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and smart environmental sensors (e.g., motion/activity sensors, temperature sensors, webcams) that monitor and calibrate the health and safety of patients within their home environments.

Comprehensive solutions In contrast to stand-alone offerings, comprehensive solutions provide end-to-end services that encompass patient education, diagnostic services, as well as ongoing disease manage- ment and treatment. While the value delivered to patients from compre- hensive solutions can be substantial, developing such solutions requires intensive effort and collaboration. There are some organizations such

as the Veteran Health Administration (VHA) that can control end-to-end service for a captive population (i.e., military veterans with VHA health plans), but the development and deliv- ery of highly comprehensive solutions will require a multi-player alliance of independent companies, each bring- ing specialized medical technology, or management capabilities and assets. Consequently, the development and testing of comprehensive solutions becomes more complex. Nonetheless, there have been

promising collaborations to deliver comprehensive solutions. Industry reports show insurance providers are becoming active participants in the development of comprehensive mHealth services, with WellPoint, Humana, Aetna and Highmark launch- ing initiatives that enable remote and/ or mobile monitoring of symptoms for a variety of conditions and diseases. Some of these collaborations are

between unlikely partners. According to news reports, Best Buy, the consum- er electronics giant, was chosen by Microsoft to help advance Microsoft’s HealthVault medical record initiative. Best Buy sells wireless enabled devic- es that make the tracking and commu- nication of records easier. Similar

news reports show that Significa Insur- ance Group and AllOne Health have a comparable collaboration; England’s National Health Service has launched remote monitoring of chronic obstruc- tive pulmonary disease patients; and the telecommunications company Orange is also testing mHealth serv- ices. The results of mHealth initiatives

are encouraging, whether focused on a specific disease or patient segments. The New England Healthcare Institute found that remote monitoring for heart failure patients reduced the re-admit- tance rate by 32 percent following a heart failure hospitalization, resulting in net savings of more than $1,861 per patient.4

This result was mirrored in a

meta-analysis of remote heart moni- toring studies involving 9,500 patients with chronic heart failure compiled by the Cochrane Review which showed a reduction in mortality for heart patients using remote follow-up moni- toring. Given that comprehensive mHealth

requires a significant information tech- nology infrastructure and can involve development of new devices or prod- ucts, companies known for their engi- neering like Bosch, Intel, and Philips have all begun investing in mHealth solutions, sometimes partnering with provider groups to test offerings. The momentum behind mHealth is accel- erating in part because these trials and pilots have shown positive results and improvements in patient care.

Challenges with the adoption of mHealth As with any new technology and capability, adopting mHealth is not without its challenges. A few of the more pressing challenges are outlined below:

Evolving business models While innovation on the technical front is advancing, the marketplace moves more cautiously, stymied by

a healthcare business model where the interests of medical practition- ers, health insurers, and patients are often out of sync. Remote and in-home monitoring can threaten traditional revenue streams of practi- tioners and institutions. What’s more, health insurers are holding the line on new treatment methods until they are proven medically effective and cost effective. This has created a Catch- 22 situation where new technolo- gies won’t be funded until proven, and can’t be proven until funded. The other issue is the consistent reim- bursement and payment policy. This will vary across markets and systems, yet ideally should be consistent to support larger scale and basic avail- ability, whether someone is treated by Kaiser Healthcare or at the Mayo Clinic or through a local network.

New technologies won’t be funded until proven, and can’t be proven until funded.


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