Improving medical technology through interoperable devices

The healthcare industry is actively developing and commercializing personal health devices that can be used to monitor patients remotely. Improving medical technology and increasing the number of interoperable devices lead to improved patient health and quality of life. They also can reduce hospitalization requirements while giving providers convenient access to the data they need to make care-related decisions.

The industry's ambitions are laudable, but many cost and deployment barriers undermine its potential. Most interoperable devices are expensive, each one costing about $50 per month. Vendors also tend to use proprietary communications protocols, a practice that fragments the market and makes any deployment product-specific and time-consuming for patients and providers. Costs and deployment requirements increase if individual patients must be monitored for multiple conditions.

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Consumer adoption of interoperable devices will increase and costs will decline as more companies develop and adopt standards that make devices immediately deployable.

Research is beginning to quantify the cost impact. For example, a large-scale, multi-year study conducted by the National Health Service in the United Kingdom assessed the effect of home-based telehealth services for treating patients with diabetes, chronic obstructive pulmonary disease and congestive heart failure. The techniques reduced hospital admissions and mortality among telehealth patients, but cost savings were modest -- around $288 per patient per year -- and relatively small, "especially compared to the potentially high costs of these types of telehealth intervention," according to the study.

Such studies discourage regulators and health insurance companies from authorizing personal health devices. The industry must bring device costs down substantially, preferably to about $20 per month, to support wide adoption. Devices and services must also minimize deployment requirements and systems integration processes.

Interoperable devices based on widely accepted technology standards can help the industry meet these needs. Standardized products can interoperate with one another, and that encourages customer adoption, stimulates competition among vendors, expedites product development, and yields more product choices for patients and providers. Competition also can build economies of scale, which drives down costs.

At the Department of Information Systems and Computing at Brunel University, our researchers have embraced technology standards to develop interoperable devices and software platforms to achieve low-cost targets and easily deployable objectives.

Hydra Gateway, developed in partnership with Acute Technology, is a plug-and-play interoperable gateway that patients can install in minutes. It employs the Institute of Electrical and Electronics Engineers' 11073 standards to communicate with any compatible personal health sensor. It uses the Health Level 7 message format to transmit the data via mobile networks to remote servers, where the data can be accessed as needed by clinicians or patients.

The industry also needs integrated, intelligent software platforms and services that are easy to adopt and use. Our team has designed a platform that gives healthcare organizations plug-and-play capability to add new devices to their networks without needing to perform any integration services. In the inCASA project, we use the integrated platform for storing and managing remote patient data and coordinating the care of elderly patients. The Reaction project monitors and manages the long-term care of patients with diabetes.

Vendors are realizing the benefits of interoperability. Consumer adoption of interoperable devices will increase and costs will decline as more companies develop and adopt standards that make devices immediately deployable. Personal health devices might be able to connect to any smartphone. Interoperability between health devices, sensors that support applications for independent living, and health and fitness products will enable innovative monitoring services. Regulators and payers must authorize reimbursements, however. Their involvement in the marketplace has yet to be determined. Regulators and payers can potentially benefit from the lower costs and conveniences that standardization and interoperability provide.

About the author
Malcolm Clarke is a reader in telemedicine and eHealth systems in the Department of Information Systems and Computing at Brunel University, and former chair of the American Telemedicine Association Special Interest Group in Technology. He is a member of CEN (European Committee for Standardization), HL7, IEEE and ISO committees working on standards for medical devices. Let us know what you think about the story; email
editor@searchhealthit.com or contact @SearchHealthIT on Twitter.

This was first published in May 2013

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