After that less than stellar performance in the Sunday Age [below] Tim Barlass redeems himself with a fascinating piece about a trial in rural NSW in which elderly patients given a broadband “medibox” which monitored details of blood pressure, heart rate, blood oxygen and weight and logged them remotely to doctors, demonstrated a dramatic decrease in hospital admissions, and shorter stays.
Fifty patients in NSW with an average age of 87, suffering serious heart or lung conditions requiring regular bouts in hospital, were enrolled in the six-month trial last year, which resulted in faster preventative action. 
The study seems to have been funded as part of the government’s national broadband network planning, and there’s no indication of how it might be applied more permanently. The story says “it remains unclear who would finance the mediboxes”, but I can’t help wondering if there might increasingly be cheaper alternatives as medical apps for mobile consumer devices like the iPhone/iPad and Android devices proliferate.
The potential for elderly patients to use these devices is indicated by a phone call I received on Sunday from a friend of mine, Dr Henry Konopnicki, who has an aged care practice in Melbourne. He had just been called out to an 88-year-old patient, and she’d remarked on the fact that Henry was using an iPad.
“I’ve got one of those,” she told him.
Henry was sceptical until she pulled an iPad 2 out of a drawer and showed him how she used it for email and maintaining contact with her son, in Brisbane.
Perhaps we should be looking at solutions that give people greater participation in their own healthcare, and allow elderly people to maintain their independence using mobile technology. There are, however, some critical issues that have to be sorted out.
I mentioned Walt Mossberg’s review of the Telcare device in an earlier post, and over on the 3G Doctor blog, there’s an interesting take on some of the issues that have to be settled with these devices, principally bugs and usability. They arose from the comment thread on Mossberg’s review.
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Terrifically encouraging piece! The original SMH article does not say how many days these patients needed to be in hospital, but it does state that the incidence of hospitalization was reduced by 47%, and those hospital stays were on average 38% shorter. If these results can be sustained it sounds as though the payback period for this technology would be quite short. There is a bonus dividend of course in the well-being of the participating folk. Note that the bandwidth requirement is trivial, at least for the telemetry aspects. The “always connected” nature of broadband is useful though. The article did say that if a person’s measurements were awry a doctor or nurse came on the computer screen to give advice. It is only this video-call which needs any broadband capability. In fact I think we can safely say that the whole trial was done without any NBN involvement.
I expect we’ll see a lot more of this type of telemedicine as more devices come on the market, and at lower prices. It is only in recent years that we have been able to buy fully automatic digital blood pressure meters, but today they are common, and I daresay some have a USB or even Bluetooth interface. I wouldn’t worry about the technical flaws in devices like Telcare’s blood sugar monitor. This is Mk I – the devices will get better and better. The real stumbling blocks will be legal, financial, regulatory and human factors! Speaking of which, I wonder how much of the improvement in the health of the trial participants was simply due to the comfort of knowing that their blood pressure etc was being monitored daily? Someone was caring for them every day!
These two products seem particularly relevant to this article. Whilst somewhat expensive, cheaper alternatives will surely appear in time.
http://householdtechnology.com.au/index.html
It might seem restrictive that the blood pressure monitor attaches only to an iOS device. On the other hand iPhones and iPads are being ubiquitous, and in the absence of either of these the iPod Touch is a relatively inexpensive way to provide both a local readout and means of relaying results (by Wifi) to a network.
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