitoring my behavior, sometimes using technology to manage me more than I know. She uses Find My Phone to make sure I haven't wandered off into a forest fire, though also relies on non-verbal cues and strong words like "stop" or "halt" or "car" to head off danger. She's like my real like Dr. Seuss novel, keeping me safe from myself. Like the wall I keep bumping into that I swear wasn't there last year. I haven't been hospitalized--at least not in awhile--but I did need urgent care for that one time I banged my forehead on the Dunkin Donuts counter, which is really hard to do. I tallied up my misteps over the years - the time I backed the volkswagen into the electric pole and nearly electrocuted myself, and the set of times I stepped on a nail barefoot.  Maybe $2K in costs, though my wife estimates that without her interference and monitoring I'd have cost the health system north of $1 million dollars by now. And I’m not even counting the savings from the time she didn’t hurt me for weed whacking all her Black-Eyed Susans just before they bloomed. That would have required inpatient care, for sure. So thank goodness for her, and for remote monitoring, in all its forms...