Nick Hunn in his Creative Connectivity blog raises the question ‘Can mHealth save the NHS?’ although more specifically it is ‘Can mHealth save the NHS money?’ It’s an amusing and wide-ranging article but it boils down to the conclusion that ‘increasing communications with patients may or may not increase efficiency but almost certainly doesn’t result in system-wide cost savings’. [My interpretation. Ed. Steve. However, monitoring specific patients at home can produce savings in costs associated with those particular patients. If you scale it up there comes a point where real savings can be made in reduced staff and facility costs if – and it’s a big if – the healthcare provider has the determination to identify and make those savings.] Read Nick’s article: Can mHealth save the NHS and take in the comments too.
Efficiency, staffing and declining number of physicians
Based on the discussion of this over at LinkedIn’s Wireless Health group, the consensus seems to be: it won’t lower costs all by itself, it may change staffing factors (the major cost) but reallocating those are the hardest (mandatory ratios in UK and also here in many US states–and I will add the politicization of healthcare staffing, including SEIU, the highly politically influential US health care union, makes this a very hot potato).
If you cannot access this, here are some of the highlights (I’ve identified the major commentators, but these are a result of the dialogue of course so credit to all).
(Paul Sonnier) In the US, we have countervailing factors that may help to shift those ratios: a tidal wave of aging boomers plus millions in the system added by ‘healthcare reform’, all demanding more healthcare services, with a declining number of physicians. Increased efficiencies brought by mHealth will be needed.
(Michael Kremliovsky and David Albert) In an mHealth world, there are also major conditions on ownership of medical data (personal or primary care?) and the shift in personal responsibility (and reimbursement) plus IT infrastructure that are prerequisites.
(Albert) But where is all this data going, who is acting on it, what do you do with non-actionable data and what are the liability questions? If it overwhelms the doctor and clinical staff, there might be a rebellion, and certainly resistance.
So we return (again) to the prevailing questions of eHealth and especially mHealth, which transcend national boundaries: where will this spiffy data go, who owns it, how and when it will be integrated into health records (privacy/security), who will act on it, who can access and who will take action on it. Finally, who will pay for these services? (If I’ve left anything out–or if you differ–we invite your comments below.)
Can mHealth save the NHS money?
Thank you, Steve and Donna, for this great take on Nick’s thought-provoking post in his blog and in the Wireless Health group.
The ensuing discussion by other leaders in the field that is occurring highlights the value of having a forum dedicated to advancing knowledge and building relationships between professionals interested in the convergence of wireless technology with the continuum of clinical healthcare (preventive, chronic, and acute) and consumer health (physical fitness and wellness).
For readers of Telecare Aware who are interested in viewing the complete discussion on this topic in the LinkedIn group — and are not already group members or don’t have LinkedIn accounts yet — they can follow this link (http://www.linkedin.com/groups?gid=2181454) and then click on the Join button. It would be great if they mention Telecare Aware when requesting membership.