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Mobile Telehealth
Health Care Services
Through Mobile Access
2
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Introduction
What is telehealth?
Telehealth refers to a means to provide health care and other
medical services remotely through modern communications networks. In general terms, telehealth can be divided into a number of different service segments:
? exchange of treatment speci? c information between health care professionals
? delivery of health related information to the public, mainly over the Internet ? monitoring of patients on off-the-hospital premises, typically at home ? remote consultation.
The main objectives of telehealth are to reduce treatment costs and to provide individuals with less expensive access to health related information. It certainly makes economic sense to transfer
information instead of transporting people, whenever possible.
Contents
Introduction
2Mainstreams of mobile telehealth 3Mobile telehealth business model 4
Telehealth builds on
standard communications solutions 5Mobile telehealth revenue models 6Conclusions
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With today ’s technology, this can be done without compromising patient integrity or the quality and con ? dentiality of the treatment in any way.
Mobile telehealth adds value
Mobility has brought a totally new dimension to telehealth and to the whole interdisciplinary provision of regional health care. Treatment can now be provided in virtually any location where access to a mobile communications system is available. Mobile telehealth applies mobility as a potential means to bring signi ? cant improvements to emergency and home treatment, routine check-ups, medical
consultation and sports medicine applications.
Just as the Internet will be in the future be in every pocket, health care will also become highly
‘pocketable ’, allowing everyone to access health care services
wherever they are needed: at home, at work or on the move.
Drivers of mobile telehealth The cost of health care is rising constantly and national health care organisations are striving to ? nd ways to make limited resources meet ever-growing demands.
As the average age of the population grows steadily, more resources are needed, but not necessarily
allocated, to take care of people ’s health problems.
Mobile networks provide an ideal platform for the home treatment concept. Personal monitoring devices can be carried anywhere, yet maintain a connection to treatment professionals 24 hours a day.
Thus, mobile telehealth brings sizeable cost savings and ? exibility without compromising the values of health care: full con ? dentiality, total privacy and high reliability. To hospitals, mobile telehealth means reduced bed stay and cost of care. To local health care providers, such as general practitioners,
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mobile telehealth means a greater reach of consultancy services.
To patients themselves, who appreciate a high quality of care but may prefer to stay at home instead of going to the hospital, mobile telehealth means independence and fewer consultations with their doctor, as well as virtually no constraints on location.
In developing countries, mobile telehealth provides an inexpensive means to extend basic medical services to regions that cannot be covered by any traditional health care system.
Traditional treatment practices are being challenged
Although all traditional face-to-face appointments with a physician or any other health care professional will not be replaced, there are cases that can be managed by using a more modern approach, i.e.,
by establishing a remote session
between a client and the treatment
personnel. Most routine checkups,
renewal of prescriptions, changes
in daily drug taking programmes
etc. can be managed remotely,
freeing the client and the physician
from unnecessary traveling and
visits.
Preventative treatment becomes
more effective, too, as the clients
now have the option to send their
vital parameters for the physician’s
consideration whenever
convenient, or when there is
something important to ask.
Better quality of life,
better medical outcomes
Statistics indicate that by moving
patients from the hospital to the
home, recovery rates can be
improved. This also removes the
potential risk of infection when
being treated in a hospital.
For those being cared for at home,
on-line consultation provides
improved communication –
the help is there when it is needed,
there is less delay in diagnosis
and treatment, and patients are less
stressed by hospital visits.
In emergency care, mobile
telehealth can save lives through
immediate provision of the right
instructions to paramedics,
enabling them to provide the right
treatment at an accident site.
Ambulatory patients can receive
better monitoring and advice.
New approaches for clinical
trialing are also possible, resulting
in less expensive and more
consistent data collection.
Preventative care
It is not surprising that people are concerned for their physical condition. This is very well indicated by the tremendous popularity of Internet based health care services in the US. The ability to check all vital parameters and to get immediate feedback will be very attractive to health-conscious individuals.
Home care
Typically, home care refers to the post-hospital monitoring period, when a client is under observation for some time to ensure that the recovery proceeds successfully.
From a hospital’s perspective,
this frees a great number of beds
and other resources and hence
shortens the queuing times of new
patients who are waiting to go into
hospital.
Emergency care
In emergencies, mobile
communications is one of the most
crucial instruments to ensure
that casualties are given the correct
treatment and medication during
transport to a hospital. In this case,
the basic mobile telehealth concept
is complemented by new advanced
services such as voice recognition
and map information combined
with driving instructions.
Information services
Whenever necessary, the treatment
services can be complemented
by information and advice from
treatment personnel. This typically
deals with medication, dietary
advice, evaluation of the overall
condition of a client, or simply
general health related information.
Feedback is extremely important to
the client, giving reassurance that
they are being cared for properly.
Mainstreams of mobile telehealth
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The business model of any given telehealth service is a complicated one, due to the large number of potential interest groups.
Typically, the activities shown in Figure 1 are included, either as single business entities or through a number of partnerships.
In Figure 1, the following functions and activities can be identi ? ed:Health Care Service Provider is a business entity that is authorised to provide medical or health care services. It will typically be a hospital, private clinic, health
centre or their equivalent. Like any business, hospitals may specialise in certain ? elds of medicine,
which will have an effect on what kind of treatment options ? t with their existing offering.
“MobileTelehealth Ltd” refers to a business entity that is capable of providing the technology and equipment needed to implement the remote health care concept.Biosignal technologies refers to the technical solutions used for measuring and transmitting vital parameters of clients treated outside the traditional premises. Typically, modern technologies facilitate the measurement of blood pressure, pulse rate, temperature, ECG or glucose content of blood. The signals to be measured may vary within wide limits, depending on the complexity of the treatment case.Adaptation to IT systems refers to the skills to integrate individual measuring systems with the existing IT systems in hospitals, in terms of data postprocessing, database management, access security and so on.
Telecom & datacom services refers to the communications means needed to transfer the information from clients ’ premises to hospitals. Reliable communications services are extremely important, especially if the treatment becomes fully dependent on the condition of mobile and ? xed networks between the patient and the hospital.Logistics management refers to the skills to streamline warehousing, transportation, installation,
repair and replacement of all infra and terminal equipment involved in remote treatment https://www.360docs.net/doc/063830845.html,rmation services refers to the option to provide Internet based, health related information,
to complement the actual treatment services.
On top of the basic remote treatment concept, the Nokia solution
incorporates an easy-to-use means to access a number of medical information services offered by public institutions, or commercial entities such as drug companies.Payers refers to insurance
companies, national agencies or employers that pay for the treatment partly or in full, depending on the compensation model.
Figure 1. Mobile telehealth business model
“MobileTeleHealth Ltd”
Biosignal technologies
Telecom & datacom services
Logistics management
Information services (ISPs)
Adaptation to IT systems
Health Care Service Provider (hospital, health centre)
Client
Payers
Mobile telehealth business model
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From a network operator’s perspective, telehealth is quite a transparent service concept.
A GSM networks “sees” a remote care client as an ordinary subscriber, although the health care terminal differs from the traditional one.
In technical terms, a remote health care session is similar to a data call between two computers:
one located in the terminal and the other located on the Intranet of the health care organisation.
Wireless LAN access can be used in hospital premises to make the communication between a client and the treatment personnel as convenient as possible.The clients’ terminals shown in
Figure 2 are permanently connected
to the service nodes in hospitals
or health centres. For medical
consultation, the information can
be pre-processed and transferred
to physicians’ terminals that are
connected to the system.
The following information is
typically transferred in the network:
? ordinary voice calls
?picture & video information
?multi-channel ECG graphics
? client’s blood pressure, heart rate
& temperature information
? prescriptions.
Figure 2. Mobile telehealth service architecture
Hospital
Wireless
LAN Access
Mobile
Access
Mobile Access Internet
Intranet
Home
client
Emergency
client
School
client
Consulting Physician
Doctor Information Health Centre
Telehealth builds on standard communications solutions
Normal security and encryption
procedures are applied, to protect
client speci? c information and
privacy in all cases. Nokia security
solutions make unauthorised access
to the system virtually impossible,
through sophisticated login,
authentication and encryption
procedures. A number of access levels
can be created, restricting user groups
to certain types of information.
The recently launched WAP
(Wireless Application Protocol) can
be used effectively as a platform for
new information services, available
either on the public Internet or on
private Intranet domains.
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The overall mobile telehealth business case is a complex one. Due to the potentially large number of partners and service providers, each activity needs to be analysed separately.
Health Care Service Provider
To a hospital or health centre,
the option to treat patients effectively and reliably outside the traditional treatment premises presents a great opportunity. The implications are:?The resources available are used in a better way, i.e., more patients can be treated without increasing the overall treatment costs. This means a lower cost per patient.
?Consultation can be given on-line, although the patients to be treated are elsewhere. This enhances
the ef? ciency of the treatment organisation still further.?Routine inspections and monitoring can be done at a patient’s home, releasing costly resources for more demanding treatment cases in hospitals.?New businesses, such as preventative treatment, or home care of elderly people, can be developed effectively. This means a new source of revenues or alternatively a lowering of the burden on national health care resources.
“MobileTelehealth Ltd”
The role of this new business entity is that of a service enabler.
It does not provide the primary treatment service but takes care of all equipment, software and supporting services necessary to implement and run the mobile telehealth concept. There are several
models of how to generate revenues,
some of which are listed below:
?Sales of supporting service
packages to health care service
providers, i.e., hospitals and
their equivalent
?Distribution and maintenance
of equipment related to remote
treatment, i.e., terminals, servers,
sensors etc.
?Resale of airtime in GSM or
other networks as part of the
supporting service package
?Sales of upgrade packages.
Biosignal technologies
Typically, small enterprises
specialising in biosignals and
bioelectronics have limited
resources for global sales and
marketing, and the time-to-market
easily becomes too long.
Therefore, the partnership with a
sales-orientated organisation such
as MobileTelehealth Ltd. potentially
makes market entry easier and
much faster. In this context,
the earning model is based on:
?Gross sales of special devices to a
major telehealth speci? c
distribution organisation
?Sales and upgrades of application
software through the same outlet
?Sales of consultation services to
client health care organisations.
Adaptation to IT systems
The information systems of
individual health centres and
hospitals are often very different
from each other. There are
differences in such things as user
interfaces, structure of databases
and security solutions, meaning
that no global standards are likely
to be taken into use in the
foreseeable future. Therefore,
some tailoring will probably be
needed when the new telehealth
sub-system has to be integrated
with an existing IT platform.
To an IT engineering company,
mobile telehealth thus means a
new opportunity in the form of:
?Sales of integration and
commissioning know-how
?Sales of maintenance services
?Sales of computing and other
IT equipment.
Telecom & datacom
The revenues of a network
operator consist of:
?Sales of new subscriptions and
airtime in GSM networks
?Sales of Internet access services
whenever feasible
?Sales of network speci? c special
services such as voice
recognition, map and routing
information.
In particular, voice recognition
is an attractive technology that
easily ? nds several applications in
remote treatment. At the moment,
this technology is being trialled
for emergency services, but it will
also be available for consumer
type applications.
In the near future, 3rd generation
mobile networks will be taken into
use. This will make transmission
of biosignals much more effective,
and will facilitate the creation of
new service tariffs based on the
amount of information transferred,
rather than on the duration of
a call.
Mobile telehealth revenue models
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Logistics management
We believe that due to the strategic importance of logistics management, it will remain an integral part
of MobileTelehealth Ltd above.
Information services
In the same way as a telecom operator above, an independent Internet Service Provider (ISP) or Application Service Provider (ASP) can establish a partnership with MobileTelehealth Ltd, to collect revenues from access to the Internet and health related services.
The revenue models are typically:?Sales of health and treatment information to professionals ?Provision of access to medical databases
?Sales of health related information to chosen target groups or to the public
?Sales of advertising space in health care portals.Payers
From the perspective of an insurance
company – be it private or public –
the remote care concept means
a less expensive way of providing
adequate treatment. Hence,
earnings are increased due to a
reduction in insurance payouts.
If a person to be insured is covered
by a preventative treatment
concept, then the risk in signing
a contract – for life assurance for
instance – is clearly lower than
when such a treatment concept does
not exist.
In some cases, part of the treatment
and insurance costs are paid by
a person’s employer. In this case,
the preventative treatment concept
can lower the risk of something
happening to the key management,
such as a stroke, or something less
dramatic.
Conclusions
The rapid evolution of mobile
communications provides an
excellent platform for new types of
health care services. Nokia believes
that the long-term solutions to
keeping growing costs under
control will be based on treatment
options outside hospitals and
based on information transfer over
wireless networks.
There are several interest groups
involved, and the overall operating
model is highly complex. However,
the model can be implemented
through effective partnership
management and sharing revenues.
All the technologies needed to make
mobile telehealth a reality are
already in place, either from Nokia
or from its partners. The great
challenge is to convince health care
professionals and administrations
that mobile telehealth makes sense
not just in theory but also in
practice. We believe this can be done
through a set of small-scale trials
in a number of countries, each
having its own legal guidelines,
working habits and attitudes.
Copyright ? Nokia Networks Oy 2000. All rights reserved.
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N o k i a c o d e : 000001100 L i b r i s ? N o k i a N e t w o r k s 2000. A l l r i g h t s r e s e r v e d . N o k i a a n d N o k i a C o n n e c t i n g P e o p l e a r e r e g i s t e r e d t r a d e m a r k s o f N o k i a C o r p o r a t i o n .O t h e r p r o d u c t a n d c o m p a n y n a m e s m e n t i o n e d h e r e i n m a y b e t r a d e m a r k s o r t r a d e n a m e s o f t h e i r r e s p e c t i v e o w n e r s .P r o d u c t s a r e s u b j e c t t o c h a n g e w i t h o u t n o t i c e .
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Mobile Telehealth
Health Care Services
Through Mobile Access