Mobile information technology makes advances in medical field
Health care sits on a precipice with a wave of 76 million baby boomers swelling behind it. The surge of boomers brings challenges: more patients with multiple, chronic conditions and disabilities; low health literacy rates, especially among those 65 and older; and a dwindling pool of providers to take on the growing demand.
Mobile health ̶ or health-related services via mobile platforms, such as smartphones, tablets and laptops ̶ aspires to ease this burden by making health information user-friendly, bolstering doctor-patient communication, encouraging consumer involvement and inspiring personal accountability.
It’s a lofty goal in an industry that’s more plodder than pacesetter, but examples of successful mobile health interventions abound. There are remote heart monitors that save lives, health education apps that provide consumers with decision-making tools and wellness trackers that churn out data to motivate people to lead healthier lives.
Will technology help define and direct a new model of health care that is patient-centered, community-focused, connected and a part of every day life? That might be up to us.
Bringing health care home
Mary Tappe had just arrived at a meeting on an ordinary afternoon when she died from Sudden Cardiac Arrest, a condition where the heart suddenly stops beating, preventing blood flow to the brain and other vital organs. If not treated within minutes, SCA usually causes death. Lucky for Tappe, her coworkers sprang into action, performing CPR and using an Automated External Defibrillator to shock her heart back to life.
Doctors couldn’t provide an explanation for what occurred, but the Automated Implantable Cardioverter-Defibrillator they placed in her chest gave her some comfort.
“I consider my ICD to be my EMS team in my chest and my CareLink to be my dispatcher. It’s a true enabler of my health care.” – Mary Tappe, patient
Tappe then had a second SCA as she slept. But this time, her device delivered two shocks to restart her heart and stabilize its rhythm, and sent an alert to Medtronic, the AICD manufacturer. The alert was then forwarded to her cardiologist, Dr. Charles Fuenzalida, at Aurora Denver Cardiology Associates.
“In the United States, there are between 40,000 and 80,000, what we call, cardiac implanted electrical devices, that go in per year,” Fuenzalida says. “So that means the number of people out there with these devices is pretty high, particularly as people get older.”
Implantable cardiac devices have been around in cruder forms since the late ‘50s. The ability for remote monitoring, however, is a fairly new technology and one that continues to evolve.
Health care enabler
Since receiving her AICD 10 years ago, Tappe has benefited more than once from her remote monitor, CareLink, which she tucks behind her bed at home and brings along on trips. “CareLink now uses wireless technology. So, as I’m sleeping, it is reading the device, which gives me great peace of mind,” Tappe says. “If anything were to happen, it would send an emergency reading to the on-call doctor at Aurora Denver Cardiology Associates.”
As the Sudden Cardiac Arrest Association chair of the Board of Directors and a member of several SCA support groups, Tappe has heard numerous anecdotes about how home monitoring has saved lives and improved patient care. One friend was awakened in the night by a call from his cardiologist to tell him he was in heart failure and an ambulance was on the way. As he slept, his monitor had alerted the doctor, who quickly responded. There is a degree of fear and despair that accompanies a chronic heart condition, like SCA, and Tappe says monitors can make it feel a little less frightening.
“I consider my ICD to be my EMS team in my chest and my CareLink to be my dispatcher. It’s a true enabler of my health care,” she says.
Studies and clinical trials suggest remote monitoring will do its part to resolve some challenges facing health care by personalizing care, lightening patient loads, and managing chronic conditions, such as heart disease and diabetes.
Power to the patient
When Larry Ratcliff, 66, downloaded the iTriage app, he didn’t expect much.
“I got the app to humor my wife, who had read about it in a mobile home magazine. I didn’t think we’d use it much,” he says.
His opinion changed late one night when his wife, Barbara, a diabetic, snagged her toenail ̶ a potentially life-threatening injury for someone with her condition. Self-described snowbirds and RV enthusiasts, the couple travels to Florida each winter and crisscrosses the country throughout the year, and it’s not always easy to find an in-network specialist on the road.
“I used the iTriage app on my iPhone and looked for a podiatrist near our campground in Florida. At 2:38 a.m., I called Dr. Harris and left a message telling him we needed to see him immediately. We got a call from his office as soon as they opened, and two hours later, we saw the doctor. She got excellent care in a timely manner.”
Ratcliff says it’s reassuring to have reliable health information at the couple’s fingertips. In non-emergency situations, they use iTriage to look up medication information, check symptoms and get health news.
Founded by two emergency medicine doctors, iTriage is a free mobile app and website that provides decision support tools to help answer two common medical questions: “What could be wrong?” and “Where can I go?”
At the iTriage office in downtown Denver, a large monitor displays similar accounts from satisfied consumers, many who say iTriage saved their lives by helping quickly diagnose a life-threatening condition, find the nearest hospital, recognize severe medication side effects or share vital information with clinicians.
From a smartphone or computer, iTriage users can check symptoms, research diseases, treatments and medications, determine if they should seek care and where, check emergency room wait times, schedule appointments and store and manage their personal health information.
Transformation through knowledge
According to the National Assessment of Adult Literacy, only 12 percent of U.S. adults have proficient health literacy. That means nine out of 10 adults may lack the skills to manage their own health and prevent disease. That percentage falls even lower among people older than 65.
Jim Greiner, President of iTriage, says low health literacy rates are, in part, an upshot of the way medicine has been practiced for centuries. “Healthcare has been very paternalistic, until the Internet made health information more available.” As the axiom goes: knowledge is power, and Greiner says giving consumers accessible, useful health intelligence will transform the health care system and improve population health. “We believe the real way to bring health care into the future is not being pushed by payers or providers, but to have consumer pull,” he says. “It’s been done in other industries, like banking and travel, and those industries have transformed.”
The iTriage mission, to empower healthcare consumers with information, is part of a broader industry trend: using technology to demystify health care. Other companies are following suit, working to illuminate darkened corners of the care spectrum or integrate health data into everyday life.
The Yelp of health care, HealthGrades provides consumers with information about providers, including their education, experience, patient satisfaction levels and hospital quality. Aetna’s CarePass is like a health data aggregator that displays information from various apps on one dashboard along with progress toward the user’s personal goals.
Despite the innovations over the past five years, Greiner says we are just scratching the surface of consumer-driven health care. But, he says, the industry is ripe for change. New payment models and diminishing concerns about health privacy, especially among younger generations, will spur the adoption of mobile health technologies that can improve outcomes, decrease costs and help both doctors and patients adapt to the changing health care landscape, he says.
For many, patient accountability needs to take a turn before any of that can happen, but Tappe’s near-fatal experience suggests mobile health care might help lead the way. “For 20 years, as an adult, I just did whatever my doctor told me to do,” Tappe says. “Now I ask questions, create relationships with the doctors and nurses, and try to understand the relationships between patient care, medicine and technology.”
How to Improve Your Health Literacy
Find reliable information on health websites that have been medically reviewed. Some good options:
- iTriage partners with Harvard School of Medicine to provide comprehensive, medically reviewed health information on its app and website.
- The Mayo Clinic website provides an easy-to-use symptom checker tool and First-Aid guide.
- Medline Plus combines the National Library of Medicine and the National Institute of Health, covering more than 800 health topics in English and Spanish, with links to view the website in more than 40 other languages.
- PatientsLikeMe is an interactive website where patients with similar diagnoses can connect from all over the world to share experiences and track health data in real time.
Always dial 9-1-1 when an emergency is suspected; wasted seconds on new technology could cost lives.
- Get Red Cross certified in CPR, First Aid and Automated External Defibrillator use.
- Download one of today’s tens of thousands of health and wellness apps, which target everything from weight loss to medication adherence to coping with chronic conditions.
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