A Sigh of Relief for Patients with Chronic Diseases

A Sigh of Relief for Patients with

Chronic Diseases

© 2015, HCL Technologies. Reproduction Prohibited. This document is protected under Copyright by the Author, all rights reserved.

Table of Contents

Abstract

Abbreviations

Market Trends and Challenges

Solution

Case Study

Conclusion Conclusion

Reference

Author Info

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Table of Contents


Healthcare providers have always endeavored to provide the best care across all segments of the popu-lation. Several factors, such as the availability of resources, reachability, and service cost have made this goal quite difficult to accomplish. Healthcare systems are struggling to improve quality care in the face of chal-lenges such as the growing demands of chronic care patients, a lesser number of clinicians, and a system being required for the treatment of acute conditions.

According to WHO, chronic diseases are a major cause of premature deaths, accounting for 60% of all such deaths worldwide. Incidences of chronic disease are rising and huge costs are being incurred to provide healthcare to the affected. The least effective way to provide care for such patients is through hospitals, because of the risk of infection. Various studies have confirmed that care for chronic conditions is best deliv-ered at home, and delivering remote care can significantly reduce the chances of infection and hospital visit frequency.

WithWith the emergence of transmuting technologies, there are humongous opportunities for providers and patients to explore new methods, giving a new magnitude to healthcare. Remote Patient Health Monitoring is one such transmuting technology that is emerging in the healthcare market, which aims to improve the quality of care provided to patients with chronic health conditions. Such a system offers patient monitoring outside of the conventional clinical setting, and aims at increasing access to healthcare services while bringing down the delivery cost.

ConnectedConnected healthcare systems help health service providers’ access patient health data remotely to pre-scribe medicines or diagnostic tests without the patient actually being present at the hospital. This allows the patient to be monitored for physiological health parameters using medical devices that can capture and send these health parameters to the server. The data in the server is further securely processed as per the stan-dardized medical data format. The data can then be retrieved by healthcare service professionals for an accurate diagnosis to prescribe the right medicines to the patient.

This paper presents a solution for remote health monitoring. It commences with the definitions for a better understanding of the terms used, and then excavates into perceiving what technology-enabled care is.

Abstract

A Sigh of Relief for Patients with Chronic Diseases | 3


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EMR

PHR

PHI

HL7

Electronic Medical Record

Patient Health Record

Patient Health Index

Health Level 7

Full FormAcronyms

According to a study, more than 200 million people in the world suffer from one or more chronic diseases like diabetes, asthma, cardiac arrhythmia, sleep disorders, and hypertension. These conditions reduce both - the quality of life and expectancy, and also cause substantial costs.

AnAn increasingly ageing population burdens the healthcare system. In 2010, 207 million people worldwide were over the age of 75 years. This figure will reach 265 million by 2020. With the increase in the ageing popu-lation, a significantly higher burden will rest on the healthcare systems. There will be a need to achieve “value for money” within healthcare budgets. As the ageing population desires to continue living independently for as long as possible, there is a need for assisted living solutions.

The healthcare market is moving from a pay-for-service to a pay-for-outcomes model for care delivery, which is being driven by three major forces:

Patients with chronic illnesses want a better quality of life and prefer minimal hospital visits, thereby retaining their independence, preventing complications, and minimizing their healthcare costs.

Payers want to ensure lower insurance payouts by reducing hospitalization time and controlling hospital visits and admissions.

Care providers confront increasing cost pressures of the burden on the healthcare delivery system brought about by an increase in patient volumes.

Market Trends and Challenges

Abbreviations


Challenges in the existing solutions:

Most medical devices do not gather data in the standard format specified by the Continua Health Alliance High power consumption by existing medical devices poses a problem for the patient to move around, affecting their quality of life Problem in integration with existing EMR Not operating in a secure environment that protects data integrity and confidentiality Do not offer scalability to add newer devices to an existing remote patient monitoring solution

The solution comprises:

A Personal Health Device (PHD) – a wearable device that collects vital parameters of the patient. Comprises of various sensors that collect a patient’s physiological data such as ECG, SpO2, body temperature, heart rate, and blood pressure Has connectivity, to send the data to a cloud

The following solution is ideal to provide care at home for patients with chronic diseases. It involves a home-based monitoring system that integrates the patient’s vital data with the EMR, thereby enabling physi-cians to remotely monitor the health of the patient.

This solution aims at achieving a high level of patient engagement and care across the globe.

Figure : Solution Design



Solution

Cloud – provides cloud-based data storage and data analytics for effective decision making by healthcare management. The application hosted on the cloud provides interoperability and ensures the integration of patient data with present Medical Health Records by translating the received device data into IHE profiles Sends alerts, reminders, consultation, and monitors patient data via mobile and web application

The 4 C’s of the Solution

Figure : 4 C’s illustrated



Solution Features Portable, wearable device for hassle free movement Installation requires no patient intervention – just power on the device and use Always available, transmits data at any time of day Real-time access to the patient’s data for doctors – provides better clinical outcomes for patients outside the hospital Reduces re-admission risks by continuously monitoring the patient Threshold Monitoring - On reaching patient-specific thresh olds, sends an alert via SMS or email to the care giver / physi cian Flexible architecture with support for adding multiple sensors

Value Proposition

- Improved patient experience - Independence to effectively self-manage health - Reduced health service cost - Seamless plug-n-play operation - - Easy integration with EMR - Secure cloud data storage - Optimized use of healthcare service resources - Scalable solution

· Anytime anywhere availability of real time vital patient data · Easy to use solution · Easy integration of patient data with EMR

Cardinal · Helps in achieving the goal · Device records and transmits real time data to physician

Coordinator

· Timely treatment · Reduced hospital visit and duration of hospital stay · Improved quality of healthcare and reduced cost of delivering care

Completeness · Transform the way healthcare service is delivered · Personal care delivered within the comfort of the home · Optimized use of medical resources

Conclusion



Who will benefit from the Solution?

Patients Patients will benefit from low cost personal health monitoring at home. Improved quality of life Real-time support and interventions Extension of care at home after discharge from the hospital, thereby preventing emergencies and re-admissions Reduced hospital stays

Care Providers The device offers PHI, making it easy for caregivers to ascertain the health status of a patient in a blink Easy access to a patient’s health data Regardless of patient location, the device continuously monitors the patient’s health Reduced cost from readmissions and hospital stays

Healthcare Service Providers Able to serve an increasingly large number of people Reduce the chances of infection from chronic disease Optimized use of healthcare services and resources Patient data is integrated into the EMR

Insurance Payers Reduced cost of care

Provides dashboards to clinicians for health management and decision making Provides a patient portal to the care giver for access to health information and treatment plans Allows availability of healthcare services to more people at any given time, thereby optimizing the use of healthcare resources

If any of the vital parameter fall outside of a pre-specified normal range for Ms. XYZ, the alert is sent to her doctor and sonand son

Figure : Solution Deployment



Meet Ms. XYZ. She is 52 years old and has diabetes and cardiac arrhythmia. She is able to live safely at home, thanks to the proposed remote health monitoring solution that monitors her health without the need of frequent visits to the doctor.

Case Study

The data from the Personal Health Device signals her care team (clinicians and family members) when support is needed.

The Personal Health Device automatically uploads the vital readings via a secure wireless connection to XYZ's personal health record.

Ms. XYZ performs her daily chores, mentally assured that her Ms. XYZ performs her daily chores, mentally assured that her doctor is monitoring her condition. Based on the vital readings, a change in medication dosage is recommended and communi-cated back to her when needed.

Conclusion

Data Collection & Transmission The patient wears the PHD which collects his/her vital signs periodically, or as advised by the physician Data collected by the device is sent to the cloud over the Internet

Data Analysis The patient’s data is analyzed and transformed as per medical standards. The transformed data is then transmitted to the EMR system. Vital signs data is compared against a pre-specified reference range or threshold, to identify ‘out of normal’ range readings. Alerts and notifications are generated to the care giver and members of the clinical team, cautioning them of the abnormal readings. The clinician has access to the web-portal to review the patient’s information. The web-portal offers the functionality to make clinical notes, and modify the patient’s treatment plan. Once the treatment plan is updated, an alert is sent to the care-giver to view the updated plan on the patient’s portal.


Implementation Steps

The usefulness of use case varies based on the following key points:

There is a high degree of inconstancy in maintaining patient data. The proposed system is generally deployed in co-existence with legacy systems used to manage patient healthcare, and typically, very little integration exists. The type, frequency, and schedule of the information collected from the patient is highly dependent on the patient’s condition and other factors prevailing in the system. The data collected is transformed into standardized information by using machine computability and advanced analytics.

As the pervasiveness of chronic disease alarmingly rises, the strain on the world economy and healthcare system cannot be relieved without the creation of an innovative, cost-effective solution that involves patients proactively managing their healthcare.

The solution fulfils the needs of patients, care providers and payers, and effectively addresses the problem of delivering care for chronic conditions. It aims at transforming the healthcare market to become more accessi-ble, available, and affordable for all, and the healthcare service cost for both patients and the Government providing public health systems, can be significantly reduced.


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Harsha VachherHCL Engineering and R&D Services

Reference

Author Info

[1] http://en.wikipedia.org/wiki/Remote_patient_monitoring

[2] http://searchhealthit.techtarget.com/definition/remote-patient-monitoring-RPM

[3] http://www.preventice.com/mobilehealthsolutions/remotemonitoringsolutions/

The solution benefits patients, caregivers, and health service providers by offering:

Consistent and instant data availability Data security and confidentiality Wider support of medical health standards Easy to use features like real-time data display, PHI and feedback

TheThe solution makes patient care at home a reality by reducing the cost of service delivery and the insurance cost, while also improving the patient’s experience.


A Sigh of Relief for Patients with Chronic Diseases

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