Posted on September 13, 2016 by Bobby Gheorghiu
Earlier this summer, at e-Health 2016, I had the pleasure of moderating a very interesting and distinguished panel of clinical researchers from British Columbia who described each of their initiatives aimed at providing virtual care for patients with various types of chronic diseases. While the technical solutions that each presented were different, many common threads emerged that should get on the radar of policymakers throughout the country. At the top of the list were these three: simplicity, ubiquity, and affordability.
The Virtual Heart application presented by Annemarie Kaan of Providence Health Care in Vancouver is a simple web interface where patients log in each day and answer a few basic questions about their condition at that time. An equally simple dashboard on the clinician side allows them to monitor their patients while email-based alerts prompt them to review anything that requires immediate attention. The web interfaces were designed with end users in mind and are free from clutter or unnecessary information.
The mDAWN (mobile Digital Access to Wireless Network) program, presented by Dr. Kendall Ho of UBC, uses SMS and social media to communicate with program participants and their caregivers while in-home wireless biosensors transmit patient health data to the program coordinator on a daily basis. All equipment is intuitive and requires minimal training.
Lastly, the Weltel application, presented by Dr. Richard Lester of UBC, is the simplest of them all, relying solely on two-way SMS messaging between an automated program that asks how you are feeling and the end user. If the patient indicates that they are unwell, a care coordinator is prompted to follow up.
Ubiquity comes from the fact that all three interventions use technology that is readily available to most consumers. As a matter of fact, a basic smartphone is pretty much all that is needed in order to communicate via SMS or access a web page. The biosensors used by mDAWN are an exception; however, they are still available to consumers at an accessible cost. This brings up the last point, which is affordability.
The Virtual Heart application is free and the Weltel program is very cost effective. A study found that on average, a nurse can manage 85 highly vulnerable HIV positive clients at the same time, spend two hours per week responding to client messages, all at a cost of only $115 per patient per year. Lastly, even though the biosensors used in the mDAWN program are more expensive, only 17 per cent of participants indicated that they would not pay for the equipment out of pocket.
Simple, ubiquitous, and affordable: three common items that should figure prominently on any policymaker’s checklist of criteria needed to fund investments in virtual care.
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Bobby works with stakeholders in academia, private and public sectors to develop and monitor performance targets for initiatives such as PrescribeIT®, Canada’s national e-prescribing service, to ensure widespread adoption of technology and to demonstrate tangible benefits of investments in digital health. He holds an MHSc in Health Policy, Management, and Evaluation from the University of Toronto.