Connected health

• Home care via remote monitoring of chronically ill patients including surveillance connected devices or patient controlled monitoring of health parameters^[citation needed]
• Traditional telehealth programs, where care is provided in remote areas by teams of local clinicians or community healthcare workers teamed up with specialists in medical centers^{[citation needed]}
• Monitoring programs whose aim is to ensure the safety and quality of life of elderly parents living at a distance from their relatives^{[citation needed]}
• Web-based second opinion services for patients in need of medical care^{[citation needed]}
• Lifestyle and fitness coaching for wellness or health risk reduction^{[citation needed]}

The Center for Connected Health is implementing a range of programs in high-risk, chronic and remotely located populations.^{[citation needed]}

Inherent in the concept of connected health is flexibility in terms of technological approaches to care delivery and specific program objectives. For instance, remote monitoring programs might use a combination of cell phone and smart phone technology, online communications or biosensors and may aim to increase patient-provider communication, involve patients in their care through regular feedback, or improve upon a health outcome measure in a defined patient population or individual. Digital pen technology, global positioning, videoconferencing and environmental sensors are all playing a role in connected health.^{[citation needed]}

Goals

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Proponents of Connected health view it as a critical component of change in human healthcare and envision:

• Reductions in the cost of providing quality care to the chronically ill, estimated by the Center for Health Care Economics at the Milken Institute to be over $1 trillion per year
• Improved global and local public health surveillance, with a resultant reduction in epidemics, increased control over infectious disease and improved drug safety
• Diminished rate of medical errors
• Better "customer service" in healthcare
• Ongoing preventive health, with attendant reductions in: morbidity, mortality and the cost of care
• Consumer engagement in health and self-management
• Safer and more effective clinical trials

Evolution

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Rising costs, increases in chronic diseases, geographic dispersion of families, growing provider shortages, ethnic disparities in care, better survival rates among patients fighting serious diseases, an aging U.S. population and longer lifespan are all factors pointing to a need for better ways of delivering healthcare.^[8][9][10]

Direct-to-consumer advertising is a demonstrated contributor to the rise in consumer demand, as is the mass availability of inexpensive technology and ubiquity of the Internet, cell phones and PDAs.^[11][12] Connected health experts such as Joseph C. Kvedar, believe that consumer engagement in healthcare is on its way to becoming a major force for change.^{[citation needed]}

In summary, connected health has arisen from: 1) a desire on the part of individual physicians and healthcare organizations to provide better access, quality and efficiency of care 2) dynamics of the healthcare economy (such as rising costs and changing demographics) 3) consumerism in health care and a drive towards patient centric healthcare. Together, these factors are providing impetus for connected healthcare in the United States and many other industrialised nations and forcing innovation both from within and outside the system.^{[citation needed]}

Evidence

While connected health is yet emerging, there is evidence of its benefit. For example, in a program being implemented by the Center for Connected Health and Partners Home Care, over 500 heart failure patients have now been monitored remotely through the collection of vital signs, including heart rate, blood pressure and weight, using simple devices in the patient's home. The information is sent daily to a home health nurse, who can identify early warning signs, notify the patient's primary care physician, and intervene to avert potential health crises. A pilot of this program demonstrated reduced hospitalizations.^[13] Another initiative at the Center for Connected Health uses cellular telephone technology and a "smart" pill bottle to detect when a patient has not taken their scheduled medication. A signal is then sent that lights up an ambient orb device in the patient's home to remind them to take their medication.

Funding and implementation

It appears that connected health programs are operated and funded primarily by home care agencies and large healthcare systems.^[