Keeping well at home – the new frontier

A smart partnership between a major health insurer, a big telco and a niche international telehealth and health management company highlights the promising new frontier in chronic disease management.

By Keryn Curtis

Australia’s largest not-for-profit private health insurer, the country’s largest ‘telco’ and the local arm of a global telehealth company has announced a new alliance that promises to take health promotion and chronic disease management to a whole new evidence-based level.

The strategic partnership between HCF, Healthways Australia and Telstra, involving the largest ever rollout of a telemonitoring program in Australia, is designed to enhance HCF’s award-winning My Health Guardian program, which already provides tailored personal healthcare support and advice to more than 25,000 HCF members who have chronic health conditions. 

The new telemonitoring program will augment that support by recording and automatically reporting real data from a range of smart Wi-Fi-enabled health monitoring devices – such as weight scales, tools for measuring blood pressure, glucometers for monitoring blood glucose levels for people with diabetes or hypoglycaemia, and oximeters for measuring the oxygen saturation levels in blood  – that can be placed in people’s homes.

Chief Medical Officer for HCF, Dr Andrew Cottrill, said the same approach had been tested with a small pilot late in 2012 that worked by feeding the health data into apps on mobile phones.

“The pilot was very well received in that when we surveyed people, everyone who started it definitely wanted to finish it.  But most of the participants were in the older age group and for many of them, the biggest problem was handling and dealing with the technology.

“In the meantime, technology is changing so very rapidly and now Telstra has this new technology that operates completely independently and automatically.  You now don’t need a mobile phone or an internet connection or even a landline at all.  And you don’t need to be a Telstra account holder.

“You just need to be within range of the Telstra Next G network, which Telstra says covers 99 per cent of the country now.  And you need to be able to use these devices,” Dr Cottrill said.

He said the new program, planned to commence in the first half of 2014, would target particular people already on the My Health Guardian program managing chronic diseases such as diabetes and hypertension, who the clinicians feel would benefit from closer monitoring and support.  

“The nurses will discuss the program as an option with the patient or member. If they are willing and interested, then we will send them the health monitoring device in a post pack.  

“There’s a hub, which is the size of a small block of soap, that comes in the pack with the device.  When the person uses the device to measure their blood pressure or their blood glucose levels or whatever it does, the device automatically sends the data to the hub which is connected to the Next G network and it sends the data to the Healthways system.  

“The nurses receive the data and can use that to better inform their monitoring and support.  The person might be using the device two or three times a day.  If the nurse can see the data trending in the wrong direction, then they might give them a call and they might recommend that they go back to their GP and meanwhile increase the frequency of the contact.  Also, if they can see that the person hasn’t reported for a while, then they can follow up.” 

Dr Cottrill said the system could also feed the data direct to the person’s GP, if the person provided permission.  It also has the potential to feed into the new national Personally Controlled Electronic Health Record (PCEHR) system in the future.  “It’s not in our sights yet, but we see that as part of the evolution,” he said.

Part of the solution

Dr Linda Swan is Managing Director of Healthways Australia – the clinician-led telehealth company that delivers HCF’s My Health Guardian program. She says the enhancements to the program are an important new part of the strategy of empowering individuals to improve their own health.  

“We know that losing weight or getting good control of your blood sugar levels doesn’t just happen because your GP tells you to do it in a fifteen minute consultation.  It requires ongoing support, ideally one to one support, tailored to the specific needs and context of the individual.

“This is a consumer-centred approach – it’s about coaching people to find a way to improve their health in whatever way best works for them. We look at people not as being ‘a diabetic’, but in a holistic way and we will often have to look into their living arrangements and their social setting, as well as whether they are managing their medicines or doing their exercises,”  she said.

But Dr Swan said the role of the telehealth service is as facilitators and catalysts, not direct care providers. 

“We don’t provide face to face services but we have partnerships with services that do that and we help people work out how to access other services.  

“We very much see our program as linked in with the care that is provided by the person’s GP and the aim is to keep people in the loop.  

“There are a lot of good initiatives being implemented right across the healthcare spectrum – what we need to do is link people up with the people who do what they do best.   

“These services are going to be part of the future of healthcare. We do know that we can’t keep doing what we have been doing which is costly and inefficient and sometimes results in adverse outcomes so we are in the process of trying to find alternative models.  

“This is demonstrating a different and more cost effective way that people can manage their own healthcare and be in control.  It won’t work for everyone but we are on a journey and we see this as part of the solution.”

Tags: hcf, healthways-australia, my-health-guardian, pcehr, telehealth, telemonitoring, telstra,

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