US National Broadband Plan talks up mHealth:
Mobile Broadband and the Future of Health
Mobile health is a new frontier in health innovation. This field encompasses applications, devices and communications networks that allow clinicians and patients to give and receive care anywhere at any time. Physicians download diagnostic data, lab results, images and drug information to handheld devices like PDAs and Smartphones; emergency medical responders use field laptops to keep track of patient information and records; and patients use health monitoring devices and sensors that accompany them everywhere.1 Through capabilities like these, mobile health offers convenience critical to improving consumer engagement and clinician responsiveness. Innovations in mobile medicine include new modalities of non-invasive sensors and body sensor networks.2 Mobile sensors in the form of disposable bandages and ingestible pills relay real-time health data (e.g., vital signs, glucose levels and medication compliance) over wireless connections.3 Sensors that help older adults live independently at home detect motion, sense mood changes and help prevent falls.4 Wireless body sensor networks reduce infection risk and increase patient mobility by eliminating cables; they also improve caregiver effectiveness. Each of these solutions is available today, albeit with varying degrees of adoption.
Mobile medicine takes remote monitoring to a new level. For example, today’s mobile cardiovascular solutions allow a patient’s heart rhythm to be monitored continuously regardless of the patient’s whereabouts.5 Diabetics can receive continuous, flexible insulin delivery through real-time glucose monitoring sensors that transmit data to wearable insulin pumps.6 Advances in networked implantable devices enable capabilities that did not seem possible a few years ago. For example, micropower medical network services support wideband medical implant devices designed to restore sensation, mobility and other functions to paralyzed limbs and organs.7 These solutions offer great promise in improving the quality of life for numerous populations including injured soldiers, stroke victims and those with spinal cord injuries. Human clinical trials of networked implantable devices targeting an array of conditions are expected to begin at the end of 2010.8 Mobile and networked health solutions are in their infancy. The applications and capabilities available even two years from now are expected to vary markedly from those available today. Some will be in specialized devices; others will be applications using capabilities already built into widely available mobile phones, such as global positioning systems and accelerometers. Networked implantable devices stand to grow in sophistication and broaden the realm of conditions they can address. These solutions represent a glimpse into the future of personal and public health—an expanded toolkit to achieve better health, quality of life and care delivery.
and Video Consulting…
Broadband and Video Consultation
Video consultation is especially beneficial for extending the reach of under-staffed specialties to patients residing in rural areas, Tribal lands and health professional shortage areas (HPSAs).9 For example, the American Heart Association and American Stroke Association recommend use of video consultation technology for stroke patients to help overcome the dearth of neurologists and to make decisions about whether to deliver the life-saving, clot-busting drug known as tPA.10 In addition to increasing access to otherwise unavailable care, video consultations combined with store-and-forward technologies (e.g., sending images to a specialist at night, as opposed to obtaining a diagnosis during a patient’s visit)11 could lead to significant cost savings from not having to transport patients. Avoiding costs from moving patients from correctional facilities and nursing homes to emergency departments and physician offices, or from one emergency department to another, could result in $1.2 billion in annual savings.12 Video consultation and remote access to patient data may also be critical during pandemic situations. If hospitals are at capacity or if isolation protocols are necessary to prevent the spread of infection, these technologies can help health care providers assist more patients and help patients avoid public areas.
Just a little shame the authors didn’t realise the potential for Mobile Video Calling…
Download the Healthcare Chapter here. An interesting well researched document that in terms of thought must be at least 5 years ahead of the Irish National Broadband Scheme and contains some great links to background reading:
1 Adam Darkins et al., Care Coordination/Home Telehealth: The Systematic Implementation of Health Informatics, Home Telehealth, and Disease Management to Support the Care of Veteran Patients with Chronic Conditions, 10 Telemed. & e-Health 1118, 1118 (2008)
2 Qualcomm Inc. Comments in re NBP PN #17, filed Dec. 4, 2009
3 Body sensor networks are very short-range networks consisting of multiple body-worn sensors and/or nodes and a nearby hub station. The sensors and/or nodes take readings of key patient-specific information, such as temperature, pulse, blood glucose level, the heart’s electrical activity, blood pressure, and respiratory function. Antenna components embedded in the sensors and/or nodes make it possible to wirelessly transmit data to bodyworn or closely-located hub devices. Hub devices may process the data locally and/or transmit it wirelessly for centralized processing, display, and storage. West Wireless Health Institute Comments in re NBP PN #17, filed Dec. 4, 2009, at 2.
4 West Wireless Health Institute Comments in re NBP PN #17, filed Dec. 4, 2009, at 5.
5 Wireless cardiovascular solutions are designed to enable early detection, prevention, and treatment of cardiovascular conditions. These solutions consist of wearable sensors, global wireless capabilities, and comprehensive web-based infrastructures. See, e.g. Corventis Home Page
7 Amendment of Parts 2 and 95 of the Commission’s Rules to Establish the Medical Micropower Network Service in the 413–457 MHz Band, RM-11404, Petition for Rulemaking (filed Sept. 5, 2007).
8 Letter from Cheryl A. Tritt, Counsel to the Alfred Mann Foundation, Morrison & Foerster LLP, to Marlene H. Dortch, Secretary, FCC, ET Docket No. 09-36 (Feb. 2, 2010) (Alfred Mann Feb. 2, 2010 Ex Parte)
9 Sixty-five million people reside in Primary Care Health Professional Shortage Areas (HPSAs). HHS designates HPSAs as having a shortage of primary medical care, dental, or mental health providers. They may be urban or rural areas, population groups, or medical or other public facilities. See HRSA, Shortage Designation: HPSAs, MUAs & MUPs
10 Lee Schwamm et al., Recommendations for the Implementation of Telemedicine within Stroke Systems of Care: A Policy Statement from the American Heart Association, 40 Stroke 2635 (2009) The United States has approximately 4.0 neurologists per 100,000 persons, who ideally need to be caring for over 780,000 acute strokes per year, and many parts of the country lack access to acute stroke services entirely. Id. at 2638. Tissue plasminogen activator (tPA) is a clotbusting drug that must be administered within three hours of ischemic stroke onset to be effective. Id. at 2641. Richard Knox, Drug Can Stop Strokes, But Most Patients Don’t Get It, NPR, Dec. 14, 2009
11 Store-and-forward technologies represent the collection and storage of clinical data or images that are forwarded for interpretation at a time distant from an in-person clinical encounter. Ctr. for Info. Tech. Leadership, Health Care Information and Management Systems Society (HIMSS), The Value of Provider-to-Provider Telehealth Technologies (2007) (CITL, The Value
of Provider-to-Provider Telehealth Technologies).
12 CITL, The Value of Provider-to-Provider Telehealth Technologies. CITL modeled pre- and post-telehealth costs based on national baseline number of transports, transport cost, and number of avoided transports. Annual savings were calculated by subtracting post telehealth costs from pre-telehealth costs for each provider-to-provider setting. These savings sum to $1.2 Billion.