Two major US Internet portals have begun to provide remote monitoring services to have their condition monitored online for a monthly fee.
Monitoring of chronic diseases, such as diabetes and heart disease, is emerging a practical application of the Internet to directly support patient care. Online monitoring can contribute to the effective management of chronic conditions and help reduce the need for patients to go to their doctors for a routine blood test or weigh-in.
The promise of remote monitoring of chronic diseases is that it can improve health outcomes and potentially lower health care costs of managing patients with chronic illnesses, who account for a growing proportion of overall health care costs
In August, Yahoo Inc. and iMetrikus Inc. launched Medicompass, a service that diabetics can use to track blood sugar levels. The Yahoo Web site creates an "action plan" based on guidelines from the American Diabetes Association, provides users with feedback and advises them whether they need to consult their doctor.
To use the service users will have to pay $4.95 a month or $39.95 a year and can authorise their doctors and other clinicians to access their data electronically. Yahoo, says it plans to expand the service to offer it to individuals with other chronic conditions by the end of the year.
The field of online chronic disease management is also being targeted by leading US e-health firm WebMD Corp, which in September will launch a fee-based service targeting patients with diabetes and other chronic conditions.
Another online service targeting chronic disease management is Medem, a venture partly owned by the American Medical Association, which is marketing its secure messaging network to insurers as a communication vehicle for their online disease-management activities.
One of the main barriers to more widespread adoption of online monitoring services has been the fact that few US health insurers have been prepared to reimburse doctors for remote monitoring. However, this is beginning to change.
According to a report in American Medical Association news, Medem recently signed a deal with US health insurer, ConnectiCare which in October will begin a yearlong online diabetes management research project.
The new service will allow patients with diabetes covered by ConnectiCare to send their glucose readings to their own doctors securely via the Internet. The service will initially be made available through ProHealth Physicians, a primary care physician group with over 150 physicians in more than 70 locations across Connecticut.
“This is a logical next step in the evolution of disease management and the integration of the Internet into the routine practice of medicine. This service can mitigate inconvenience and the loss of patient time, reduce lost patient income from absenteeism, and enhance employee productivity,” commented Paul Bluestein, MD, Senior Vice-President and Chief Medical Officer for ConnectiCare.
In the UK Docobo was in August awarded a Department of Trade and Industry (DTI) SMART research and development grant for an e-health project based on home-based remote management of the outpatient care for hypertensive diabetics.
The 1998 NHS information strategy ‘Information for Health’, still ostensibly the policy template for the National Programme for IT (NPfIT), set the goal for All local health services will have facilities for telemedicine by 2005.
The current Output Based Specification (OBS2) for Integrated Care Services (ICRS), published by the NPfIT in August 2003, states “E-Health and telemedicine solutions are an essential part of what LSP (local service provider) are expected to deliver.” It goes on to state that remote monitoring will be one of the areas of ‘emerging technologies’ that LSPs will be expected to deliver on.