Tag Archives: telehealth services

Is de zorg klaar voor zelfmetingen?

English version >

Uit de Nictiz publicatie ‘zelfmetingen en de Nederlandse gezondheidszorg’ wordt duidelijk dat zelfmetingen nog niet of nauwelijks op de juiste manier in het reguliere zorgproces worden geïmplementeerd. Zelfmetingen starten op initiatief van de patiënt en behandelaar. Om zelfmetingen op een goede manier te kunnen regelen, worden er door Nictiz een aantal aanbevelingen gedaan.

  • De invoering van zelfmetingen in het reguliere zorgproces is nuttig en biedt veel kansen voor efficiëntere zorg; Vitaphone sluit zich hier helemaal bij aan. Wij zorgen voor de tools en services zodat personen op een eenvoudige en precieze wijze zelfmetingen kunnen doen en kunnen communiceren naar de arts.
  • Er is zeker behoefte aan standaarden zodat uitwisseling van gegevens mogelijk wordt. Daarbij moeten internationale standaarden voor interoperabiliteit en connectiviteit, zoals HL7, IHE en Continua Health Alliance, als uitgangspunt dienen.
  • Specifieke certificering van zelfmeetapparaten is nodig; hiermee wordt er vooral gedoeld op de verschillende apparaten (sensoren, mobiele apparaten en apps) die gegevens vastleggen, zodat de betrouwbaarheid van gegevens beter gegarandeerd is.
  • Naast de industrie en de consumenten zijn ook de zorgprofessionals aan zet; er is vaak weinig kennis over zelfmeetapparaten. Zorgprofessionals moeten zorgen voor kennis vergaring en overdracht.

De gezondheidszorg en -industrie is deels klaar voor verdere invoering van zelfmetingen, maar er moeten duidelijk nog verbeteringen doorgevoerd worden.

Auteur: Indy Kavelaars @ Vitaphone Netherlands

Bronnen: Whitepaper ‘Zelfmetingen en de Nederlandse gezondheidszorg’ door Nictiz

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True Value Telehealth

Eyeforpharma recently published a report called “True Value Telehealth” what gives a good insight in the current and future market of telehealth and telecare. I made a summary of the most valuable points of this report. Go to the link below for the full report.

Market now and for the future

Research firm InMedica predicts that the American telehealth market will grow by 600 percent between 2012 and 2017. This would represent an increase from the current 227,000 telehealth patients to reach up to 1.3m patients in 2017. They think this is mostly related to the reimbursement changes in the US.

In Europe, telehealth adoption is expected to gather pace as more governments seek innovative ways to manage budgetary pressures, amidst ongoing economic difficulties. According to a report by Deloitte, ‘Primary Care: Working differently: telecare and telehealth – a game changer for health and social care’ estimated spending on telehealth in Europe is 170 m€ in 2010. This figure is expected to increase to 353 m€ in 2015.

The diagram below shows the market share of telehealth and telecare in Europe. It is interesting to see that the UK has the biggest market share.

Market share telehealth europe

Market share telehealth europe

Developing markets

The developing countries are really emerging. This is because these countries are masters of maximizing resources. Take a diabetes management telehealth program as example: while the project uses relatively basic technology (SMS), it’s expected to have a huge impact on patients. Applications include reminders about diet, well-being, medicines, appointments and getting their prescriptions filled. The project has its limitations, but it will have an impact and it’s obviously really simple and low-cost to develop. So what we learn of this is that it doesn’t have to be complex and it doesn’t have to be expensive.

Why telemedicine works

Jon Linkous, CEO of the American Telemedicine Association, gives a clear message about the most important driver of telehealth. ‘Number one – telemedicine saves lives.’ Beyond this, Linkous notes, ‘it facilitates independent lifestyles, keeps people in their own homes in their own communities, it improves the quality of their care and it makes it a lot more convenient for the patient.’

Garth Sutherland, the CEO of Nexus6 a private company that provides electronic remote monitoring devices for inhaled drug delivery, also sees a major role for telehealth in helping to boost adherence. As an example, for newly diagnosed patients, he notes that, ‘it’s very important to establish great adherence to therapy very quickly.’ To enable this, ‘it requires a real-time system because it’s important that patient behaviors are driven towards adherence on a very timely basis. Following hospital admission, adherence drops from between 75-95% on the day after discharge to less than 50% after 10 days.’ I suggest to implement a medication adherence support system!

Costs, the biggest problem

One of the most common objections to adopt telehealth is cost. A World Health Organization survey found that the perception of costs for telehealth being too high is the greatest barrier for increased adoption of programs. However, cost concerns are most important in developing nations, where initial funding challenges must be overcome. In western countries, the debate centers on the cost-effectiveness of telehealth programs.

Interoperability

Rick Kates, who is the CEO of Viterion TeleHealthcare, also champions the importance of effective data integration. Key is, he says, to ensure that physicians are not ‘overwhelmed’ with the information.’ This can be achieved by understanding that they ‘don’t need more information, just better information.’ Kates also notes that interoperability of telehealth systems is essential. ‘Healthcare professionals and payers don’t want to be looking at multiple user interfaces and have to worry about whether or not certain data is going to come across and how it’s going to come across.’

Author: Indy Kavelaars @ Vitaphone Netherlands

Source: Eyeforpharma

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Telemonitoring reduces the number of hospital days by 87 percent!

ECG Telecardiologie

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Research at the Scheper Hospital in Emmen, The Netherlands, shows that telemonitoring of chronic heart failure gives great improvements in several areas. The research took 2 years and included more than one hundred patients with an impaired cardiac pump function.

The care process for these patients was very differently planned through telemonitoring or remote care. The patients did daily monitoring of their weight, blood pressure and heart rate and sent these vital signs to the heart failure clinic. Through these daily monitoring, preventive and proactive actions were taken by the care professionals. This resulted in:

  • a decrease in the number of admissions per patient by 26 percent;
  • a decrease in the total number of admissions with 64 percent;
  • a reduced number of outpatient visits with 39 percent;
  • a lower average number of hospital days; a decline of 87 percent!

This is a conformation that telemedicine is effective. It also shows the possibilities of a different care model like remote care monitoring. The financial results will be published in an analysis next year. The portfolio of Vitaphone is even more extensive: we additionally offer tele-ECG monitoring. The ECG will directly be sent with or without a report to the treating physician. This means that the care professional already can act even when there are no actual symptoms or problems yet.

I like to close this blog with a quote from the cardiologist, Michiel Nagelsmit: “The deployment of e-health makes it possible for us to provide care to a larger number of patients with chronic heart failure in same available time.”

Author: Indy Kavelaars @ Vitaphone Netherlands

Source: Scheper Ziekenhuis

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When is telehealth useful?

We are overwhelmed with mHealth apps that can measure, uh, EVERYTHING; from weight to temperature, from ECG to blood glucose level. At Vitaphone, we think these developments are great. But are they groundbreaking? We don’t think so! The follow-up of these readings is essential and that’s what’s missing in mHealth apps. It is not just the presentation of data; it’s about the translation of this data to relevant information for the user. We understand the need to combine the data results, but this requires research and improved statistics.

“Researchers from the Nuffield Trust found no change in contact frequency between patients being remotely monitored and those receiving standard care.” This finding, published in Biomedcentral Health Services Research, flies in the face of the opinion that widespread use of telehealth technologies will increase demands on primary care. But simultaneously, it fails to lend support to claims that telehealth cuts GP workload. The study suggests that it might have a more significant role to play in secondary rather than primary care. The authors did note that telehealth might have a different effect on workload if the system were designed differently.

The reaction of Graeme Duncan, the Group Director of PharmaTimes World News, is the same as ours. “It is not surprising that the technology alone makes no demonstrable difference in the service utilization. However the appropriate use of technology in a well understood and researched patient pathway can make a huge difference.”

When we look at our services, they are tools for care professionals and patients to get the best treatment right from their own home. The ECG service ensures that patients can report directly to their cardiologist if they feel an arrhythmia. Our other ECG services can even report automatically on pre-defined parameters. Our medication adherence support services ensure that patients and caregivers do not forget the medication. This service is also a powerful tool for care professionals to interfere if an error is made. The medical management gets insight of the medication adherence in their organization.

These examples show additional value to the biomedical info; and that’s what brings true value to healthcare.

Author: Indy Kavelaars @ Vitaphone Netherlands
Source: Pharmatimes

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eBook: Telehealth monitoring

First I want to set something straight; telehealth/telemedicine comprises technologies that supports healthcare in a very wide range, and not only video conferencing as mentioned in this eBook.
Reimbursement—or lack thereof—remains one of the sticking points for providers that want to expand telemedicine services. B Chris Wasden, Global health innovation leader for PwC: “To make telehealth more successful and sustainable, it needs to mimic the prescription model. We’re seeing movement in this direction with health monitoring solutions, where a physician has been able to order the product, send the patient home and arrange for in-home training.”

In the Netherlands we see initiatives to get a “telepharmacie” compensation; the physician can order this type of support. But many physicians aren’t even aware of this.

Jon Linkous chief executive officer of the American Telemedicine Association states: “Sustainability starts with integrating the service into physician workflow and organization strategy”. Spread the word!

Quote FierceHealthIT

Quote FierceHealthIT

I also think, like Michael McConnel, it is necessary to move from a model which rewards delivering care to a model that rewards delivering care more efficiently and even get paid for keeping people healthy.

Author: Indy Kavelaars

Source: FierceHealthIT, eBook, Telehealth Monitoring: Creating Profitable, Sustainable Programs

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Does do-it-yourself blood pressure monitoring work?

Yes, it does work! Well there’s a “but” though, because it only works really well, when the patients’ doctor has an infrastructure to follow-up the readings. If there is no support by the doctor, taking the readings at home is much less beneficial. This is kind of obvious because if there is no action on the readings what is the point of taking them?

Speed-bumps are that doctors only get paid when a patient physically visits a doctor. Also the extra services and resources needed to act on the data aren’t always available too. But results like an improved systolic pressure by 3.4 points to 8.9 points after a year, compared with usual care, are very promising.

Many different indicators of diseases can be measured right from your own home. At Vitaphone we are going a step further; we are providing patients’ the tools to manage their own care. For example take a look at our Medication Adherence Support System; the PICO.

Source: The Wall Street Journal

Author: Indy Kavelaars

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Synchronous telehealth intervention reduces costs

A quasi-experimental clinical study in Taiwan has researched the cost-effectiveness of a synchronous telehealth service for seniors and non-seniors with cardiovascular diseases. Conclusion of the study is that synchronous telehealth intervention may reduce costs, decreases all-cause admission rates and decreases durations of all-cause hospital stays in cardiovascular disease patients, regardless of age. Our experiences tell us the same.

In the study, 3 components of telehealth services were provided. Firstly, real-time transmission of biometrics from the patients was sent to the health care team, including blood pressure, pulse rate, electrocardiography, oximetry, and glucometry. Glucometry was performed in patients with diabetes mellitus and those with impaired fasting glucose and impaired glucose tolerance. Nondiabetic patients did not have glucometry as a telemonitoring module. Each transmitted clinical biometric was recorded in health record clouds that were under synchronous surveillance by the Telehealth Center at NTUH. Second, there were telephone exchanges between the health care team and patients for communication and health promotion. Third, full-time case managers and cardiologists were in charge of care 24 hours a day. The telehealth services included health education, diet therapy, fluid status evaluation, drug adverse effects evaluation, drug compliance monitoring, mood or emotion care, and patient surveillance through the advanced information technology-based monitor system.

We are impressed by the integration of all telehealth components. Vitaphone is a full telehealth service provider and it is stimulating to see the results. Especially with cardiovascular diseases, because we are a leading partner in ECG monitoring. We expect to see telehealth be implemented not only for cardiovascular disease but also for people with other medical conditions. Care support at everyone’s fingertips for a more cost-effective healthcare!

Author: Indy Kavelaars

Source: JMIR

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Telehealth, relevant to everyone!

What is telehealth and what does it mean for the future? We stumbled upon a video of Dr. Malcolm Fisk which gives a very good explanation of the term ‘telehealth’. It also shows a very open and broad vision of telehealth with many opportunities. Watch the interview at Healthcare news or read the interview below.

“Telehealth is one aspect of the research done at the Age Research Centre, Coventry University. And here with me is the Co-director Dr. Malcolm Fisk. For people who don’t know, can you give me a definition of ‘telehealth’?”

The means by which people can access or the way that services are delivered through telephone, the internet or through communications technologies generally. Obviously we have seen a rapid development in the way that technologies are available to people and the role out of broadband has helped in this. So this means that we can start to think about services been delivered or accessed in this kind of ways and that the new technologies we use are very much part of this.

“So what would the typical things be that people would do at home using technology?”

Well if you are a younger person for instance with diabetes they might well enable you to send information to a healthcare practitioner. Or indeed gather information just for yourself and store it on a cloud or somewhere to help you manage your own health condition.

More important perhaps the larger number of older people with chronic conditions. Very often heart conditions or respiratory conditions, who use different devices to measure different vital signs on a daily basis usually, to send that information again to the healthcare practitioner. So then they can then advise them as to what they should do with the medication and things like this.

“What do you see as the implications of new technologies for telehealth services?”

Well there are very, very important implications here because of the way mobile technologies are developing. What it means is that whilst perhaps being guilty of thinking about telehealth too narrowly around vital signs monitoring. We can actually think of in terms of the relevance to all people of all ages in the way that they access and use news services. So it is not just a technology or a range of services that help people stay independent at home it is potentially helping people when they are travelling when they’re in work, when they’re going to college or school. Relevance to people of all ages.

“Now you are working on European code of practice on telehealth. Now do we need one and what is your opinion about it?”

Well we need one because telehealth is evolving so rapidly. We can see that the nature of telehealth services is changing rapidly as well. Possibly there may be a hundred-and-one different aspects of telehealth from medication compliance to helping care for someone with dementia all these things are in the mix. A code of practice will establish a benchmark quality standard to which we hope anyway to which telehealth services will reach across Europe and will provide the safe guards which are necessary in such an area of care and support.

“And what does telehealth mean for traditional health services?”

Well we can see changes will have come about because many more people will choose to use telehealth services themselves. And will, very often, be gathering information and data about their health conditions. Which they will take to their consultants or GP’s and they will clearly have to respond to these services and new technologies. Rather than the collisions being necessarily dictating the frameworks of health provision or support services that you may need.

Source: Naidex & Healthcare news

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