Providing out-patients with monitoring systems tied to smart phones so they can report progress to doctors is a good call, according to healthcare providers.
At the Women’s College Hospital in Toronto, for instance, a mobile remote monitoring pilot project that hands Samsung smart phones to 30 breast cancer and 30 orthopedic out-patients not only improved the frequency and accuracy of their reports, the system also reduce pateint re-admissions, emergency room log jams and helped the hospital cut expenses by as much as 30 per cent, a mobile health care conference in Toronto was told Thursday.
With the hospital’s new focus on providing ambulatory care that cuts down patients’ post-operation stay in the hospital from an average of 6.5 days to just 18 hours, Women’s College, a couple of years ago, began looking for a system that would help them keep tabs of their out-patients’ progress.
“The first 30 days after an operation is critical,” said Dr. John Semple, surgeon in chief and head of the plastic surgery division at Women’s College. “It is within this period that most complications and re-admissions occur.”
Speaking at the Mobile Health Care Summit in Toronto yesterday, Semple said Women’s College partnered with Samsung, wireless service provider Rogers Communications and e-commerce and software-as-a-service hosting firm Tenzig Managed IT Services in a six-month project which sought to provide healthcare providers better insight into their patients’ recovery process.
The program involved a brief health assessment questionnaire embedded on Samsung Android-powered smart phones given to the patients. The questionnaire had to be answered and transmitted to their healthcare provider regularly. Patients also had to routinely take photos with the smart phones of their operation area or injuries and send the images back to the hospital.
Women’s College said it costs the healthcare system as much as $224,635 per 100 patients to cover expenses associated with out-patient care and re-admission. By using tools like the smart phone patient monitoring system, Semple said the cost can be cut by as much as 30 per cent.
A similar program to monitor mental health patients was initiated by the Lawson Health Research Institute, London Health Science Centre, the Canada Mental Health Association – London, Middlesex and Telus Health, the tele home care and e-health record division of Telus.
The program included an easy –to-use mobile apps that let patients:
- Indicate their moods and physical state at certain periods of the day;
- Record medication intake and side effects;
- Make specific reports available to the appropriate healthcare providers;
- Immediately contact essential people in their circle or care in case of emergency
“At first, people were very skeptical about us handing out iPhones to mental health patients,” said Mike Godin, housing advocacy team leader of CMHA – London Middlesex. “They said patients would likely lose the device or break them or sell them.”
Out of the 400 devices used in the study he said, only 12 were lost or broken.
“The patients learned the value of the technology. They knew it was useful and they were being empowered so they took ownership,” said Godin.
Care providers noticed marked changes in the mood of mental patients in the program. For instance, patients were able to identify and understand better what factors triggered emotional stresses and mood changes. Many became less stressed out and this showed in the marked decrease of panic attacks and emergency calls healthcare providers got from those in the program.
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The program has a big potential in slashing the cost of providing care for as many as 80 per cent of Ontario’s mental health sufferers, according to Stephanie Brown, manager grant facilitation and strategic development at Lawson Health Research Institutes, a group of health care centres in the London, Ont., area.
Security was a primary concern, according to Nick Zamora, chief clinical advisor of Telus Health. In managing the information involved in the London project, Telus leveraged existing health system databases that complied with industry and government data protection and privacy rules.
Handling, transmission and storage of data were carried out in compliance of Health Insurance Portability and Accountability Act and the Personal Health Information Protection Act.
For example, The Women’s College project transmitted data with 256 bit SSL/TLS encryption and database servers used AES 256 bit encryption.
In both case studies, creating intuitive and simple user interfaces was essential.
For example, the Women’s College project made use of the smart phones touchscreen features to develop pain and quality of health indicators which only required users to slide swipe coloured arrows up and down with their fingers.
Mental health in patients in the London program tapped on “smily” and “frown” faces on their iPhones to indicate their mood. If they register a certain number of frown faces within a certain period, they were instructed to call their healthcare provider.