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MedCityNews reports a speech yesterday by the UK’s Secretary of State for Health at the Health Datapalooza IV conference in Washington DC. If the hype in the headline is enough to make you suspicious, the rest will leave you wondering if Jeremy Hunt is not floating free of reality: Six health data advances from England that will be “bigger than the Internet”.
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Telehealth and Telecare Aware posts pointers to a broad range of news items. Authors of those items often use terms 'telecare' and telehealth' in inventive and idiosyncratic ways. Telecare Aware's editors can generally live with that variation. However, when we use these terms we usually mean:
• Telecare: from simple personal alarms (AKA pendant/panic/medical/social alarms, PERS, and so on) through to smart homes that focus on alerts for risk including, for example: falls; smoke; changes in daily activity patterns and 'wandering'. Telecare may also be used to confirm that someone is safe and to prompt them to take medication. The alert generates an appropriate response to the situation allowing someone to live more independently and confidently in their own home for longer.
• Telehealth: as in remote vital signs monitoring. Vital signs of patients with long term conditions are measured daily by devices at home and the data sent to a monitoring centre for response by a nurse or doctor if they fall outside predetermined norms. Telehealth has been shown to replace routine trips for check-ups; to speed interventions when health deteriorates, and to reduce stress by educating patients about their condition.
Telecare Aware's editors concentrate on what we perceive to be significant events and technological and other developments in telecare and telehealth. We make no apology for being independent and opinionated or for trying to be interesting rather than comprehensive.
I don’t suppose he delivered that as a virtual presenter over video to save some time and money?
I do think the headline is a poor paraphrase of what is reported he compared to the founding of the internet.
… and apparently we were all wrong 3ML is neither telehealth nor telecare … it is now telemedicine! Will changing the word mean that is happens to timescale? Wonder how the tender process is going in Worcester or has ‘telemedicine’ given them an opportunity to withdraw from the tender and start afresh?
Now, now Cathy….who would want to miss the buzziness of Health Datapalooza IV in Washington, DC, the buzziest place in the country? Where real estate is climbing to the sky and employment is soaring (only partly due to Virginia’s welcoming business climate)? Where one can be feted as a harbinger of the future, rather than dealing with the realities of 3ML? One can only hope that Jonathan Bush of athenahealth took him aside and perhaps gave Mr. Hunt a talkin’ to. Now make allowances… Mr. Hunt may not have said ‘telemedicine’–US usage/reporting (except here, of course) is notable for its lack of rigor in describing exactly what’s what in health tech, even in MedCityNews. ;-)
#4 Care Connect–two pilots in two hospitals asking patients directly about the care they receive is, as they say in New Jersey, ‘whatta notion.’ It does not exactly strike this Editor as ‘bigger than the Internet’. But heck, it’s a great handle!
Universal coverage–I had to chuckle, as we are no closer to it than before, but further away. And in terms of what you get? The half of Americans who do already have employer coverage will be seeing big cuts later if not sooner. Based on a Wall Street Journal analysis, baked into the ACA’s 2000+ pages is the permission for large employers (50+ employees!) to reduce coverage to low-benefit ‘skinny’ plans that only cover preventive care, a limited number of doctor visits and perhaps generic drugs. They wouldn’t cover things such as surgery, hospital stays or prenatal care. Private brokers are seeing it in large companies for which they consult in designing insurance plans. Insurers like AFLAC and Humana are lining up for the bonanza in supplementary plans to cover those unimportant things (reference this article written by Michael Barone http://www.detroitnews.com/article/20130529/OPINION01/305290001).
We in the US would be wholly better off with 100 percent private purchase of plans, tailored to what the insured needs and wants, rather than this dog’s breakfast. (And I am concerned that dogs would find this insulting.) It would also tamp down the insecurity that all parts of the health care sector have been experiencing since the early 2000s. We have a lot of defensive medicine in the US due to bad tort law. There’s also the big fact that no big players are massively buying into tech except in EHRs as mandated–and they are their own problem both in cost and rapid obsolescence–in HIT to somehow manage the proliferation of DIY mobile devices–and now preventing 30-day same cause readmissions (due to Medicare and Medicaid managed plans–another government diktat, not care driven!) Mobile IT is just layered on to this. The drive towards outcome based payments may actually be covering up a larger mess, lower care levels, more defensive medicine and less appropriate right time-right place care.
I understand that there may have been ‘loose’ reporting at play but Jeremy Hunt has a team of staff and one of the jobs they should be doing is to make sure that what he did say is publicly available to correct any misinterpretation. Having looked in all the places I would expect to find it, I can’t!
The bigger than the Internet comment appears to relate solely to the point about mapping 100,000 genomes with EMR. We don’t yet have EMR – it has been ordered to be in place throughout England in a year’s time. In order to have EMR for 100,000 people with cancer at age 40, to do the genomic profiling and then for those patients to still have an EMR in their 70s is going to need longer than that 30 year age gap. It didn’t take the WWW that long to get established!
Of more immediate concern is that although the genomic data may be powerful, whilst Jeremy Hunt is aspiring to be better than the Internet, people are missing out on consistently high quality care for the disease and surgeries they need now rather than in 50 years time.
In an international context, Jeremy Hunt’s aspirations for England, make the divisions between healthcare in the developed world and developing world even bigger… another difference to the Internet which offers people opportunities to join together and work collaboratively for better healthcare around the world.
Bragging is never attractive … it often comes back to bite one (especially high profile politicians) on the behind …