The Centers for Medicare and
Medicaid Services reported that in 2009 US healthcare spending increased 5.6%
to $2.47trillion and represented 17.3% of the US economy. The increase from
2008 to 2009 is the largest jump in healthcare spending since 1960, and it is
remarkable that in a year in which the US economy contracted by 2.4% healthcare
and the federal government were the only sectors to show an increase. This
growth is also occurring from a high base, starting at a level 30% to 50%
higher than most industrialized countries, and is unsustainable.
Part of the healthcare cost
problem is the way that most healthcare services are provided. Hospital Care
represents 31.1% of all healthcare costs and is notoriously expensive. The
average cost for 1 day in the hospital in 2002 was $1,290, nearly double the
average cost from 1990 and since 2002 hospital costs have increased by more than
50%. Professional Services, which in the Center for Disease Control (CDC) data
includes Physician and clinical services, Dental services and other
professional services represents another 31.3% of total healthcare costs and
Nursing home care a further 5.9%. All of these services are provided onsite, in
facilities and environments that are costly to maintain and where costs are
increasing rapidly and represent more than 68% of the total healthcare
expenditure in the US in 2007.
Cost however, is only part of the
problem with this centralized model of healthcare delivery. Hospitals, clinics,
Doctors offices and even nursing homes are notorious for spreading disease.
According to a February 2003 article in The New England Journal of Medicine
between 5% and 10% of all patients admitted to an acute-care hospital acquired
one or more infections. The CDC estimates that there are 1.7million hospital
acquired infections each year resulting in approximately 99,000 deaths, various
sources have estimated that these terminal cases alone result in over $6billion
in healthcare costs each year. These economic costs pale in comparison to the
pain, suffering and loss of life resulting from these infections.
The centralized model also
provides a setting that is at best impersonal and often dehumanizing. By design
the institutional feel of hospitals, clinics, Doctors' offices and nursing
homes can increase the physical discomfort of patients through raised levels of
anxiety, disorientation, helplessness and even depression. Also the very nature
of such institutions entails interruptions at odd hours by staff and other
patients and a constantly changing cast of care providers that further add to
the discomfort of the patient.
Treating patients in the home is
much less costly and provides a familiar setting for the patient. It is also
usually an environment that is more comfortable, lowers the risk of spreading
infection and adds to the patient's sense of control over their treatment. The
difficulty is that up until now much of the technology for cost and
accessibility reasons needed the centralized model to be effective.
Telemedicine involves the use of
telecommunications either through traditional phone networks, cell phone
networks or the internet to diagnose, treat and monitor patients across large
distances. Early use has focused on telecardiology and teleradiology where EKG
and X-Ray information is transmitted over communication lines and monitored and
analyzed at locations remote from the patient. Recently, new procedures now
allow surgeons to perform certain procedures remotely and many hospitals have
implemented remote nursing stations that can monitor patients from many
facilities from one centralized location.
Telemedicine is also being used
in the home healthcare setting to provide emergency alerts through personal
emergency response systems and the monitoring of patients vital signs such as
heart rate, blood pressure, cholesterol and glucose level. The latest advances
in home healthcare telemedicine have been in the area of medication management,
which given the costs of poor medication compliance represents an enormous
opportunity to not only save costs but to also greatly improve medical outcomes
and save lives.
Over 50 million people in the US
are on three or more prescriptions. While many of these medications are
critical to improving the health of the patient the average compliance rate
with their medication regime is only 50%. Poor medication adherence according
to the Center for Disease Control represents a significant healthcare problem
resulting in increased costs and poor medical outcomes. The current poor rate
of medication adherence results in 10% of all hospital admissions (30% of all
hospital admissions for elderly), 22-40% of all Skilled Nursing Facility
admissions, 125,000 deaths per year and from $150billion to $300billion in
annual cost/waste.
And this problem will only get
worse as longer life spans and relatively low birth rates increase the nation's
average age over the coming years. The older we get, the more medications we
require and as the number of prescriptions increases so too does the amount of
non-compliance. As a result, the cost to the health care system due to poor
adherence is rising significantly.
There are a number of ways to
improve compliance that have been tested by the medical community. Adherence
rates can be significantly improved through better education, the monitoring of
patients in the home, and improved medication management. Medication management
devices help by organizing dosages, providing reminders to take pills and
sending alerts to care givers when dosages are not taken. Telemedicine based
medication management devices significantly improve compliance rates by utilizing
all three of these strategies.
One such product that provides
all of these functions is the Dispense-a-Pill (DAP) from HealthOneMed. The DAP
is a telemedicine product that provides automated dispensing of pill based
medications and supplements for specified doses, reminders of when to take each
dose and alerts to caregivers and/or healthcare providers when doses are not
taken. The DAP also provides, instructions, indications (what the medication is
for) and warnings for each medication to be dispensed. It is the only home
medication management product on the market capable of all of these functions
and utilizing the DAP will reduce medical expenses, improve outcomes and save
lives.
HealthOneMed is a medical device
manufacturer that has developed a unique product to improve medication
compliance in the home healthcare environment. Our product, the Dispense-a-Pill
(DAP) is an automated pill dispenser that can handle a 90 day supply for up to
8 medications and includes reminders for when to take medications,
instructions, indications, warnings and alerts to caregivers when medications
have not been taken. Studies show that the use of reminders and pill organizers
improves medication compliance. We feel that the DAP is a significant
improvement over existing pill organizers and will greatly improve compliance
rates for those that use it.
