Domestic assistance

Home-based healthcare could revolutionise the treatment of chronic diseases. So why are providers so reluctant to branch out?

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By  Administrator Published  January 21, 2008

Global business is now in the broadband age, but, for the most part, healthcare is still plodding away with dial-up. Technology has historically been viewed with a skeptical eye by physicians, but online home healthcare could be ready to make a serious impact on healthcare provision. Making small alterations to patient's treatment can take a physician seconds. For the patient, virtual care can cut time spent in the waiting room. Small but regular tweaks to medication can avert medical crises, and could be a real boon to more effective disease management.

"There is no longer a logical reason why many aspects of healthcare are still provided within an institutional setting - that's just inertia," argues Charles Walsh, founder and executive chairman of UK-based company Healthcare at Home. Individual management of chronic disease could have an enormous impact on healthcare systems, but Walsh complains that people are stuck in a mindset where building more facilities is the only solution to gaps in medical services.

There is no longer a logical reason why many aspects of healthcare are still provided within an institutional setting - that’s just inertia.

Recent statistics estimate that the GCC states are currently investing upwards of US$10bn on building new hospitals. Yet, with a virtual blank canvas, the GCC also has an opportunity to lead the way in establishing technology infrastructures, believes Herbert Weber, director of Intel's Digital Health Group (EMEA)."There is a lot of momentum and potential for growth in the Middle East, [but] it is really a question of getting the right systems in place."

Part of the problem in established markets is that legacy systems exist and institutions are often unwilling to change their ways. As a relatively new market, the GCC can start afresh with home healthcare systems. "They are very keen on building healthcare on the cutting edge of technology," insists Weber.

Lifting the burden

The Middle East has more than its fair share of patients with chronic conditions - who are the main beneficiaries of digital domestic care. Weber believes the logical step is to move chronic care out of the hospital and into the home.

"People don't like to stay in hospitals - people don't even like to go to physicians for regular checkups," he points out. "Diabetes is a long term disease and it doesn't require a lot of intervention, but it does require a lot of monitoring...so you can make small corrections to the medication," Weber observes. "If you do it in time, you're okay. If you wait too long, it's a disaster.

Charles Walsh started Healthcare at Home in 1992, it has five times appeared in the Fast Track 100, a list compiled by an Oxford-based research company to note the UK's 100 quickest growing companies. They now have 50,000 patients and a turnover exceeding £600mn. Clearly, Walsh says, there is a demand for home healthcare.

"If they are chronic patients then they are going to be receiving medical treatment in the long term and it makes sense for them to be taught administer their own treatment if possible, which it is in the vast majority of cases," he explains.

Virtual reality

The idea of digital communication between patients and their physicians sounds futuristic, but the potential for home healthcare has been around for a long time, notes Walsh. "Telemedicine type technology we've had for decades but nobody has been using it," he insists. The slow take-up of home healthcare could be explained by technology advancing faster than ageing physicians and patients. Doctors tend to be stoutly independent in their views, and technology has to make sense to the way they practice if it is to be accepted.

"There have been computers around for a long, long time but neither the typical elder patient or the physicians and nurses tend to be computer geeks," comments Weber.

Part of the battle has been communicating the benefits of home healthcare in a language that is accessible to physicians and patients. "The biggest challenge for a technology company like Intel is to keep it simple and keep it very user-friendly," Weber admits. "Physicians are willing to use technology but we need to show them the benefit: they don't use technology because it is cool - they use it because it does the job.

Safe as houses

A traditional concern surrounding home healthcare is safety. Human error is a constant in any calculation of medical danger, and the worry is that figure is amplified in a domestic setting. Weber points out that if someone in a bank makes an error that can cost you money.

If someone in healthcare makes an error that can cost you your life. With home healthcare, it is vital that people understand it is a support system, not a complete solution, argues Weber. "Devices should never replace the physician's judgment - what they can do is assist the physician by offering alerts to potential conflicts.

When Walsh started Healthcare at Home one of the initial hurdles was working out a suitable insurance policy. Malpractice cover was particularly difficult to provide, as assessing risk in a domestic setting was uncharted waters for insurers. Regardless, Walsh claims that Healthcare at Home have yet had to put their policy to the test, which he believes is indicative of just how stable telehealth systems can be. "In many ways it is safer for patients in their home as there is no risk of cross infection - we have practically no line infections," he states. "If you are working to well-defined protocols with fully-trained staff then it is a very safe environment to be treating patients.

Companies such as Walsh's are starting to break down the barriers to home healthcare and deliver to areas that need it most - such as chronic diseases. GCC states are investing heavily in hospitals, but the burden of chronic illness demands they consider innovative care. Perhaps it's time for patients and physicians in the Middle East to get connected.

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