Imagine an electronic device that knows whether you’ve taken important medication and reports that to your health provider. What about a device that can tell whether you have gotten out of bed in the morning? For many of us this scenario sounds like an absolute nightmare. Yet, whether we like it or not, high-tech medical devices in the home are becoming part of the recipe for health, safety and happiness.
We now face dramatic changes in the demographic structure of the population. In 2030, 22 percent of the population will be over 65 years of age, based on National Center of Health Statistics estimates. The number of people over 75 will rise fastest. Predictions indicate that by 2050 we’ll be dealing with 50 million octogenarians. Although our soon-to-be elderly are healthier, more active and better educated than the previous generations, aging still comes with disabilities.
As time goes on, more Americans will require assistance with activities of daily living, disease and medication management. At the same time, this group would rather grow old in their own homes, a familiar environment close to family and friends, than move to assisted-living facilities or nursing homes.
It is not just the seniors of our society who battle with chronic disease and disability. Fully 133 million Americans, or roughly 1 in 2 adults, are living with at least one chronic illness. Many of them are unwilling to give up independence, but require more medical management and assistance than they can get from a weekly doctor’s appointment.
For both groups, technology can help. Smart devices that monitor vital signs, pill dispensers that give a signal when it is time to take your meds, Nintendo Wii Fitness programs that keep you active and even talking bathroom scales that inquire about your sleep and appetite are no longer something from a science fiction movie. They also allow for direct interaction with physicians and family members, simultaneously ensuring independence and safety.
The telemedicine platform iHealthHome is an example of an in-home monitoring and communication system. It captures biometric data, including blood pressure, weight, pulse, temperature, blood sugar and respiratory rate. It also monitors activity and reminds its user of appointments, scheduled activities and medication times. It also provides a database of service providers that allows the user to make an appointment at the hairdresser or order a meal with just a click on the screen. All data are evaluated by a registered nurse. In case intervention is required, a physician will be contacted. Ho‘okele Health Navigators, a private company that helps patients navigate the health care system for $165 an hour, uses the iHealthHome technology in Hawaii.
Vital Point, from Troy, Mich.-based CJPS Medical Systems, is another device that, in addition, allows direct access by the primary health care provider. Research has shown that devices like iHealthHome and Vital Point will not only keep health providers up to date, but can also predict chances of a fall or emergency room visit based on restlessness in bed, decreased activity or a change in gait over a period of one or two weeks. This can allow time to put preventive measures in place.
Especially in more remote areas where access to health care is restricted, technology at home can make all the difference. Hawaii’s rural counties have poorer health compared with Honolulu County due to limited access to medical services, as reported by the Hawaii Journal of Medicine and Public Health. Seniors and people with chronic disease are especially vulnerable as they are less mobile and more likely to develop urgent medical conditions.
Teladoc Connect, another telemedicine service, connects patients and physicians 24 hours a day through telephone or video. If the patient’s own care provider is not available, the system automatically connects to the state database of available physicians and tries to find a match.
Tele-ICU and TeleStroke are the most advanced telemedicine options out there. They help hospitals in rural areas with a shortage of personnel to provide around-the-clock critical care. TeleStroke, for instance, connects neurologists to ERs in remote areas without a neurologist on call to help diagnose stroke and recommend interventions. Tele-ICU and TeleStroke are not yet available in the home care setting, but these kinds of applications have future potential.
Although technology is less invasive (and much more affordable) than hiring an in-home caregiver, many people might not feel comfortable being monitored all the time. Having someone stop by to help with medication management or take blood sugar values is for many people a source of much-desired human contact during the day. Yet in the long run, the switch to IT devices might really benefit all, allowing patients to remain independent in their own homes, their families to have peace of mind and ultimately enable the health care system to provide for those who need more.
Ira Zunin, M.D., M.P.H., M.B.A., is medical director of Manakai o Malama Integrative Healthcare Group and Rehabilitation Center and CEO of Global Advisory Services Inc. Please submit your questions to info@manakaiomalama.com.
