The True Burden of Connected Health?

Wednesday, March 22, 2006  | Ravi Nemana


Much like the Cambrian Explosion that gave rise to modern biodiversity, there is an explosion of diversity in consumer devices underway today.  Devices such as iPods™, smart phones, laptops and PDAs promise the ability to personally adapt to the needs, wants, and capabilities of the people who use them.  With these diverse devices and through other, specialty medical devices, come the potential to deliver healthcare through the same channels as entertainment and communication.  However, there is a banal, nuanced and interesting question that we will have to answer in order for adoption to occur:  What will we carry?

A walk through a crowd will readily illustrate the problem: people's pockets, jackets, purses, and backpacks bulge and sag with the weight and heft of devices.  Each person today will leave their house with at least three or four things-- keys, cell phone, and purse/wallet, and possibly a music player.  Add to this the armament of many workers: the laptop and PDA.  Then add the accoutrements-- cables, couplers, chargers, and extra batteries (which is an issue of its own).  Now add specific tools for connected health-- the task-specific medical device such as a glucometer, spirometer, blood pressure cuff, or other device-- only some of which can be integrated well with existing devices (and then only with specific models).  One practically needs a bandoleer to hold all of the equipment.  The trend is so strong that the fashion and textile industries have begun to include extra pockets for devices and holes for cable access.

What does this mean for connected health?  Just this: we face a backlash from consumers (who are also patients) who balk at the volume of devices that they must carry.  While convergence is the long-term trend, the short and intermediate terms are crucial for adoption.  If the devices we conceive can't be made practical enough, convenient enough, unobtrusive enough, and/or "useful-enough-to-carry," then the promise of connected health can't be fulfilled.  Rather than a Cambrian Explosion, we may face a devolution.

The questions this implies are profound, and, interestingly, NOT technological:  Can medical functions be made modular to leverage (or consolidate) the platforms that exist today?  Can the profit motive that provides an incentive for device innovation be maintained while allowing for the standardized, modular additions for medical use?  Can devices be brought to market where medical functions can be added in standardized ways-- a "plug and play" (tm) for consumer medical devices?  Can a model for connected health be developed where "re-creation" or "re-programming" or other "re-work" can be minimized as models and device characteristics change?  In the end, what will we carry?

 

Member Comments


I believe that our relationship with our patients get stronger with all this new technology. The patient want to have a doctor as close as they need it, so this is our opportunity. But in some way the new technology will not ever displace the face to face contact.

Eduardo Arias

Dermatologist
Hospital CIMA

I like general dermatology and i practice MOHS surgery

 

Posted by: Eduardo Arias
3/23/2006

 

I believe that what is required for a mobile healthcare system to be successful is a security paradigm that creates a "circle of trust". An adaptive "content based" key for each member of what we call the 4PEG (four Ps an E and a G)Patients, Physicians, Payers, Providers, Employers and Government all seek Technology that will eliminate the friction in the flow of information, but only with the assurance that the source and audience is within a well defined circle of trust.

Ken Waldbillig

Director of Clinical Informatics
EMC

 

Posted by: Ken Waldbillig
3/28/2006

 

Consider the possibility that patients with a chronic disease, who have to use self-testing devices, might more willingly collaborate and participate in the management of their disease (e.g. disease management in diabetes) if their mobile phone also made data telemetry convenient. What if the data accumulated in insulin pumps and glucose meters - possibly HbA1c diagnostic testing devices - found their way to the patient's physician automatically? And what if this function made better care - intelligent intervention - and a nicer patient-physician relationship feasible?

Emery Stephans

President
Enterprise Analysis Corp.

Founder and president of a nineteen year old consulting company that serves clients in clinical medicine, life science, and IT and other technologies sold to those two sectors.

 

Posted by: Emery Stephans
3/28/2006

 

Emery's vision is right on. The hidden value of connected health technologies is that they inform patients of their health prompting better overall care plan adherence. It remains to be seen if the health care establishment can harness this concept and fully exploit it, but movements such as pay for performance and the medicare demonstration projects represent and encouraging start.

Joseph Kvedar

Director
Center for Connected Health

Joseph C. Kvedar, M.D., is the Founder and Director of the Center for Connected Health, applying communications technology and online resources to increase access and improve the delivery of quality medical services and patient care. Dr. Kvedar is also a board-certified dermatologist and Vice-Chair of Dermatology at Harvard Medical School. In his role with the Center for Connected Health, Dr. Kvedar launched the first physician-to-physician online consultation service in an academic setting. He is also leading important research into novel approaches for connected health in a variety of medical specialties, including post-operative care in the home, wound care, and remote monitoring of patients with chronic diseases. Dr. Kvedar is a past President and member of the governing Board of the American Telemedicine Association (ATA). Dr. Kvedar is also Chair of the American Academy of Dermatology (AAD) Task Force on Telemedicine. Dr. Kvedar is internationally recognized for his leadership and vision in the field of connected health and the application of communications technologies to improve healthcare to patients. Dr. Kvedar is co-editor of a new book, Home Telehealth, which was published in May 2006. He is a frequent lecturer and has authored over 60 publications on telemedicine and connected health. In 2003, Dr. Kvedar was honored by the New England Business and Technology Association for his extraordinary leadership in the field.

 

Posted by: Joseph Kvedar
3/28/2006

 

Two comments on this one...first, there are glucometers available integrated into phones, in use in Asia, with software to deliver results over the WAN to physician office systems for monitoring...however, both this approach and the fact that trying to get converged devices with too many components into them creates a nightmare for health systems and for manufactures, especially when you consider that the product life cycle of low end devices, the potential lag between generally available product and FDA certification, and the giant-killer of the need to sell millions of them to recoup the special engineering, will probably see lots of churn in this space. I have been involved with at least a dozen or more physician workstations, EMR PCs, health PCs, and bedside systems, over the years, and none met the volume test...other than those that were essentially standard product with software layerd on top.

It would appear that an alternative would be to consider which services are justifiably delivered and data collected at times when the individual is in the closest proximity for routine updates...which may, for some disease states be with fixed zigbee networks or something affordable and simple enough to survive years rather than product turns every 6 months. This is a tough call for care delivery as well as for manufacturers....

Jim Jones

Manager Healthcare Solutions
HP

 

Posted by: Jim Jones
3/28/2006

 

I am leading a special project that seeks to test the feasibility and value of equipping HC professionals with a single device which they use for ALL their IT and Comminications needs, that they carry everywhere and can use for anywhere, anytime, anything access. You can find some details about this here. Feedback on what you think of this cocept would be of great interest to the Committee overseeing this project.

Peter Haigh

HC Industry Mgr
Verizon

 

Posted by: Peter Haigh
3/30/2006

 

Peter: the concept is a good one - but is the infrastucture industry ready and further are the standards there to support it?

Joseph Kvedar

Director
Center for Connected Health

Joseph C. Kvedar, M.D., is the Founder and Director of the Center for Connected Health, applying communications technology and online resources to increase access and improve the delivery of quality medical services and patient care. Dr. Kvedar is also a board-certified dermatologist and Vice-Chair of Dermatology at Harvard Medical School. In his role with the Center for Connected Health, Dr. Kvedar launched the first physician-to-physician online consultation service in an academic setting. He is also leading important research into novel approaches for connected health in a variety of medical specialties, including post-operative care in the home, wound care, and remote monitoring of patients with chronic diseases. Dr. Kvedar is a past President and member of the governing Board of the American Telemedicine Association (ATA). Dr. Kvedar is also Chair of the American Academy of Dermatology (AAD) Task Force on Telemedicine. Dr. Kvedar is internationally recognized for his leadership and vision in the field of connected health and the application of communications technologies to improve healthcare to patients. Dr. Kvedar is co-editor of a new book, Home Telehealth, which was published in May 2006. He is a frequent lecturer and has authored over 60 publications on telemedicine and connected health. In 2003, Dr. Kvedar was honored by the New England Business and Technology Association for his extraordinary leadership in the field.

 

Posted by: Joseph Kvedar
4/1/2006

 

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