Mobile phone ‘nurses’ track health of patients

“Mobile phones are being used to track the health of patients under a new scheme that could improve the lives of thousands of chronically ill Britons.”
Article
Matthew Moore, The Telegraph, 20 November 2008

Indiana health data exchange offers ‘practical tool’ for chronic disease care

“The Indiana Health Information Exchange has launched a chronic disease management program called Quality Health First, aimed at helping physicians and patients achieve better health outcomes.
The program is designed to simplify how physicians and quality managers gather and organize clinical data.”
Article
Bernie Monegain, Healthcare IT News, 19 November 2008

Cleveland Clinic & HealthVault Unite

“In an interesting twist, Cleveland Clinic and Microsoft’s HealthVault Grp announced a partnership this morning to address chronic disease management. The interesting twist is that Cleveland Clinic was the showcase beta customer for Google Health, which was announced by Google’s CEO Eric Schmidt earlier this year at HIMSS. Like their counterpart in Boston, Beth Israel Deaconess Medical Center, who was part of the initial Google Health public roll-out in May and who has since also established a link to HealthVault for their PatientSite users, Cleveland Clinic is taking an agnostic approach to the major platform plays with this agreement.”
Article
John Moore, Chilmark Research, 10 November 2008

Telemedicine for the benefit of patients, healthcare systems and society

“Telemedicine - the provision of healthcare services at a distance - can help improve the lives of European citizens, both patients and health professionals, while tackling the challenges to healthcare systems.
European citizens are getting older and are increasingly living with chronic diseases. Their health condition often requires enhanced medical attention. Medical support may not be available in remote areas and for certain specialities as easily or as frequently as their health condition would require.
Telemedicine can improve access to specialised care in areas suffering from a shortage of expertise, or in areas where access to healthcare is difficult. Telemonitoring can improve the quality of life of chronically ill patients and reduce hospital stays. Services such as teleradiology and teleconsultation can help to shorten waiting lists, optimise the use of resources and enable productivity gains.
The benefits go beyond improving patient care and healthcare system efficiency. Telemedicine can also make a significant contribution to the EU economy. This sector, where European industry - including thousands of small and medium-sized enterprises (SMEs) - is well placed, has been expanding rapidly in the past decade and is expected to continue to grow at a fast pace.
Despite the potential of telemedicine, its benefits and the technical maturity of the applications, the use of telemedicine services is still limited, and the market remains highly fragmented. Although Member States have expressed their commitment to wider deployment of telemedicine, most telemedicine initiatives are no more than one-off, small-scale projects that are not integrated into healthcare systems.”
Communication
The Commission to the European Parliament, the Council, the European Economic and Social Committee and the Committee of the Regions, 4 November 2008

Intel introduces new technology aimed at new approach to care

“Intel has rolled out its first in a series of health monitoring devices aimed at tracking chronic and age-related conditions. The new technology, which connects patients and physicians, gives the company a foothold in what is considered a new category of personal health systems.”
Article
Bernie Monegain, Healthcare IT News, 10 November 2008

Patients’ prospectus launched on NHS Choices

“The Department of Health has launched its patients’ prospectus on NHS Choices.
The prospectus, promised in a speech by Prime Minister Gordon Brown in January, aims to offer the 15 million people in England living with a long term condition access to a choice of ‘active patient’ or ‘care at home’ options.”
Article
e-Health Insider, 10 November 2008

Your Health, Your Way

Barriers and Drivers of Health Information Technology Use for the Elderly, Chronically Ill, and Underserved

“Objectives: We reviewed the evidence on the barriers and drivers to the use of interactive consumer health information technology (IT) by specific populations, namely the elderly, those with chronic conditions or disabilities, and the underserved.
Data Sources: We searched MEDLINE®, CINHAHL®, PsycINFO®, the Cochrane Controlled Trials Register and Database of Systematic Reviews, ERIC, and the American Association of Retired Persons (AARP) AgeLine® databases. We focused on literature 1990 to present.
Methods: We included studies of all designs that described the direct use of interactive consumer health IT by at least one of the populations of interest. We then assessed the quality and abstracted and summarized data from these studies with regard to the level of use, the usefulness and usability, the barriers and drivers of use, and the effectiveness of the interactive consumer health IT applications.
Results: We identified and reviewed 563 full-text articles and included 129 articles for abstraction. Few of the studies were specifically designed to compare the elderly, chronically ill, or underserved with the general population. We did find that several types of interactive consumer health IT were usable and effective in multiple settings and with all of our populations of interest. Of the studies that reported the impact of interactive consumer health IT on health outcomes, a consistent finding of our review was that these systems tended to have a positive effect when they provided a complete feedback loop that included (a) monitoring of current patient status, (b) interpretation of this data in light of established, often individualized, treatment goals, (c) adjustment of the management plan as needed, (d) communication back to the patient with tailored recommendations or advice, and (e) repetition of this cycle at appropriate intervals.
Systems that provided only one or a subset of these functions were less consistently effective. The barriers and drivers to use were most often reported as secondary outcomes. Many studies were hampered by usability problems and unreliable technology, primarily due to the research being performed on early stage system prototypes. However, the most common factor influencing the successful use of the interactive technology by these specific populations was that the consumers’ perceived a benefit from using the system. Convenience was an important factor. It was critical that data entry not be cumbersome and that the intervention fit into the user’s daily routine. Usage was more successful if the intervention could be delivered on technology consumers used every day for other purposes. Finally, rapid and frequent interactions from a clinician improved use and user satisfaction.
Conclusions: The systems described in the studies we examined depended on the active engagement of consumers and patients and the involvement of health professionals, supported by the specific technology interventions. Questions remain as to (a) the optimal frequency of use of the system by the patient, which is likely to be condition-specific; (b) the optimal frequency of use or degree of involvement by health professionals; and (c) whether the success depends on repeated modification of the patient’s treatment regimen or simply ongoing assistance with applying a static treatment plan. However, it is clear that the consumer’s perception of benefit, convenience, and integration into daily activities will serve to facilitate the successful use of the interactive technologies for the elderly, chronically ill, and underserved.”
Report
AHRQ, November 2008

Telemedicine: Commission adopts plans to help doctors and patients access healthcare from a distance

“Today, the European Commission adopted a Communication to support and improve access to telemedicine for EU citizens and healthcare professionals across Europe. In response to a call for action from Member States, this initiative aims to increase and broaden telemedicine services, including diagnosis, treatment and monitoring at a distance across Europe. Such services will allow, for example, a patient suffering from a rare retinal disease to be diagnosed in his hometown by a specialist working at a European Centre of Excellence for eye diseases located thousands of kilometres away. Patients with chronic heart failure will be able to have their disease more closely monitored and to enjoy better quality of life while staying at home. The European Commission proposes 10 actions to address the related challenges in the years to come.”
Article
HealthTechWire, 4 November 2008

Telehealth age dawning

“Well, it is according to this article in the EE Times. Actually it’s a useful canter over the telehealth countryside with an emphasis on what’s ahead. It puts the forthcoming Continua Alliance initial guidelines into context as a significant event.”
Article
Telecare Aware, 3 November 2008

Remote Health Monitoring: Using Communications Technology to Deliver Health Care Services

“Last week, the Better Health Care Together coalition held a briefing at the National Press Club to unveil a new study written by economist Dr. Robert Litan.
The study, entitled Vital Signs Via Broadband: Remote Health Monitoring Transmits Savings, Enhances Lives, found that the United States could cut $197 billion from its health care bill over the next 25 years by the widespread use of remote monitoring to track the vital signs of patients with chronic diseases such as congestive heart failure and diabetes.”
Article
Robin Strongin, Disruptive Women in Healthcare, 31 October 2008

Report: Patient-monitoring tech could save $200B in health costs by 2033

“Remotely monitoring patients with chronic diseases could cut nearly $200 billion from the country’s health care costs in the next 25 years, according to a new study by economist Robert Litan.”
Article
Nancy Ferris, Government Health IT, 24 October 2008

Group launches online Zip code atlas of population health

“A public health organization will launch an online database this fall that could help forecast the demand for health care services in specific locations for chronic conditions including diabetes, obesity, and HIV.
The National Minority Quality Forum has created the “Zip Code Analysis Project” to collect data on disease activity among both general and minority populations by postal code.”
Article
Kathryn Foxhall, Government Health IT, 18 September 2008

Visiting nurses to use telehealth program

“The Visiting Nurse Association of Greater Philadelphia will be monitoring patients in Montgomery County through a telehealth program.
The association will provide a personalized telehealth service in Montgomery County, a suburban county northwest of Philadelphia, for patients with chronic heart failure and chronic obstructive pulmonary disease.”
Article
Molly Merrill, Healthcare IT News, 18 September 2008

Hybrid Telemedicine Program Connects Rural Providers, Part 1

“Louisiana last year showed a slight improvement in terms of overall health: Its ranking among the 50 states by the United Health Foundation crept to 49th place from 50th. With 21 percent of Louisiana residents uninsured and 32 percent residing in medically underserved rural communities, the state faces undeniable challenges in providing access to quality health care.”
Article
Jamie Welch, Andrew Hurd, HHNMostWired, 10 September 2008

FDA OKs Intel Telemedicine Device

“The chip maker will work with a yet-to-be-announced manufacturer to produce an Intel-branded computer with a touch-screen for use in the homes of patients, especially those with chronic illnesses, says Ray Askew, Intel’s chronic disease management market segment manager. The small devices, measuring 11 inches by 3.5 inches by 10.5 inches, will include a camera for video conferencing between patients in their homes and clinicians. The devices also will have storage capability so that patients can enter data when Internet access is interrupted, Askew says.”
Article
Health Data Management, 1 September 2008

NHS Choices publishes long term conditions guides

“A series of online NHS health guides for people with long term conditions has been launched on the NHS Choices website. The guides take patients from symptoms to diagnosis to living with and self-managing their condition.”
Article
e-Health Insider, 14 July 2008

Intel gets FDA OK for personal health system

“Intel Corp, the world’s biggest computer chip maker, said on Thursday it won clearance from the U.S. Food and Drug Administration to sell a personal in-home health monitoring system for patients with chronic conditions.
The system, called Health Guide, combines an in-home patient device as well as online access that enables healthcare professionals to monitor patients and remotely manage care.”
Article
Reuters UK, 10 July 2008

The deployment of integrated care services for chronic patients (NEXES project)

“Abstract: The societal adaptations required for reducing the burden of chronic disorders and ageing have been recently framed by the WHO initiative on Innovative Care for Chronic Conditions. With this scenario in place, a successful deployment of innovative integrated care services to support healthier and independent living for chronic patients and elderly has emerged as an urgent unmet need. The NEXES project aims at undertaking the deployment of four integrated care programs addressing various aspects of chronic disorders selected because of promising outcomes generated by previous small-scale randomized controlled trials:

• Wellness-rehabilitation: Early diagnosis, promotion of healthy life-styles and patient self-management. Physical activity and cognitive aspects being main components
• Enhanced Care Support of unplanned hospitalizations
• Home hospitalization of patients with exacerbations
• Support: Transient remote support to diagnosis and/or treatment

The project focuses on the main factors modulating the success of an integrated care approach in delivering the services, namely: a) the co-morbidity challenge; b) articulation of healthcare and community services; c) organizational and educational issues; d) modularity, scalability and interoperability of the ICT platform, and, e) identification of business models ensuring service sustainability. Accordingly, the validation strategy prioritises the discovery of evidence supporting the extensive use of the services, applicable at the level of policy decision makers.
Technologically, the Linkcare platform (Linkcare eTEN 517435) sets the reference architecture. Modularity, flexibility and scalability are based on Service Oriented Architectures (SOA) using the IBM UML 2.0 Profile for Software Services. Briefly, the platform consist of a web-based application addressed to management of chronic patients and elderly, facilitating organizational interoperability following a distributed model. The following services are available at the moment: a) Health portal, b) Call centre service, c) Professional mobile access, d) Patient wireless monitoring service, e) Collaborative work service, f) Security modules, and g) Interoperability module with hospital information systems and shared electronic patient records. In the future, it will incorporate knowledge management applications and it is foreseen its evolution towards an IMS platform.”

Bárbara Vallespín, David Fonollosa, Albert Alonso, Josep Roca
Hospital Clinic de Barcelona. Villarroel, 170, 08036 Barcelona, Spain

To be presented at the ICMCC Event

Electronic Medical Record–Facilitated Care Process Redesign Enhances Access to Care, Reduces Hospitalizations and Costs for Patients With Chronic Illnesses

“Health care organizations that have information systems, including EMRs, often fail to take advantage of their capabilities, as they are not adequately integrated into care management processes and workflow. This problem is particularly significant for physician practices, which often do not take full advantage of such systems even when they have spent significant sums of money to purchase them.For example, a National Center for Health Statistics study found that, while 25 percent of office-based physicians reported using EMRs in 2005, an evaluation of the actual functions used suggests that only 10 percent are using the electronic systems in a meaningful way.”
Article
AHRQ, 12 May 2008

E-health anchors R.I. hospital project

“Memorial Hospital of Rhode Island has completed the first phase of Project Anchor, an initiative that tests an e-health enabled patient-centered medical home model of providing patient care.”
Article
Bernie Monegain, Healthcare IT News, 9 May 2008

People with chronic illness benefit from telehealth intervention

“Telehealth, using telecommunication technology to deliver health care, is increasingly being used to improve the delivery and availability of health care services to patients. A University of Missouri researcher found that patients who received a telehealth intervention from care providers had significantly delayed hospital readmission rates when compared to patients who received traditional care.”
Article
Science Centric, 8 May 2008

“Smart Forms” in an Electronic Medical Record: Documentation-Based Clinical Decision Support to Improve Disease Management

Abstract:
Clinical decision support systems (CDSS) integrated within Electronic Medical Records (EMR) hold the promise of improving healthcare quality. To date the effectiveness of CDSS has been less than expected, especially concerning the ambulatory management of chronic diseases. This is due in part because clinicians do not use CDSS fully. Barriers to clinicians’ use of CDSS have included lack of integration into workflow, software usability issues, and relevance of the content to the patient at hand. At Partners HealthCare, we are developing “Smart Forms” to facilitate documentation-based clinical decision support. Rather than being interruptive in nature, the Smart Form enables writing a multi-problem visit note while capturing coded information and providing sophisticated decision support in the form of tailored recommendations for care. The current version of the Smart Form is designed around two chronic diseases: coronary artery disease and diabetes mellitus. The Smart Form has potential to improve the care of patients with both acute and chronic conditions.
Abstract
Jeffrey L. Schnipper, Jeffrey A. Linder, Matvey B. Palchuk, Jonathan S. Einbinder, Qi Li, Anatoly Postilnik, and Blackford Middleton, Journal of the American Medical Informatics Association, April 24, 2008 as JAMIA PrePrint; doi:10.1197/jamia.M2501