Innovation: Is the future of healthcare online?

For practical reasons, health workers are often unable to talk to home-based patients with chronic conditions on a daily basis – but they could keep an eye on an online medical record that is automatically updated whenever the patient measures their own blood pressure, checks their weight, or takes their medication. Such technology could help medical workers ensure remote patients are healthy, and detect any problems at an early stage before they become serious.

The move beyond traditional telehealth – remote contact with a patient through phone calls or video conferencing – is being encouraged by the Continua Health Alliance, a non-profit open industry group. The alliance boasts some powerful players in both the technology and medical arenas, including IBM, Intel, Google, Kaiser Permanente and the UK’s National Health Service.

From:New Scientist

Burden of Disease today:

10-year risk of cardiovascular events:¹

• Diabetes.
• Previous personal history of CHD or non-coronary atherosclerosis (e.g., abdominal aortic aneurysm, peripheral artery disease, carotid artery stenosis).
• A family history of cardiovascular disease before age 50 in male relatives or age 60 in female relatives.
• Tobacco use.
• Hypertension.
• Obesity (BMI >30).

Cardiovascular disease, including coronary heart disease, accounts for nearly half of all deaths in the United States. Over the past 50 years, there has been a long-term downward trend in cardiovascular mortality associated with improved risk factor management and access to early detection and new treatments. The 2002 age-adjusted death rate for heart disease was 59% lower than the rate in 1950.²

The lifetime risk of having a coronary heart disease event, calculated at age 40, is estimated to be 49% for men and 32% for women in the United States; nearly one third of coronary heart disease events are attributable to total cholesterol levels above 200 mg/dL. Consistent, good-quality evidence from long-term prospective studies has shown that high levels of total cholesterol and LDL-C and low levels of HDL-C are important risk factors for coronary heart disease. The risk for coronary heart disease events and mortality increases with increasing levels of total cholesterol and LDL-C and declining levels of HDL-C, in a continuous and graded fashion, with no clear threshold. Coronary heart disease mortality is associated with several risk factors, including dyslipidemia, high blood pressure, tobacco use, diabetes, a family history of premature coronary heart disease, older age, male gender, and diet; other risk factors for coronary heart disease include socioeconomic status, obesity, and physical inactivity. Consideration of lipid levels along with other risk factors allows for an accurate estimation of coronary heart disease risk.³

References:

1.Wilson PW, D’Agostino RB, Levy D, Belanger AM, Silbershatz H, Kannel WB. Prediction of coronary heart disease using risk factor categories. Circulation 1998;97:1837-1847.

2. National Center for Health Statistics, US, 2004 with Chartbook on Trends in the Health of Americans. Hyattsville, Maryland, 2004.

3. Helfand M, Carson S.  Screening for lipid disorders in adults: Selective update of 2001 U.S. Preventive Services Task Force review.  Prepared for the Agency for Healthcare Research and Quality; by the Oregon Evidence-based Practice Center at the Oregon Health and Science University, Portland, Oregon, under Contract Number 290-02-0024. April 2008.  Evidence Synthesis No. 49. AHRQ Publication No. 08-05114-EF-1. Available at http://www.ahrq.gov/downloads/pub/prevent/pdfser/lipides.pdf.

Is screening effective  for disease

Screening for and identifying lipid disorders in adults do not appear to have important psychological sequelae or produce important changes in indices of mental health. The research to date has not been sufficient, however, to rule out important changes in small subsets of patients or to detect subtle changes in anxiety.

ref;

Screening for Lipid Disorders in Adults;Recommendation Statement

Date: June 2008

Mobile health care does offer preventive medicine.In a recent study by researchers  at Harvard medical school,it was shown that mobile health care offered $36 as return of investment for every dollar invested.

Researchers from Harvard Medical School have led the development of a prototype “return on investment calculator” that can measure the value of prevention services. Using a Boston-based mobile health program called the “Family Van” to test the tool, the team found that for the services provided in 2008, this program, in the long run, will return $36 for every dollar invested.

The Family Van, a program of HMS, is a mobile clinic providing preventative health care and education to disadvantaged areas throughout Boston. The Van provides screening, testing, and education in areas such as nutrition, weight management, diabetes, heart disease, pregnancy, and STDs, to name a few. Their goal is to train and educate people in taking the steps necessary to prevent or better manage chronic disease.

Ref

Harvard Medical School. “Mobile Health Care: Preventative Medicine Returns $36 For Every Dollar Invested, Study Suggests.” ScienceDaily4 June 2009. 26 July 2009 .