Mobile Collaboration in Health Sector

MOBILE COLLABORATION IN THE HEALTH INDUSTRY: THE VIRTUES OF INSTANT MEDICAL ATTENTIONBy Kishore JethanandaniA FuturistLens White Paper, January 2011In the health industry, centrifugal forces are increasingly a lot stronger than the centripetal forces. Hospitals were the center of a universe of care. Consumer needs, rising costs and technology are driving care to the edges. More often than not specialists work freelance providing care to multiple hospitals. Home care is becoming more common with the rising incidence of chronic illnesses which are far too expensive to treat in hospitals. Emergency care in the field is more common with higher incidence of catastrophes and natural disasters. Incipient mobile and on-premise collaboration in the health industry exists in rural and prison care. Remote care in these niches has a palpable value. In rural areas, the cost of moving patients to urban areas can be as bad as flying them by helicopters or at the least a road trip to a well-equipped hospital. In snow-covered rural regions like Alaska or Canada and much of Eastern USA, the logistics of the journey to the closest regional tertiary care center is formidable. In the end, the labor of a long journey may not be worth it if the symptoms were a false alarm. Before making the trip to the city, video-assisted consultations could help patients determine whether the trip is worth the cost. In emergencies, mobile video collaboration helps to monitor patients on their way to urban hospitals.The care of prison inmates has always been fraught with danger as they make their way out of the jail to the hospital and while doctors attend to them. Prison guards accompany prisoners and secure the doctors when they treat the prisoners. Remote care, video-assisted, can enable doctors to remotely examine the prisoners in jail itself. Emergency care, for any patient group, can benefit from real time care that is possible with mobile health care technologies. Time makes all the difference between life and death in trauma care. The delay in reaching the hospital could be fatal. Remote care with specialists collaborating with paramedics in the field can dramatically improve outcomes. An analysis of the claims in emergency situations concluded that adverse events and the indemnity payments could be reduced by 43% with real-time prompts and video evidence. Wider adoption of remote care is now possible with the panoply of technological tools now available such as sensors, medical devices, smart mobile devices and internet video. The sensors let doctors read vital signs from a distance, robots let them do hospital rounds more frequently without being present, video lets them see a patient in another location, smart mobile devices with embedded cameras let them track emergency situations in real time and internet connections let them download images from distant storage devices. Concurrently, the demand for remote care has grown and is still way below its potential. For one, the population of the chronically ill, with diseases like diabetes, dementia, long-term disabilities, has exploded. Hospital costs for the treatment of such patients can be prohibitive. Their relatives also spend a significant amount of time caring for them besides travel to the hospital. These types of patients can benefit from more frequent but short visits by doctors. They are tested more often and need a feedback from their doctors before continuing their medications. Many more specialists attend to patients and they work in multiple facilities. They can do this more conveniently from a remote location. The patient’s own home, equipped with modern medical devices, sensors and gadgets, is increasingly seen as the place to house patients with long-term illnesses. Pilot programs for home care indicate that regular monitoring of the chronically helps to lower the rate of hospitalization which has been observed to be as low as 3% to 8%. Even within hospitals, remote care will help especially in large hospital complexes where doctors are dispersed. Delays can happen when the patients, doctors, surgeons, specialists, nurses, radiologists and laboratory personnel are unable to communicate in real time with data, text, video and audio needed to diagnose and treat a condition. The surgeons could be in another floor, the physicians could also be teachers in their university departments, the general physician in their own medical practice, a patient could be in an ambulance with wounds, the test results in another part of the building while the nurse maybe attending to a patient in another room. They can be a lot more productive if camera embedded smart phone afford an opportunity to have real-time conferences. Critical care and regular care are often undertaken in two different facilities separated by a significant length of distance. The transfers from one facility to another create problems of logistics, information transfer and emotional distress. One case is of Adena Health System in Ohio which provides care for newborns and their mothers. For critical-care, however, babies are sent to the Nationwide Children’s Hospital which is seventy miles away. The journey to the critical-care facility is hard enough for a newborn baby and its worse when families are separated. Remote care, video-assisted, helped specialists in the Nationwide Children’s Hospital reduce transfers by 50%. In the remaining cases, the doctors at the critical care facility have an opportunity to acquaint themselves with the case before they have to attend to it.Prompt attention of the doctor at any location could well make all the difference to health outcomes for patients. The radiology department might have detected a build-up of fluid in the pleura of a pneumonia patient but a delay in the arrival of the doctor could deteriorate into a lung collapse. A nurse may not be able to inform a surgeon about the schedule for blood-thinning drugs which could unnecessarily delay an operation. Real time transfer of data and content can reduce the latencies in communications that are often damaging to the quality of health care. Patients are more aware of preventive care and would like to check on seemingly innocuous symptoms that may reveal more serious problems lurking. A twisted ankle could well be dismissed as a sprain rather than a fracture and delayed treatment could lead to arthritis in later years. The thought of a trudge to the doctor’s office could well be a disincentive to seek treatment immediately. They are likely reluctant to take time off from their regular business to visit a doctor but a remote consultation is a worthwhile alternative. According to one survey of the Health Research Institute, of PWC, forty-percent of physicians believe that eleven to thirty percent of the office visits could be eliminated with mobile health technologies like remote monitoring, email or text messaging with instant messages. Time is of the essence in health care. Delays in reaching specialists, in processing vital signs data and attending to conditions makes all the difference in the quality of care. Remote care for real time collaboration with real time feeds of data and content helps to bring attention where and when it is most needed. The spiraling costs of health care can be lowered with the technology for real time care.

Mobile Collaboration in Health Sector

by Kishore Jethanandani

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