Tag Archives: Telemedicine

mHealth trends

In this digital era healthcare industry is changing towards a more mobile and efficient system: mHealth is the future. What are the ongoing trends in this industry? An article in the Beckers Hospital review gives a top 10. I would like to highlight some items:

“Mobile devices and apps are becoming an integral part of telemedicine. Telemedicine crosses the geographic expanse and connects providers to patients, even providers to other providers, to extend services to underserved areas. Many major telemedicine companies are offering telemedicine apps as a means for patients to connect and communicate with physicians remotely and on-the-go. It’s an increasingly popular service — 84 percent of young adults age 18 to 34 said they would prefer a consultation via a mobile device. While more hospitals and health systems are toying with telemedicine, the service is also coming under fire as the industry debates payment and reimbursement practices and what telehealth services should be used for.”

As a telemedicine company, we think further than only digital consultation. We understand that if patient, non-patient or care professional need support, that can be provided by technical solutions. Like support with medication treatment or monitoring heart rhythm after an operation.

The cost benefits of mHealth may be enormous. If a patient is tracking his or her symptoms and those symptoms are being wirelessly transmitted to a clinician in the hospital, that patient just saved a trip to the clinic and the hospital saved costs associated with treating that patient. With mHealth comes a more comprehensive, accessible and data-driven industry that helps utilize resources more efficiently and effectively.”

Vitaphone Netherlands daily collects thousands of vital signs and presents the results to healthcare professionals and sometimes patients too. Further investigation might translate all these efforts into a financial result.

Author: Indy Kavelaars

Source: Beckers Hospital Review

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Guest blog: vitaphone USA: Silencing the Silent Killer in 30 Days

Over thirty percent of the US population has hypertension, and fewer than half of those with hypertension have it under control. Many people never know they have high blood pressure, suitably dubbed “the silent killer.” Is it any wonder then that the prevalence and hospitalization rates of congestive heart failure (CHF) have continued to rise, when the majority of patients have hypertension, very likely uncontrolled, before developing CHF? How can we get ahead of the CHF curve? In a 30 day pilot, vitaphone’s patient engagement and mHealth solution empowered cardiologists and patients to drive the average systolic blood pressure down by 20 points in just four weeks, dropping it a total of 30 points by week five.

In the newly-published study 30 Days to Make a Difference, vitaphone shows how Los Angeles area physicians’ use of remote patient monitoring and patient engagement and education by a Telemedicine Service Center (TSC) greatly shortened the provider feedback interval, facilitated more precise medication therapy, and left patients feeling more confident in their ability to manage their conditions. vitaphone’s international expertise in using similar methodologies to reduce admissions for CHF patients was a powerful ally to physicians who wanted to see if it could also address a frequent precursor to CHF: hypertension.

Interested to engage, educate and monitor patients remotely? Pick up your copy of the peer-reviewed, Journal of Healthcare Information Management (JHIM) publication 30 Days to Make a Difference: Evaluating the 30-Day Effects of a Comprehensive Remote Patient Monitoring, Shortened Provider Feedback Interval, and Patient Engagement and Education Program on Hypertensive Patients in Orlando, Florida, February 24-27, at the HIMSS14 vitaphone health solutions kiosk, Qualcomm Life Pavilion, booth 6489. Or, contact us at 702-374-1270 / btritle@vitaphoneus.com HIMSS members can also access the mobile health JHIM edition digitally at http://tinyurl.com/ohp68sw

Author: Brad Tritle, vitaphone USA

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Telehealth saves anually $2,931 per COPD patient!

Research was conducted to determine if “self-monitoring via home-based telehealth equipment could, when combined with ongoing remote monitoring by a nurse, reduce the incidence of hospitalizations and emergency department (ED) presentations for people with chronic obstructive pulmonary disease (COPD).” The vital signs monitored were; blood pressure, weight, temperature, pulse, and oxygen saturation levels. These vital signs were automatically sent to the telehealth nurse by telephone. If recorded measurements were out of patient’s normal parameters, specified by their GP or specialist, it triggered an alert to the nurse and he or she would undertake action. Vitaphone supports this type of setup to manage chronic diseases. Especially because it results in cost savings as demonstrated in this report.

An important result is that the telehealth group visited the hospital 10 times less as the control group did; 26 visits in the control group versus 16 visits in the telehealth user group. This resulted in 77 less hospital stay days over 6 months; 162 hospital days in the control group vs. 85 hospital days in the telehealth group.

The participant satisfaction in this research was also great:

“Approximately half felt that the telehealth intervention had reduced the number of times they had been to the hospital. Participants commented that in the past they may have gone to the hospital because they were worried or anxious about breathing difficulties, but being able to take their own measurements reassured them that their measures were within normal limits.”

“Participants generally agreed that receiving telehealth monitoring had provided reassurance and peace of mind knowing that a nurse was monitoring their results daily. Participants described having more control over their condition and being more confident in self-managing their condition as they were now more conscious of what their body was doing.”

It is great to see these numbers and the satisfaction level proof, what we advertise… go telehealth, go!

Author: Indy Kavelaars @ Vitaphone Netherlands

Source: Telehealth Remote Monitoring for Community-Dwelling Older Adults with Chronic Obstructive Pulmonary Disease, by Kristen De San Miguel, BSc, Joanna Smith, BPsych, and Gill Lewin, BSc Hons, MSc, MPH, PhD, Published in Telemedicine and e-Health, September 2013

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Bondskanselier Merkel ziet kansen voor betere zorg door telemedicine

In een persbericht van 31 januari 2014 in de “Pressebox.de” wordt duidelijk dat de bondskanselier grote kansen ziet in het verbeteren van de gezondheidszorg door middel van telemedicine. In de beleidsverklaring van de derde regeringsperiode van Angela Merkel maakt ze duidelijk dat telemedicine in de toekomst een belangrijke bouwsteen wordt om de gezondheidszorg te ondersteunen en aan te vullen. Ze ziet vooral de mogelijkheden bij patiënten die afgelegen wonen. De bondskanselier zegt in de beleidsverklaring dat telegeneeskundige diensten een belangrijke rol zullen spelen binnen de continuïteit van de gezondheidszorg naar de toekomst.1 Vitaphone Nederland ziet telemedicine ook als een eenvoudige manier om de kwaliteit van de zorg te waarborgen en betaalbaar te houden.

Duitsland (4de op wereld ranglijst 2013-20142) heeft één van de meest competitieve economieën van de wereld. Wij doen het zelf ook niet slecht, 8ste plaats2, maar onze regering kan nog veel leren van deze vooruitstrevende inzichten van de bondskanselier.

 

Sources; 1 Pressebox
2 World Economic Forum

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A-ICU: A good telemedicine market?

US Ambulatory Intensive Caring Units (A-ICU) essentially brings the intensive care unit (ICU) out of the hospital and into a patient’s home by using dedicated care teams to deliver customized care, installing remote monitoring devices, performing in-home check-ups, and supplying other services as needed.

In a 2009 article for Health Affairs, Arnold Milstein, professor of medicine, and colleague Elizabeth Gilbertson held up four examples of “medical home runs” that improved patient outcomes while achieving 15 to 20 percent cost reduction compared to neighbouring peers. Each of the four programs focused on providing meaningful, preventive primary care for their sickest patients.

“Severely chronically ill patients are typically at high risk for costly ER visits and unplanned hospitalization” states dr. Arnold Milstein. To fight against these high and unexpected costs, in these programs, an A-ICU team conducted home inspections and interviews to map all threats in patients’ everyday lives. I think these programs excelled in the high level of individualized care. The provider team is free to be creative in response to the needs of plan members, who are seen as partners in managing their own care. This means though that sometimes care for a patient isn’t even medical, like support in medication adherence, it will be implemented in their daily routine because, well: the patient needed it. Where do we run into trouble: the insurance. Insurance companies need also to be flexible enough to accommodate innovative, preventive services that may include non-medical ones.

So will A-ICU be a good telemedicine market? No, I think it will be an excellent market to cut costs and improve patient outcomes.

 
Author: Indy Kavelaars @ Vitaphone Netherlands

Source: The Atlantic

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Full european support for eHealth!

Despite the economic crisis, the global telemedicine market grew from $9.8 billion in 2010 to $11.6 billion in 2011. The global mHealth market is even set to grow to €17.5 billion a year by 2017.

There is important support from the European Parliament for the eHealth Action Plan 2012-2020. Neelie Kroes, Vice President of the European Commission leading the digital agenda, said: “In particular, I welcome the Parliament’s insistence on the importance of interoperability of eHealth systems and the need for the Commission to take a leading role in establishing international standards and an EU eHealth Interoperability Framework.” We also think this should be top priority. It is very important that there is an interoperability standard for telemedicine because only with such a standard, all eHealth, mHealth, telemonitoring and telemedicine providers will and can work together to make care and cure more efficient. Some EU countries spend up to 15% of their budgets on healthcare; this percentage needs to go down. eHealth implementations can help to make that happen!

Source: eHealthNews

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INFOGRAPHIC: Factors related to adherence

It’s good to have a clear view of all factors that influence medication adherence! A qualitative review of 102 studies resulted in very comprehensive Infographic. Let us have a further look at the demographic factors:

  • Age: most of the studies (14) show an increased compliance, some (3) a decreased and some (4) show no effect on compliance at elderly patients. With middle-aged or young patients, all (7) examined studies show a decreased compliance!
  • Ethnicity
    • Caucasian: All (4) studies show an increased compliance
    • Minorities: All (10) examined studies show no effect on compliance
  • Gender: Most studies (11) show an increased compliance, some (4) a decreased compliance and some(6) show no effect at female patients
  • Education level: only 2 studies show an decreased adherence, a few more (4) show an increase but the most (6) show no effect
  • Marital status: five studies show an increased adherence and the same amount of studies show no effect on adherence on married status

Possible conclusion: although medication adherence support systems like to focus on the elderly, this doesn’t seem to be the most important target! It’s much more appropriate to look at other factors.

Infographic-Adherence-Factors

Infographic-Adherence-Factors

Author: Indy Kavelaars @ Vitaphone Netherlands
Source: PMC, US national library of medicine

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Why wait with telemonitoring?

Electronic Health Records(EHRs), care coördination and telemonitoring help to lower the rate of hospitalizations for diabetic patients. These technologies combined can lower the rate of hospitalizations by 26% within a three-year period showed research of Western New York Beacon Community Project.

“Out of those 57 practices, 50 percent reported that the overall percentage of uncontrolled diabetic patients was down 5 percent, and 25 percent of practices reported decreases of more than 10 percent in the number of uncontrolled diabetes cases.”1

This meant in 2012 three hospitalizations where prevented for every 100 diabetes patients this represents a saving of some $600 per diabetic patient, per year. So this rises us the question: “Why wait with telemonitoring?”.

Patient story

Kenneth Wilson was one of these patients. He had been living with uncontrolled diabetes for more than 10 years, so when he enrolled and had to log into the program each day and measure his weight, blood pressure and blood glucose levels, he eventually saw some big changes.

Before being enrolled, his A1C levels – a number measuring average glucose control – ranged from 8 to 9 percent. Since participating in the pilot, Wilson has reported average A1C levels of 6.8. Similarly, before the pilot Wilson’s morning blood sugar level ranged from 180 to 240 mg/dL. Now, the level stays typically around 109 mg/dL.

“The benefits were tremendous, “Wilson said in a video commending the program.” They’d call every day … saying, ‘I heard you had some kind of issue today. You got this going on, or you got this going on. What’s the story? What can we do to help you?’”1

I am amazed what these different measurements can mean for patients. What I actually like to see is how they show the results to the users of this project. Feedback in a correct way to the patients/users of the telemonitoring solution is very important. I like to get your opinion on “Why we should wait with telemonitoring?”.

Author: Indy Kavelaars @ Vitaphone Netherlands

Source: 1 http://www.govhealthit.com/news/ehrs-care-coordination-telemonitoring-help-rein-diabetes-complications

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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

Open de Nederlandse versie >

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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