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Tele-Medicine: Applications in Aging Services. Craig Lehmann, Ph.D., CC (NRCC), FACB Dean/Professor School of Health Technology & Management Health Science Center State University of New York at Stony Brook Stony Brook, N.Y. 11794-8200 [email protected] Utilization of Healthcare.

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tele medicine applications in aging services
Tele-Medicine:Applications in Aging Services

Craig Lehmann, Ph.D., CC (NRCC), FACB

Dean/Professor

School of Health Technology & Management

Health Science Center

State University of New York at Stony Brook

Stony Brook, N.Y. 11794-8200

[email protected]

utilization of healthcare
Utilization of Healthcare
  • Office Visits to Physicians: 765,700,000 (1999) 823,542,000 (2000)
  • Most frequent principal reason: Physical 63,000,000 (1999) same for (2000)
  • Most frequent physician specialty: General and Family Practice 170,571,000 (1999) 198,578,000 (2000)
  • Most frequent principal diagnosis: Essential Hypertension 31,962,000 (1999) 35,096,000 (2000)

Source: CDC

utilization of health care by aged 65yrs or older
Utilization of Health Care by Aged (65yrs or older)
  • Visit physicians on the average 8 times a year compared to 3 times a year for those <65yrs.
  • Hospitalized 3 times as often and stay 50% longer.
  • Of the 31 million hospitalizations in the US the Aged accounted for 40% (1997).
  • It is estimated that by the year 2025 the aged will account for two thirds of the US health care budget.
utilization of healthcare5
Utilization of Healthcare

Emergency Department

  • Emergency Department Visits: 102,765,000 (1999) – 108,000,000 (2000)
  • Most frequent principal reason: Stomach and Abdominal Pain 6,800,000 (2000)
  • Number of Injury Related Visits 40,400,000
  • Most Frequent Diagnostic/Screening Service Provided: Blood Pressure (75% of all visits)
  • Type of drug most frequently Prescribed:

Tylenol (10,000,000)

Source: CDC

chronic conditions of the aged
Chronic Conditions of the Aged
  • Arthritis
  • Hypertension
  • Hearing Impairment
  • Heart Disease
  • Cataracts
  • Deformity or Orthopedic Impairment
  • Chronic Sinusitis
  • Diabetes
  • Visual Impairment
cost of managing diabetes

Cost of Managing Diabetes

100 Billion Dollars Annually

health care utilization by the diabetes patient
Health care utilization by the Diabetes Patient
  • 96.1 million out patient medical encounters
  • 53.4 million visits to physician’s office
  • 16.4 million visits to ambulatory care settings
  • Visited their physician on the average 15.5 yr. as compared to 4.9 for the general population (all ages).
  • Numerous visits to the clinical laboratory
kidney disease in diabetes end stage renal disease
Kidney Disease in Diabetes (End Stage Renal Disease)
  • Diabetes account for more than 35% of all end stage renal disease
  • Costs exceed 4 billion dollars
incidence of diabetes will rise
Incidence of diabetes will rise
  • 17 million diagnosed diabetics.
  • Another 5.4 million undiagnosed.
  • 125 million worldwide
  • Could be 30 million by 2050
  • Complications associated with diabetes:

Retinopathy

Renal Failure

Neuropathy

Atherosclerosis

Lower Extremity Amputation

what s the solution

What’s the Solution?

Better Patient Management

Tele-health

Connectivity

patient population
CHF

Diabetes

Asthma

Cancer

High risk pregnancy

Hospice

Post stroke

Frail elderly

Wound care

COPD

Poor compliance

Post operative states

AIDS

Spinal cord injury

Rural locations

Patient Population
largest users today
Largest Users Today…
  • Prison population
  • Federal programs – Department of Defense, NASA
  • Veterans Administration Home Telehealth Project
capabilities
Capabilities
  • Close patient monitoring of vital signs
  • Educational programs
  • Video visits
  • Messaging
  • Medication reminders
  • Digital pictures
provider benefits
Provider Benefits
  • Increased # of patients served
  • Improved access to patients
  • Enhanced ability to monitor patients
  • Efficient use of clinician time
3 rd generation product
3rd Generation Product

Blood

sugar

Blood

oxygen

Camera

Weight

ECG

Thermometer

Blood

pressure

Stethoscope

some tele health vendors
Some Tele-Health Vendors
  • American Tele-care
  • American Telemedicine
  • Cyber-Care
  • Home-med
  • Motorola
  • Phillips
  • Tele-med
  • Viterion
slide24
Firewall

Firewall

Application

Server

HTTP

Server

Database

Secure Viterion Network

Patient Monitor

Internet-Enabled Provider PC

DirectDial-Up

Internet

my research focus better management via telehealth

My Research Focus: better management via Telehealth

Chronic Ailments:

Congestive Heart Failure

Diabetes

impact of technology on home bound congestive heart failure patients
Impact of Technology on Home Bound Congestive Heart Failure Patients
  • Pilot Study: Congestive Heart Failure (N=20)
  • Goals:

Primary: Decrease Hospital and Emergency Department Encounters Secondary: Nurse and Patient Acceptance of Telehealth Technology

congestive heart failure study outcomes
Congestive Heart failure Study Outcomes
  • No patients from the study group utilized the emergency department. During the study three patients from the study group wanted to go to the emergency department.
  • 20% (n=2) of the control group were re-hospitalized via the emergency room.
  • All patients in the study group felt that they had received better care because of the VST and connectivity
new study diabetes research
Study Group:

Receive Telehealth

Blood Pressure

POCT: Glucose, Cholesterol and Micro-albumin

Control :

Telephone

Glucometer

New Study: Diabetes Research
diabetes research
Diabetes Research

Monitor:

  • Compliance
  • Physician Office Visits
  • Home Visits
  • Emergency Department Encounters
  • Hospitalizations
  • Clinical Evaluations
diabetes research39
Diabetes Research
  • Compliance (other data shows greatly improved)
  • Physician and Home Visits
  • Emergency Department Encounters (Our Data Demonstrated Decline)
  • Hospitalizations (should decline)
  • Overall Healthcare Costs Reduced
diabetes research40
Diabetes Research

Long-term Outcomes:

  • Overall Better Management Results in:
  • Improved Life Style
  • Lower Heart Disease
  • Less Lower Extremity Amputations
  • Early Detection of End-Stage Renal Disease
  • Much Reduced Healthcare Costs
if patients could be monitored via the internet 20 of office visits could be eliminated

“If patients could be monitored via the internet 20% of office visits could be eliminated”

1999 = 756,700,000 physician visits

20% would save 150,134,000 visits @ $40.00 per visit

Dollar Savings $6,050,400,000

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