Bringing care home

Advances in technology and medicine are enabling people to live longer and lead healthier lives. These developments have broad social and economic implications, raising issues ranging from the increasing pensions burden, to care of the elderly, and treatment of chronic illness. According to the 2002 World Health Report, chronic disease accounts for 85 per cent of the deaths and 70 per cent of healthcare costs in Europe.

Patients’ needs
For healthcare providers, the challenges are many – to provide the highest quality of healthcare to a growing number of patients, while managing costs. In response, the healthcare industry is placing the patient at the heart of the healthcare system, designing services around the needs of the individual and empowering them to take health management into their own hands.
Innovation in technology has provided the tools to enable more proactive personal healthcare, but these are not nearly as commonly being applied as needed to radically improve health and quality of life and eliminate unnecessary costs from the healthcare system.
One of the barriers the industry struggles with is interoperability – the ability of technology to communicate not just with consumers but also with each other. To become a central component of the way we manage health, innovative personal health and medical technologies must be seamlessly interoperable with each other and with other information sources.

The future of the healthcare consumer
There are a number of driving forces that are currently creating change in healthcare. Cost and quality coupled with the growing size of the aging population are fundamental issues and will certainly determine how healthcare is managed in the future. Chronic disease is on the rise and could reach epidemic proportions in the coming years. This alone is impacting our healthcare systems dramatically, as these systems bear the economic burden of caring for the aging population.
In the future, retirees will be empowered, technologically savvy healthcare consumers playing an active role in the management of their own healthcare. They will increasingly want and expect their doctor’s care at home and on the go. These societal trends are already leading to the ‘consumerisation’ of healthcare, in which individuals take responsibility for their own health management and where quality of healthcare is associated with personal choice.
Driving consensus for healthcare technology in the home

The Continua Healthcare Alliance is a groundbreaking non-profit alliance that brings together a group of leading health, wellness and assistive technology companies. Formed in June 2006 by 22 companies, the alliance now has more than 100 members.
Awareness and participation has become increasingly global, with a broad range of members from across North America, Europe and Asia. The alliance is dedicated to bringing technology vendors, healthcare organisations, and other wellness service providers together to combine products and services through connectivity standards and provide millions of people with the tools they need to better manage their health and the health of their families.

By establishing interoperable products and services, the alliance seeks to enable patients and healthcare providers to proactively address long-term healthcare needs. The alliance could have a significant impact on healthcare providers’ ability to deliver long-term goals for the care of those with chronic conditions, improving patient quality of life, helping to reduce unnecessary acute hospital use and enabling more efficient use of resources.
The primary aim is to empower people with the information they need to better manage their health and the health of their loved ones. To accomplish this, efforts must go beyond standardisation. The alliance is working with regulatory agencies and reimbursement bodies to prepare the global marketplace for interoperable personal health solutions, as well as developing guidelines that help companies build interoperable devices and technology.

Working to improve the quality of the UK’s health services
In the UK, the Department of Health is working with the Continua Health Alliance, utilising its expertise in a committed drive to create open standards and improve the way in which various telehealth technologies work together. The two parties are dedicated to exploring new care models to improve the quality of health services provided to those with chronic conditions and those that require frequent medical intervention such as the aging population.
Developed countries throughout Europe, as well as in the US and Asia, are experiencing similar issues in trying to address both the rising costs of healthcare and the need for solutions that promote independence for an aging society. Working with the Continua Healthcare Alliance, the UK Government is helping to lead the development of telehealth technologies that are gaining traction across many areas within the EU and beyond.

Defining the role of remote healthcare technology
In order to foster the development of solutions that meet the needs of patients and healthcare providers, one of the alliance’s first tasks has been to develop a core set of user scenarios. These ‘use cases’ lay out real-life situations where remote healthcare technologies can play a key role in the provision of healthcare services, as well as helping individuals to maintain their health throughout life.
The alliance has finalised the initial set of use cases, with additional features now undergoing feasibility analysis by the technical working group. The use cases fall into three major categories:

1. Elderly Monitoring – To remotely collect and monitor information about an elderly person’s status in their personal or home setting, and provide those data to care givers. These systems will record changes in health status, which enables tracking of the elder for their own safety and long-term well being, thus giving peace of mind to both elders and their care givers.
For example, Mary is an 83-year-old woman living alone; her family is concerned because she is recovering from a fall and they fear she may be developing dementia. Sensors are installed in Mary’s home and detect information about her daily activities, status and safety. This information is sent to Mary’s central health appliance, which then transmits information to a monitoring service, where it may send messages or alerts about Mary’s wellbeing, safety and location to care givers or family members.

2. Chronic Disease Management – To remotely collect biometric and other health-related data about chronically ill patients and share the information with their caregivers. These systems will work in the home, at work or on the move for non-emergency management of chronic conditions, enabling patients, with their families, to better manage their health, while staying connected to a remote care team who can monitor their condition and react as required.
For example, Harold is a 65-year-old patient with heart failure, diabetes and hypertension, enrolled in a remote monitoring program. He takes daily vital signs with home measurement devices, including his weight, blood pressure and glucose levels. These devices upload Harold’s data to a remote patient management service,
which stores this data and make it available to authorised users in Harold’s care community.

3. Fitness – To collect and share health and fitness information to increase motivation through external encouragement and accountability from friends and trainers, as well as the ability to track actual progress and results over time.
For example, Joe is a 45-year-old father of three. He can put on an exercise monitor and track his progress and record his biometric data during a run outdoors, then continue tracking his workout on an exercise bike at home or in his gym.
All of the information can be uploaded to his computer and is also sent to Joe’s online fitness service, so his personal trainer can monitor Joe’s progress and optimise his fitness regimen.

Extending home healthcare with interactive TV
A founding member of the Continua Health- care Alliance, Philips has nearly 10 years of experience with home telemonitoring. In 2006 the company introduced Philips Motiva, a groundbreaking solution that uses the common household television to deliver a personal health channel.
Motiva goes beyond the monitoring of vital signs to provide highly interactive and individualised content that engages patients in their own healthcare every day.
This gives nurses a familiar, friendly way to educate, motivate and communicate with patients, and ultimately provide them with the ability to influence long-term behaviour change.
For patients, Motiva’s ease of use brings to bear Philips’ many years of understanding consumers and their needs. Patients need only operate a few buttons on a Motiva remote control to access and use personalised messages, reminders, health tips and to view their health status.
On demand, patients can view multimedia content that’s tailored for their health conditions and personal interests. Interactive quizzes and games can test comprehension and compliance, and provide feedback to care givers.
With ease of use a major factor in engaging older people to comply, usability feedback gathered in early Motiva pilots has been encouraging. Patients in New Jersey reported feeling a closer connection to their caregivers. Initial responses were also positive in the Netherlands, where leading Dutch insurer, Achmea, is conducting a trial with several hundred heart failure patients in their ‘HartMotief’ study.

Empowering consumers to make smarter healthcare decisions
Busy lifestyles that leave little time or motivation for fitness and weight management; a rise in chronic diseases; an aging population that requires escalating levels of supervision and medical intervention – these are the lifestyle, health and demographic trends that are directly contributing to skyrocketing healthcare costs.
By creating a rich ecosystem of interoperable health and fitness devices, individuals and patients will be empowered to better manage their health, providing them with information regarding their fitness and health through personal medical devices and services. It will also enable loved ones and professional care givers to more accurately monitor and coach chronic disease patients and elderly individuals living independently.
At the Continua Healthcare Alliance our aim is to lay out an evolutionary, common-sense path towards this goal.

For more information

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