Is industry ready for telecaring, the next generation of health care?

It soon will be a brave new world in diagnostics. Products bearing the logo of the Continua Health Alliance, a group of technology, medical device and health and fitness industry leaders that is pooling standards for the wireless collection and transmission of diagnostics data, could reach store shelves as soon as mid-2008.

And that means that as early as next year early adopters will begin realizing the efficiencies and actionability associated with the smooth collection of multiple data points—blood-pressure monitors, weight scales and blood-glucose measurements—into a robust health management clearinghouse that will help manage a multitude of disease states. And it will allow a caregiver in Minnesota to be able to remotely monitor her mom’s health in Nevada—prompting her to call mom to remind her to take her medicines or to take her morning blood-pressure measurement.

It marks the beginning of telecare-giving, which may become the standard in chronic disease management, especially given the pedigree of some of Continua’s member companies—IBM, Pfizer and Sprint to name a few. Continua’s end game is to enable a network of readily connected health and medical devices that will allow people with diabetes or other chronic diseases to share information with their doctors or identified caregivers.

The potential market is huge—more than 1 billion adults are over-weight worldwide, which has been credited with both a rising incidence of diabetes and heart disease. According to Continua statistics, more than 860 million people around the globe require chronic disease management, which constitutes more than 75 percent of all healthcare spending.

The interoperable devices will, at first, include blood-glucose tests, blood-pressure monitors, pulse oximeters (a medical device that indirectly measures the amount of oxygen in a patient’s blood) and other basic vital sign monitors. Such devices as motion sensors, medication reminders and emergency response services may represent future functionality, affording new capabilities to family and professionals who provide care for the aging.

“The area of remote patient monitoring is all based on being able to help that individual help monitor themselves,” said Dave Whitlinger, chairman of the Continua Alliance. “[Caregivers] will have the ability to see subtle changes in vital signs and very quickly react … before an emergency situation occurs.” Other conceptual functionalities are expected soon to be explored by the likes of pharmacy operators and managed care—where a third-party healthcare professional, like a pharmacist, makes that call to mom in Nevada. “Where a pharmacy might be able to participate … there’s a wide variety of healthcare provider-based services, as well as retail services, that would greatly benefit those patients,” Whitlinger said.

“If you look at the portfolio of prescriptions a pharmacy has, it’s very hard to make your practice personal. But if the blood pressure [you’re monitoring] is outside that parameter, then you can contact that patient directly,” Ed Siemens, business development manager with A&D Medical, one of the charter companies of Continua, told Drug Store News. “There’s huge potential for that involvement on the caregiver continuum.”

Continua’s next steps include driving reimbursement discussions with healthcare policy makers, insurance plans, physician organizations, politicians and major employers on managing chronic disease costs. “More and more, individuals, as well as healthcare providers, see the value [in telecaregiving], as well as the scalability that this provides,” Whitlinger said. And market maturation is not too far away. “Some think the sweet spot is maybe two years, some three years, but it’s not that far away,” he said.

Continua Health Alliance announced last month it is working with Abt Associates on a research project targeting reimbursement policy. Abt Associates will assist in cataloging, synthesizing and assessing all telehealth studies and the peer-reviewed cost-effectiveness literature. “We’re going to pool that data and use that to enter into discussions with both private and public payers about what that data says on the effectiveness of remote patient monitoring both from a cost perspective and from a quality-of-care perspective,” Whitlinger said. “From that, we will start putting together some more strategic programs that have to do with removing barriers that might be identified by the payers,” he added, such as insufficient data supporting the expected improved outcomes with remote monitoring and, consequently, reduced healthcare costs.

Continua is in the process of identifying the subject matter for its second set of technical guidelines, which, judging from the number of abstracts coming in from member companies, may focus on personal health records and net compliance, Whitlinger said.

Continua last month unveiled the key components of its first set of technical guidelines to help establish a market of connected personal health and fitness products and services. These first set of guidelines, due out in early 2008, are based on proven connectivity standards, and will help to increase assurance of interoperability between devices and to enable consumers in their sharing of information with care-givers and service providers more easily.

And while the United States currently is the pacesetter in establishing this new concept of telecaregiving, it may soon be surpassed by the United Kingdom in number of lives affected by this new functionality. “The largest implementation of remote patient monitoring in the world is arguably the United States government with the Veterans Administration,” Whitlinger said, with more than 25,000 patients monitored remotely today compared with the 2,000 patients on average monitored remotely across each of the several U.S. private payers. “The National Health Service in the United Kingdom is entering … into patient trials this fall [numbering in the thousands],” he said. “Their ability to scale, though, because of the homogeneity of their healthcare system and their electronic health records is much greater than the fragmented system of the United States.”