Better Care in the 21st Century: Virtual Hospitals in the Home
Or
Executive Summary of Project for Texas Instruments, “A Better Life Today and Tomorrow: Advancing Home Healthcare Through Technology”

By Leo J. Borrell, M.D.
Health Care Equity Investors
4150 Wsetheimer, Suite 103
713-627-3532
E-mail: lborrell@hotmail.com

A new millennium is approaching that will have a direct impact on the way health care is administered to a large segment of the population. Due to new breakthroughs in technology, patients that are now being short-changed by the managed care system will soon have access to more advanced, more cost-effective forms of health care that will virtually bring the diagnostic and monitoring capabilities of the hospital into the comfort of their own homes. Though some medical procedures - such as surgery - will always have to be performed in a hospital, the philosophical shift to disease management and preventative medicine may greatly reduce the number of procedures that will be required.

(Table I: Summary of Factors Influencing the Future of Healthcare)

Telemedicine, which became a reality through the space program in the 1960’s to monitor the life functions of the astronauts in space, has gradually expanded to the general population as a result of new technologies. These include miniaturization of the sensor, videophones, interactive cable, wireless communication, and the Internet, which allow physicians to monitor the progress of patients in their homes. In the next few years, advances in technology will facilitate the production of smaller and less costly home-model versions of the diagnostic and therapeutic equipment found in hospitals. Consequently, patients’ families will be able to conduct diagnostic tests themselves in their homes. The benefits of this include early detection of potentially life-threatening diseases, and fewer hospital visits for chronically ill patients.

Another area in which up-and-coming technologies can aid the healthcare profession is information management. The 21st century has already been dubbed The Age of Knowledge. Physicians today have four times as much knowledge as they did in the early 1980’s. This is partially due to the vast amount of long-term outcome studies conducted in the past twenty years. Today, part of the diagnosis process involves comparative analysis using the wealth of information collected in these studies. In order to process all this information, so that it can be useful and effective, the management system must be organized and must meet doctors’ changing needs.

In the past, management information systems (MIS) focused on data storage and retrieval. With the advent of telemedicine, which utilizes remote diagnosis, and consultation and monitoring, data exchange is becoming more important. Doctors need to be able to give and receive information about patients’ cases, while constantly updating their medical histories. New Information Processing Systems are quickly replacing the old MIS, and will soon be able to integrate all phases of the home healthcare industry. The technology that is making this possible is Digital Signal Processing (DSP). DSP, originally designed for hand held calculators and wireless technology (such as mobile phones), is able to fulfill this need, because it offers a reprogrammable chip. This function is invaluable, because it allows the constant updating of patient files, and facilitates the tracking of their progress, as well as complex data processing and analysis, which makes possible the beginning of wide acceptance of Telemedicine.

(Table II: Telemedicine Advances)

This is of the utmost importance for today’s busy doctors who need to stay connected to their patients and their families. HCIS will experience explosive growth. It is predicted that revenues which are now $10 billion will reach $67 billion in 15 years.

(Table III: Evolution & Revolution of HCIS)

1998
Revenue $10 Billion

2003-2008
Revenue $27 Billion

2008-2013
Revenue $67 Billion

The future of healthcare will be greatly influenced by the fact that the “Baby-Boomer” generation is quickly approaching retirement age. Therefore, home healthcare is becoming an ever-increasing segment of the total healthcare market. Even now, the over-65 group is the fastest growing proportion of our society. It also has the greatest expendable income and is more knowledgeable about healthcare than any other generation of seniors before. This, and a great desire to maintain their independence, has created a great demand (which will grow even larger in the next five to ten years) for more comprehensive home healthcare products and services. Some categories of healthcare products have already been created which allow individuals more control over their healthcare. Some examples include:

1) Security and Privacy Devices: These devices use voiceprints to record personal health information, a feature that affords privacy and accountability.

2) Digital Hearing Devices: These integrate voice, digital and data information, which fosters reassurance in patients by improving compliance.

3) Smart Cards: These act like credit cards, while also being able to integrate medical records with financial information.

Whether they are doctors, nurses, or patients and their families, all participants in the healthcare system have different sets of values that are important to each particular group. These values depend on factors that impact and effect the participants’ abilities to deliver, or receive, care. These factors form a chain of values, which can be confounded by other, intervening factors (such as discontinuities in the healthcare system). As the shift from hospital-and-clinic-based to home-based health care progresses, there will be a reorganization in the value chains of each group (doctors, nurses, patients and families). The diagram below represents a Patient’s/Family’s Value Chain when receiving hospital services.

Table IV
Patient Value Chain

The implications for this shift towards more technology in healthcare, especially home healthcare, are that it provides opportunities for high tech companies to enter into the medical market. In the next five to ten years there will be a much greater demand for healthcare products that can be used in the home, as well as new technology to meet society’s changing needs. Companies can opt for a low risk venture, by developing products that can be used right now; or, if they want to become leaders and gain dominance in the market, they can assess future needs, and try to utilize new technological knowledge to come out with complex systems. Either way, the first step for any company wanting to enter the market is to establish a clear set of goals. Strong, yet flexible management, and a solid financial backing is also important, as is a cohesive company team that shares a common vision. However, for a future oriented company, the possibilities are endless - and society will also benefit.

Complete Bibliography Available Upon Request

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If you wish to purchase this report in its complete from for $100, please contact Dr. Borrell.