Mature Market Experts: more mature market news and stats more often – Why healthcare information technology should matter to you (part 2) - In my last article I discussed the benefits that health information technology could offer in relation to home health and, in particular, the experiences I had with my father when he was alive. Continuing on that theme, I would like to take some examples from my experience and demonstrate how certain key innovations could have made management of chronic ailments much easier for my father and for the family in general.

One of the chronic ailments that my father suffered from was the wet (or neovascular) form of macular degeneration. Neovascular macular degeneration affects about 10% of those patients who suffer from macular degeneration in general[1]. While there currently is no means of stopping or reversing the effects of macular degeneration, certain therapies (laser photocoagulation) can stem the bleeding associated with the wet form of the disease.

The effects on my father were heartbreaking in many ways. In my father’s working life he was a writer and editor for a number of industries, including the New York Medical Society, Ford Truck Times Magazine, and he was an advertising executive back in the 60s at J. Walter Thompson advertising as well as having his own advertising agency in the 1950s. In summary, my father’s sight was key to his livelihood. This was a man who used to read the New York Times cover to cover almost daily. In the last 5 years of his life, as a result of this ailment and the stroke he eventually suffered, he was left sightless and unable to enjoy the one thing that truly gave him pleasure.

I’m certain that many of us have equally poignant stories. During the 5 year period of both chronic and continuing medical care my father required I spent a great deal of time running him from specialist to surgeon to primary care physician to therapy and back again. I recall very vividly having to run him into Philadelphia from his home in the suburbs—about a 60-70 minute drive—for the purpose of having his eye surgeon review his progress. I remember how stressful the situation used to be: it was a fairly major production getting him out of the house and driving him down and back as he required assistance due to limited mobility. Oftentimes the visits were merely checkups of no more than 5-10 minutes duration. It was at these times that I used to ponder whether having a remote video and picture taking capability could have accomplished precisely the same thing: if his surgeon had the ability to review a photo remotely, my father could sit in the comfort of his home and have a retinal camera that I or another care giver could use to take a picture of his retina which could then be transmitted and reviewed by the surgeon remotely. Then, the visit could have been accomplished through a telecommunication session, in which the surgeon could speak with him directly over the telephone while reviewing the image. This would provide context for the imagery as well as provide for a much less stressful environment for my father.

Recently, Healthcare IT News reported “remote monitoring not only saves unnecessary trips to the emergency department, but prevents readmissions to the hospital.”[2] Unfortunately, the same article reports “healthcare payers are resistant to providing reimbursement for remote patient monitoring.” A chief reason for this seems to be the fact that the payer-provider reimbursement model is not adequately structured to take advantage of the benefit.

It would seem to me that the use of the technology would reimburse itself. Ignoring the time spent in traveling to and from the surgeon’s office, consider the fact that the visit itself could be shortened and accommodated on a schedule that could make most effective and efficient use of both parties: patient and provider. For example, a virtual office visit could be held at any time during the day (not just during “normal” office hours) and could even be managed from the provider’s home office. Of course, key to this would be the availability of a patient record in which information could be securely uploaded (e.g.: retinal imagery). A personal health record could have served this purpose. Furthermore, the relaxed setting of the patient’s home would have enabled a much more relaxed environment for the patient.

While the scenario I have described is not unique, it serves to illustrate a broader need and provides a compelling motive for telehealth and telecommunication. By linking healthcare information technology with existing means for communicating over telephone lines it is possible to achieve ends that will ultimately benefit chronically and elderly patients. In the next installment, I will address the benefits for other diseases, including stroke and glucose, and how the case for healthcare information technology has real benefits for the home-bound or chronically ill patient.

[2] Bernie Monegain, “Remote patient monitoring improves outcomes for chronically ill, study shows.” Healthcare IT News. March 24^th, 2009.