Wednesday, May 28, 2008

Remote monitoring - High Tech/High Touch Care from Afar:

Technology systems to underpin living independently, or what some call “aging in place,” are still years from being rolled out in a big way, awaiting adequate financing for research and other incentives.

Ben Garvin, “High-Tech Devices Keep Elderly Safe From Afar,” New York Times, May 24, 2008

Facing growing cases of chronic illnesses and continuing nursing shortages, the health care industry is increasingly turning to home-based medical devices to keep tabs on patients.

Elena Cherney, “New Ways to Monitor Patients at Home,“Wall Street Journal, April 18, 2006

For patients and for doctors, traveling to see each other poses logistical problems – problems that can be overcome by traveling in cyberspace. With electronic communication, the elderly can now live alone without physical assistance, and patients and doctors can talk, observe, and listen to each other without being physically together.

.As John Naisbitt pointed out 25 years ago in Megatrends (Warner Books, 1982),
“High tech/high touch is a formula I use to describe the way we have responded to technology. What happens is that whenever new technology is introduced into society, there must be a counterbalancing human response – that is, high touch – or the technology is rejected? The higher tech, the more high touch.”

As it relates to the home, high tech/high touch is now being applied in two domains.

First, to the elderly who live alone?

Emergency response systems have been around for years, but motion sensors and remote monitoring systems are now available for $50 to $85 a month.

These systems will become commonplace as the 76 million baby boomers approach ages when Alzheimer’s, diabetes, failing eyesight, and sheer age threaten the ability to live independently. The population of those 65 years and older is 40 million today, and the Census Bureau says that will more than double, to nearly 87 million, by mid-century.

Jeremy Nobel, M.D, professor at the Harvard School of Public Health who co-wrote a study on the feasibility of such technologies. “We are at the beginning stages regarding the availability of such services and before business models are developed. I expect we’ll see a significant increase in the adoption of such systems in two to five years, and widespread adoption in 10 years.”

All that prevents these systems from being rolled out in a big way now are adequate financing by government and coverage by insurance companies.

And even that may not be necessary. An AARP survey found older people are willing to use high-tech devices at home, and to pay about $50 a month.

Second, to the sick elderly confined to their homes.

As I explained in my book, Innovation-Driven Health Care: 34 Key Concepts for Transformation (Jones and Bartlett, 2007), “The chief impact of Internet-based medicine will be decentralized care.” In a case study in the book, Randall Moore, MD, CEO of American Telecare, and Erin Denholm, CEO of Centura Health, wrote that readmissions to hospitals and ERs for patients with congestive heart failure dropped 95% when patients were monitored by remote bedside audiovisual devices controlled by patients. Though these devices, doctors and nurses could observe patients, talk to them, listen to their breath sounds, and record their blood pressure, weight, and blood oxygen.

Further, patients controlled the provider encounter and quickly learned to spot their own complications. Patients learned they could find help when they needed it, earned respect as individuals with knowledge of their own disease, could take control of their illnesses, could share information they deemed appropriate, and could self-coordinate their care without wasting time, money, and worry.
While remote care in now possible and available at low costs, payment for these services is complicated by state and national regulations and turf battles between providers.

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