Any newcomer to the world of remote health will undoubtedly be challenged by the variety of different names and labels used to describe the technology. These include Telehealth, Telecare, Telemedicine, eHealth and Connected Health and depending on who you talk to, you will get different interpretations of these.

So here’s where I stand on these:

·         eHealth (or Connected Health): Health services, information and education delivered or enhanced through the internet and related technologies. This is the broadest of the labels used and eHealth encompasses all of the methods listed below.

·         Telecare: The continuous, automatic and remote monitoring of real-time emergencies and lifestyle changes over time in order to manage the risks associated with independent living. Social alarms such door sensors, smoke alarms, flood detectors and personal alarm pendants (PERS) all fall into this category.

·         Telehealth: Using communications networks to provide, access, and manage any type of health information or service. This name is commonly used to describe remote chronic disease management, with solutions such as the Intel® Health Guide.

·         Telemedicine: This is a type of Telehealth and is often used to describe the activity performed specifically by a doctor, who uses IT and the Internet for the diagnosis of a patient in another location. This term is often applied to a specialist providing a remote consultation or a second opinion to a doctor somewhere else in the country or the world.

To add to the confusion, the European Commission use the term Telemedicine to cover the delivery of and healthcare services at a distance, through the use of Information and Communication Technologies. Additionally, another term – Telehealthcare – is starting to emerge blurring the lines between Telehealth and Telecare. For all of these reasons, it is very important to understand where all parties in a discussion on these topics stand so that some of the confusion is eliminated.

In a recent customer meeting, the fall-out of all of these different labels became blatantly clear to me. This person was interested in deploying a Telehealth solution for the purposes of chronic disease management. Her challenge however, was that she didn’t have a budget line item for Telehealth (or any other tele- or e- activities), and that she was constantly getting frustrated with new labels being applied to solutions that effectively just improved existing service delivery activities. Her recommendation was that industry should stop using new labels to describe these technologies, and rather position them as enhancements to current care delivery, allowing for much easier procurement by healthcare providers.

An interesting argument indeed – but do you agree?

More information on remote health in the UK is available in this White Paper – Chronic Care at the Crossroads

As part of a futurist session today, at the Partners Connected Health Symposium, Tandy Tower from Microsoft Robotics, proposed an idea that assistive care robots could become common place in many homes within the next 3-5 years. These robots would be developed in response the ageing demographics that are evident across the world and to address the shortage of caregivers available to meet the needs of this section of the population.

These robotic nurses or home care assistants, would be able to help with medication reminders, allow medical peripherals to be connected, support video consultations with a clinician and deliver social interaction opportunities with other people in a network. Another idea proposed was that these robots could help with coaching and rehabilitation therapy for patients who have suffered a stroke.

Tower believes that this technology could be available for less than $5000 but I don’t believe that cost will be the main barrier to deployment and adoption. A bigger challenge, in my opinion, will be the acceptance of a robotic humanoid moving around your home and constantly checking up on your actions. Would you have a robonurse in your home?

The current issue of Business Week contains a feature (link) that looks at the Intel® Health Guide, a comprehensive personal health system that combines an in-home patient device with an online interface that allows clinicians to monitor patients and manage their care remotely.

The article gives a valuable insight into the life of a patient suffering with congestive heart failure, who used the solution to take daily blood-pressure and weight readings, as well as having regular video consultations with his nurse. His nurse in-turn was able to review the daily measurements from this and other patients, making any necessary interventions by getting them to see a doctor quickly.

A similar pilot was recently run in the UK at NHS Lothian (link), focusing on patients with chronic obstructive pulmonary disease (COPD), a condition that affects more than 3 million people and is the second largest cause of emergency hospital admissions in the UK.

In Great Britain, the Department of Health estimates that 17.5 million people are living with chronic disease (source) and the burden of chronic illness falls principally on the elderly, so as the population ages the incidence and prevalence of chronic diseases will increase. Recent research states that conditions such as these can be challenging for patients because they often have to make significant changes in their social and family relationships while dealing with physical pain, prolonged medical treatment, psychological distress and growing restrictions on their daily activities, and as a result, their quality of life is significantly reduced. (Stanton et al. Health psychology: psychological adjustment to chronic disease)

There is a growing impetus to make better use of information and communications technology to meet the very considerable challenges that are facing the health system, and in helping to improve the lives of patients.

What are the challenges that you see?