Home Health Services -mHealth

Organized home health in India is an untapped potential. Home health care is defined as rendering predominantly medically-related services to patients in a home setting rather than in a medical facility. Home health care may include skilled nursing in addition to speech, occupational and physical therapy. It also includes monitoring the patient's prescriptions. In an Indian context, assistance to activities of daily living does not seem to make much sense.

What are the challenges in putting together a home health delivery model?
-> Organizing a fleet of nurses and therapists (Logistics)
-> Maintaining longitudinal patient progress and history
-> Minimize manual documentation requirements
-> Lack of ability to compare the acquired data with reference values
-> Open source software to capture data at patient site
-> Sync up PC data to the Hospital Information System or EMR
-> Connectivity to the Internet at the patient premises for self monitoring
-> Medical device to PC or cellular connection using USB, wire or Bluetooth
-> Data transmission via broadband, GSM, CDMA to Hospital Information System

Some considerations:
(1) Use of wireless Body Area Networks (BAN) as an alternative to conventional monitor - Example: The disposable unit consists of a ECG patch, analog amplification circuit, battery, and radio transmitter that sends signals to a Wireless Handheld Device either through USB or Bluetooth. The handheld will connect to the Mobile Healthcare Platform of the Hospital Information System.
(2) Use of tele-health monitors that capture data from multiple devices and transmit data to back-end servers via broadband.
With advent of 3G networks and low cost broadband services and WiFi, connectivity to the back end servers will be easier than before.
(3) Evaluation of Free Open Source Software (FOSS) for mobile platform and its counterpart back end enterprise application is a challenge.
Based on survey conducted by Center for Social Research India for Novo Nordisk in 2006 for diabetes monitoring, Home based monitoring was 86% less than monitoring at hospital and 89% of the patients are self funded. For a sustainable model for the service provider, more number of people need to adopt home monitoring. Longitudinal information capture and automatic alerting, self reliance, logistical ease are good value proposals for patients to switch.