HEALTHCARE IN THE HOME
USING TECHNOLOGY TO DELIVER HEALTHCARE The use of medical devices in the home and for remote monitoring are proven technologies, but the barrier to wider use remains an economic one. Some devices are publicly funded but many arenâ&#x20AC;&#x2122;t, contributing to inequality in access to care. However, wider use of assistive technologies in the home can be cost-effective by reducing the number of expensive, unnecessary hospitalisations.
ANNE TRIMMER BA/LLB CEO: Medical Technology Association of Australia
The Australian health system is facing serious challenges. We have an ageing population and a high prevalence of chronic disease. Over $121 billion was spent on health in 2009-10 and this cost is expected to skyrocket over the next decades. A large proportion of health expenditure is spent on chronic disease management in the hospital setting. Older Australians wish to remain in their own homes as long as possible. Many are technologically savvy and willing to embrace assistive medical technologies. There has been a rapid adaptation of existing medical devices for the home health market. Almost any medical device can be wirelessly enabled to assist with healthcare delivery in the home. Technologies underlying telehealth and home healthcare such as interoperability and wireless solutions have led to major innovations in other industries (e.g., the smart phone industry).
About the author Anne Trimmer is the Chief Executive Officer of the Medical Technology Association of Australia. Prior to joining MTAA, Anne had an extensive career in the legal profession, practising law as a commercial partner of a major Australian law firm.
There are a range of assistive medical technologies that can be used to monitor and manage healthcare in the home. The conditions that are most suited for home care and remote monitoring include those that are prevalent with age such as heart disease and diabetes. Examples of assistive medical technologies are shown in Table 1.
The challenge is not in the development of new technology: the technology is there. The challenge is making the existing range of assistive technologies accessible to all Australians regardless of age, income or geographic location. Medicare Benefit Schedule (MBS) item numbers for telehealth were introduced in 2011. Telehealth item numbers cover only videoconference consultations that involve a patient, general practitioner and a specialist. The uptake of items has not been high and recent geographic restrictions have further reduced eligibility. Individuals who wish to access telehealth (vital signs monitoring) or assistive technologies must do so in an adhoc way. Funding might be accessed through state and territory pilots, aids and appliances schemes, or eligibility via the Department of Veteransâ&#x20AC;&#x2122; Affairs (DVA). In some cases, a device (e.g., a pacemaker) might be available to privately insured individuals via the Prostheses List. However, the service component (remote monitoring) is not funded. Under the current system a person is only funded to have their condition monitored and their device checked if they attend a clinic. In many cases, the technology