Elderly Lose as Rules Choke Health IT Progress : Remote sensing devices could be used to limit the cost of monitoring the health status of elderly patients.


WASHINGTON — The United States has underinvested in health information technologies that could help improve the lives of elderly people, Craig Barrett, chairman of the board of the Intel Corporation, said at the 2005 White House Conference on Aging.

Companies have been actively investigating these technologies—“just not here in the U.S.,” he said. “Many other countries are ahead of us.”

In Korea, for example, user-friendly devices such as cell phones that double as glucose monitors are being tested. “It's not trialed here. It's not allowed,” he said.

Bringing such technology to market requires research and development funding, but licensing hurdles, regulatory issues, reimbursement issues, and liability concerns slow the process in the United States. Physicians, for example, don't use e-mail to communicate with patients because they are not reimbursed for giving advice over the Internet, Mr. Barrett said.

If the United States were to coordinate companies' efforts to tap research and development funding for such technologies, elderly patients could live better quality lives in their homes, rather than in hospitals and clinics, he argued.

Those efforts also would help lower the medical costs of caring for elderly patients, who make up 15% of all patients, but who account for 85% of medical costs, Mr. Barrett said. “If we can figure out a way to lower those medical costs to help that small population of people, we'd be much farther ahead.”

Various devices capable of monitoring information about diseases could be made available to patients, caretakers, and physicians, he said. “You could turn the health care system around so that all sorts of technology could be used by individuals at home to ward off having to go to the hospital,” he said.

“You could help prevent disease, entice people to exercise right.” For example, you could put a pedometer on a patient that has a wireless connection to a PC and encourage the patient to walk 4 miles a day, then monitor the patient's progress, he said.

You could detect disease onset with monitors and sensors. By placing these technologies in the home, “you could sense if individuals are walking around, opening refrigerators, if they're taking their medication, what they're doing on a daily basis.” The sensors would be monitored remotely so that caregivers and family could check up on their parents or elders at any time.

Sensors that are available today could be usd to help monitor chronic disease, tracking variables such as mobility, sleep quality, heartbeat, and breathing regularity, he said.

Such technology could also be used to improve lifestyles of older patients, he said. “People who have memory problems often don't want to answer the phone because they're afraid they're not going to know who's on the other end. They don't want to answer the door because they're afraid they might not recognize who's at the door.”

A potential solution is to give elderly patients a simple, enhanced call monitoring system that shows them the picture of a person, their relationship, and when the two last talked.

Wireless broadband offers a communication channel between patient, physician, and caregiver, Mr. Barrett said. “As the country gets more and more broadband, the connectivity between homes, offices, and individuals, becomes easier and more useful.”

White House Conference on Aging delegates approved several implementation plans to advance health information technology, such as:

▸ Updating Medicare to place greater emphasis on establishing cost-effective linkages to home and community-based options through the Aging Network, to promote chronic disease management and increase health promotion and disease prevention measures.

▸ Establishing a new title under the Older Americans Act to create aging and disability resource centers as a single point of entry in each region across the country, charged to coordinate health and aging programs and ensure access to diverse populations.

▸ Including in the Older Americans Act provisions to foster development of a virtual electronic database that is shared between providers.

▸ Amending the Health Insurance Portability and Accountability Act and other “restrictive” regulations to allow communication between health providers and the aging network regarding client care.

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