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Telemedicine
Healthcare |
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Telemedicine Enables
Better Care Making Healthcare More Convenient, Efficient, and
Tailored to Individual Needs
Other Topics:
Medical Informatics Engineering,
Electronic Health Record (EHR)
Solution, Remote ECG Screening
Telemedicine
October 15, 2006
The concept of connected health, or telemedicine, extends
healthcare beyond the traditional confines of hospitals and
doctors’ offices to our everyday surroundings. The availability
of technology in the home, our aging population, and the
dramatic increase of patients with chronic diseases, such as
hypertension, diabetes, and obesity, are some of the factors
fueling increased interest and growth in connected health.
Combined with the relative shortage of healthcare specialists,
sharply increasing healthcare costs, and patient demand for
quality and convenience, we are seeing an increased interest and
growth in connected health and the potential for a range of
exciting new applications to address these challenges. |
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In today’s
complex healthcare environment, connected health programs are
valuable and necessary. Typically, such programs use new or
available consumer technologies, such as the Internet, cell
phones, and digital cameras, to facilitate patient-provider
communication. Some of the most common applications in connected
health today include online patient-provider consultations, home
monitoring of patients, remote lifestyle feedback, and other
home-based remote healthcare.
The new connected health models of care extend and enhance the
patient-physician relationship. Further, connected health
programs are demonstrating the kinds of measurable improvements
in access, quality, and efficiency of care that get the
attention of key players in the system. Employers are
increasingly relying on connected health to administer wellness
programs and other technology-driven care plans, while payers
are realizing that connected health technologies make efficient
use of dwindling resources to reduce healthcare costs and
deliver quality patient care. Concurrently, healthcare providers
have become more comfortable integrating technologies into their
practices, and consumers are showing more interest in actively
managing their health.
At Partners Telemedicine, we are taking a proactive role in
developing initiatives and establishing an infrastructure for
connected health. These programs are designed to deliver quality
patient care wherever and whenever it is needed.
Improving Adherence
According to the World Health Organization, 50% of patients with
chronic disease do not take their medication as prescribed.
While the reasons for poor adherence vary, the impact on cost
and treatment outcomes to patients, society, and our healthcare
system is indisputable. Given the provider shortage, the
challenge of adherence speaks directly to the need for better
patient self-management.
For example, there are over 65 million Americans with
hypertension, yet only 30% of those patients have control over
their condition. The remaining 70% contribute over $40 billion
in direct healthcare costs and generate over 17 million
physician office visits annually—not to mention indirect costs,
such as lost work days and decreased quality of life.
We believe that an essential part of patient self-management is
the creative implementation of incentives and the development of
content and interfaces that keep patients engaged—particularly
in chronic disease populations.
Partners Telemedicine is currently analyzing data from a
technology-readiness survey of several thousand diabetic
patients to assess the level of technology use, current
behavior, and barriers to adherence, as well as the
opportunities and obstacles to connected health for the
consumer. Initial data suggests that even if consumers have not
yet used these technologies in the home, they are willing to
adopt technology to share health information remotely with their
doctors.
Connected health technologies can keep clinicians connected to
patients long after they leave the office with their
prescription. This is a critical opportunity to provide the
incentives, feedback, and information that motivate patients,
improves adherence behavior, and reduces medical risk.
Smart Pill Bottles
To further develop this concept, Partners Telemedicine is
conducting a study of 70 patients using a smart pill bottle that
sends electronic messages to a central server housing individual
patient data. The server then signals back to a home device.
Using data from the pill bottle and server, the device glows red
when medication is overdue and green when the patient is on
schedule with their medication.
This is the first step toward the development of effective
behavioral strategies to improve adherence in chronic disease
populations. The study is examining the effect of unobtrusive,
no interface, personalized reminders on adherence rates.
The technology is readily available to improve adherence.
Pharmaceutical and biotech manufacturers have a real
opportunity, working with technology companies and healthcare
providers, to create solutions that will be effective in
large-scale settings or in specific patient populations.
Remote Monitoring and Care Delivery
Connected health strategies are also improving patient
monitoring and home care beyond remote monitoring to include
remote diagnostics and remote care delivery.
Several trends in employer benefits, payer programs, and
consumer expectations suggest that connected health technologies
and thoughtfully implemented disease-management programs,
together, can play a role in enhancing care and outcomes for
patients with chronic diseases, such as chronic heart failure (CHF).
Technology and device manufacturers are developing small,
user-friendly devices that monitor heart rate, blood pressure,
pulse oxymetry, and weight. The importance of these products
will grow in the home care setting, as patients continue to
become more technology savvy.
Some people have voiced concern that the elderly, who could
benefit greatly from connected health advances in home care, are
unlikely to adopt these new applications. There’s evidence,
however, that they are changing with the times: The fastest
growing segment of Internet users are over age 65.
In a collaborative study between Partners Telemedicine and
Partners Home Care, we followed 85 CHF patients for two months
following hospital discharge. Each day, patients transmitted
their weight, blood pressure, and oxygen saturation to a
telemonitoring nurse. The nurse evaluated the data and placed a
phone call to each patient to share the data and ask scripted
disease-management questions.
The use of telemonitoring devices combined with enhanced
communications demonstrated a significant impact on efficiency
of care while showing decreased hospitalization rates. Study
participants required 40% fewer nursing visits to the home and
experienced a 25% reduction in re-hospitalization rates.
Additionally, patients reported an improved quality of life and
appreciation for increased involvement in their care. As a
result of this study, Partners Home Care implemented
telemonitoring for all of its eligible CHF patients, and has
expanded the program to include patients with chronic
obstructive pulmonary disease, renal failure, and more.
Personalized Medicine and the Future of Connected Health
Genetics and genomics have the ability to change the way our
healthcare system approaches therapeutic and diagnostic
procedures and could revolutionize the delivery of care in the
near future. However, that is only a part of what we believe to
be the promise of personalized medicine.
We have the opportunity to proactively re-engineer the entire
healthcare delivery system to make healthcare more convenient,
efficient, and tailored to individual needs. In any case, as
healthcare consumers become more aware of the way their genetic
makeup, history, environment, and lifestyle choices interact,
while our healthcare system strains under the increasing demand
for services, the availability of a healthcare infrastructure
that provides patients with support, education, and self-care
opportunities will become imperative.
Now is the time for pharmaceutical and biotechnology companies
to get involved, to proactively develop connected health
programs that will afford patients, caretakers, and providers a
system for better coordination and delivery of care.
The technology exists today to help patients care for
themselves, for caretakers to have access to pertinent
information about their loved ones, for providers to monitor
patients when they are away from the doctor’s office or
hospital.
What is needed is better coordination and a connected health
eco-system where incentives are shared by patients, providers,
and payors. |
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