Telecare, interoperability

It’s good to talk: making connected personal health possible

We are living longer and it shows. The greying population trend occurs in many countries and will almost certainly continue for the foreseeable future. As populations age the incidence and prevalence of chronic diseases will increase. For the first time ever, many countries are approaching the point where the number of people aged over 65 will exceed the number of people under 65.

Today, more than one billion people worldwide are overweight (1), more than 860 million have chronic diseases (2) and more than 600 million people are aged 60 or older — and this figure will almost double by 2025 to 1.2 billion. (3) This ageing population along with the growth in chronic conditions presents a profound economic strain on healthcare systems and has social consequences worldwide.

The care of people with chronic conditions is usually episodic and reactive and leads to heavy use of secondary care services. As a consequence, chronic conditions consume a large proportion of health and social care resources — in many countries an estimated 75-85% of the healthcare spend is on chronic disease management.

Continuum of care

So how do we rise to this challenge? In a nutshell, by shifting away from today’s reactive model of care (in an institutional setting) to one that enables an integrated approach which empowers individuals to proactively and continuously improve their health from where they live their life, while reducing the burden on the healthcare system.

For example, if you look at the cost of the delivery of healthcare along a scale, at one end you have the intensive care unit (ICU) — where the cost of care per day is quite high and the quality of life for that individual isn’t so great. At the other end of the scale, you have the delivery of healthcare to the home which is less costly and the quality of life for that individual is going to be much higher.

One type of personal health technology is remote patient monitoring (RPM). RPM helps a patient measure their own vital signs throughout the day and these readings can then be accessed by the hospital or an authorised healthcare professional (HCP). Using devices that collect data and communicate directly with HCPs helps provide early warning signs of problems and allows both the patient and HCP to manage the chronic disease better.

Companies around the world are recognising the need for ways to more proactively address ongoing healthcare needs through technology that connects people and information.

Connective interoperable technology

While many of the technologies that can radically improve healthcare already exist in some form, adoption within the healthcare arena is still slow. The reasons for this are many. One of the key barriers, however, is the cost involved with adoption and the lack of standards and interoperability.

To become a central component of the way we manage health, independently manufactured personal health and medical devices must be fully interoperable with each other and with other information sources so that their unique functions can interact to advance the entire system. Interoperability allows patients to use the best devices for their individual needs and provides immediate access to health information.

In order to address this issue and accelerate the healthcare technology transformation, in June 2006 a group of technology, medical device and health and fitness industry leaders came together with the aim of establishing an ecosystem/market of connected personal health and fitness products and services making it possible for patients, caregivers and healthcare providers to more proactively address ongoing health care needs. In its first year this group, called the Continua Health Alliance, has grown from 22 to 133 member companies.

In September 2007, the Alliance unveiled the key components of its first set of technical guidelines. The Version One standards will focus on addressing interoperability in vital-signs monitoring devices for managing chronic disease, sensors for aging independently and personal health devices for the fitness industry. Such devices include blood glucose tests, blood pressure monitors, pulse oximeters, motion sensors, and medication reminders.

This comprehensive set of guidelines will help improve the quality of care by empowering consumers and their healthcare providers to more simply share information through common communication channels such as telephones, mobile phones, PCs, TV set top boxes, as well as other dedicated health devices.

The first set of guidelines, due in early 2008, are based on proven connectivity standards (Bluetooth, USB) as well as established standards from the medical informatics industry (ISO/IEEE 11073, Health Level Seven (HL7)) and will help to increase assurance of interoperability between devices, enabling consumers to share information with caregivers and service providers more easily.

Manufacturers of products that meet these guidelines will be permitted to use the Continua Health Alliance certification logo on their products. The logo will clearly identify certified products, making it easy for purchasers to choose products that they know are going to ‘talk to each other’.

Interoperability is the key to healthcare technology harmonisation and to maximising positive health outcomes. Empowering individuals and their healthcare providers to share information more easily and help us care for ourselves and each other in a better way.

David Whitlinger is Director of Healthcare Standards at the Intel Corporation and President and Board Chairman, Continua Health Alliance.

More information

The Continua Health Alliance, visit www.continuaalliance.org/home

To learn more about what Intel is doing in healthcare, visit www.intel.com/healthcare

References

1. Information sheet: facts related to chronic diseases and the WHO global strategy on diet, physical activity and health. Last accessed in September 2007 at:
www.who.int/dietphysicalactivity/media/en/gsfs_general.pdf

2. World Health Organization, McKinsey.

3. World Health Organization. www.who.int/ageing/en/