Post CES reflection on role of technology and Alzheimer's.
Boston, mid-May, 2016
Everybody's doing it - reproving benefits of telehealth. When you put these together, you have to ask why. What is the reason that large organizations don't cite previous studies rather than spend money to prove the same point? We're not talking about drug trials here, we are talking about telehealth monitoring, a technology that has been around for a decade at least, that has been studied and deployed, but not uniformly reimbursed (which is the real problem here). So it's 2010, and GE Healthcare, Intel and Mayo Clinic are launching a year-long study of a 'new' model of healthcare delivery, intent on "determining if home monitoring of patients with chronic disease will reduce hospitalization and emergency room visits." In this study, 200 high-risk Mayo Clinic patients will be monitored for vital sign changes (presumably using Intel Health Guide and some video conferencing) and will be evaluated in comparison to a control group that will be treated in the 'usual' manner. Sounds good.
Philips Healthcare releases their study results. Maybe after reading the GE press release, Philips decided to announce the preliminary results of a study funded by Philips and CARME (health service in Spain) -- this time using the Philips MOTIVA telehealth offering. No surprise, this 'innovative' use of telemedicine produced a 67.8% reduction in hospitalizations due to heart failure and a substantial improvement in perception of their quality of life (improved from a perceived quality of life), regardless of where their perceptions started. Sounds good.
Veterans Health Administration proved this in a 2008 study. Fortunately or unfortunately, depending on your perspective, the VHA study proved the same point with a similar population set suffering from chronic disease (and likely Viterion's telehealth technology, since the report is featured on Viterion's website.) In this study of 17,025 patients over 4 years, the benefits revealed were a "25% reduction in the numbers of bed days of care, 19% reduction in the numbers of hospital admissions after enrollment in the program and a mean satisfaction score of 86%." The conclusion: enterprise-wide home telehealth implementation is an appropriate and cost-effective way of managing chronic care patients in both urban and rural settings." Sounds good.
So what is behind Philips and GE's re-studying the same problem? So I admit that I am in the dark on this. Why not go with the first study and implement? Is it that they didn't believe the VHA methodology? That it seems to have used a product other than their own? That the continuous re-justification of care outside an institutional or medical setting is required because executives in hospitals still refuse to believe? Or is it possible that insurance and government programs here and abroad refuse to participate in telehealth, perhaps because doctors refuse, and perhaps that is because reimbursement rates are still not equivalent to face-to-face?