Spotlight on Electronic Medical Records March 9, 2010
Featured Article
Make health management portable and affordable

Alex Brisbourne

One of the biggest challenges facing the healthcare industry is finding new ways to drive down costs while improving patient outcomes. One proven cost-cutter is the use of in-home monitoring devices to reduce the length of hospital stays. These devices, which monitor everything from patient blood pressure to sleep apnea and heart conditions, enable nurses and doctors to remotely watch patients at home, rather than at the hospital.

In-home monitoring has become quite popular. There is a fly in the ointment, however.

Nearly one in every six homes in the United States has discontinued landline phones in favor of cell phones, and the trend is growing rapidly. Since most in-home devices rely on a traditional land line to transmit critical data back to nurses and doctors, this presents a major stumbling block to the healthcare industry. Broadband is not typically a viable option, relying too much on complex in-home connections or multiple Internet-service provider support challenges.

Advancements in wireless machine-to-machine (M2M) communications have made are allowing industries to cost effectively transmit critical data via high-speed - and increasingly global - wireless networks.

Wireless M2M is emerging as a major player in home healthcare monitoring. A Parks Associates report predicts the wireless home health market will grow from $300 million in 2009 to $4.4 billion in 2013.

With healthcare monitoring devices no longer tied to the home, patients can lead more active lives while still having their medical diagnostics reported back to a doctor through wireless connectivity. Healthcare facilities specializing in Alzheimer's or autism treatment can employ wireless, wearable sensors to locate patients who wander beyond the boundaries of the physical facility.

Wireless M2M will impact healthcare-delivery applications, as well. Ambulance emergency medical technicians on the way to an emergency room can use wireless devices to deliver critical, life-saving information to the hospital before the patient arrives.

Nurses with GPS-enabled laptops can meet with patients in the field and send data back to a central database. The GPS will also allow the hospital or clinic to track their location, determine how much time was spent there, and implement changes to make these visits more productive and less costly.

Healthcare IT professionals may play a leading role in the deployment of wireless solutions. What questions should they ask when vendors begin knocking on their door offering a new wireless device and/or service?

Ask which wireless network they employ and whether there is a choice regarding network access. This is critical, since many telehealth solution providers are turning to mobile virtual network operators (MVNOs) that specialize in M2M communications, providing access to major carriers from a single platform.

By delivering a platform that includes major wireless carriers, an MVNO reduces potential coverage or connectivity issues. The vendor (and end-user) receives seamless code division multiple access or global system for mobile communications access on a single platform - one that is capable of serving a global customer base through specialized, cross-border arrangements. A patient should be able to travel without being concerned about coverage holes or domestic roaming challenges.

Then ask about the data-service options. A smartphone or data card agreement typically requires a one- or two-year contract with a fixed monthly fee. That will not work for a monitoring device, which consumes only a fraction of data. A vendor should allow paying only for the data the device actually consumes. This should keep monthly service fees to a minimum.

Next, ask about security. Will the patient data be sent over the Internet, or will it be delivered via a private, carrier-grade network, directly to the application? Most vendors should offer a virtual private network (VPN) connection with redundancy and automatic failover.

Finally, check on reliability. Are there highly reliable connections built into the network? Is knowledgeable service staff available around the clock if needed?

Monitoring devices typically do not deliver personally identifiable information. To comply with HIPAA privacy regulations, most identify the patient's data via the device I.D. number. Some patients, however, will still have security concerns, and having a VPN connection should ease their concerns.

Organizations should have the ability to self-activate or deactivate the device on an as-needed basis. The vendor should provide a Web-based self-management service portal that allows the activation/deactivation of devices, but also can check their status, including up-to-the minute network usage information.

Finally, most hospitals or clinics already have Blackberry, PDA and/or laptop wireless plans in place. Why not simply add these purpose-built telehealth devices onto an existing carrier agreement and manage the program in house? Because no single carrier can provide the coverage and technology choice of a multicarrier M2M platform, there could be reliability issues, which is critical considering the type of information being transmitted.

Requiring the vendor to deliver a turnkey solution - hardware, software and wireless service - means every problem is the vendor's problem. Most will configure and test each device before shipping it to the field, and then back it up with experienced service technicians who specialize in quickly resolving end-user issues.

The benefits of M2M are the same: enhanced mobility and tracking; reliable coverage 24/7; affordable data plans; secure VPN connections; and the ability to self-manage each and every device.

About the author

Alex Brisbourne is president and COO of KORE Telematics. For more information on KORE Telematics solutions, click here.

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