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New Devices Help Monitor Health of the Elderly from Home
By Victoria Colliver, San Francisco Chronicle
August 15, 2005
Although it's just a small device with a screen and four buttons, Barbara Brown calls it a computer.
Every day, the 73-year-old San Jose, Calif., woman uses a Health Buddy home monitoring system to answer a series of questions about her health and well-being. She said it takes just a few minutes to complete and makes her feel more secure. Not to mention, it will beep if she fails to respond before noon and will alert a social worker if she fails to use it for a day or two.
"You have to give your opinion. When you give your opinion, they know exactly what you're doing and how you're doing," said Brown, who has osteoarthritis and lives with two cats.
Health Buddy, developed by Health Hero Network Inc. in Mountain View, Calif., is a small, interactive box that transmits through a telephone line questions and health information for specific chronic conditions, such as diabetes or congestive heart failure.
On the other end, a doctor or managed-care company receives and reviews the user's daily responses. Sometimes a potentially alarming response is flagged for the person reviewing the answers, indicating the need to follow up on a patient, who then may be instructed to consult a doctor or seek immediate medical attention.
Health Hero's Health Buddy is being used in nearly 7,000 homes nationwide through agreements with the Department of Veterans Affairs, health services giant McKesson Corp. and Health Dialog, a disease-management company.
The Health Buddy program is part of a larger effort by the federal government to test a variety of programs and services, including physician home visits and other technologies.
Medicare would consider the Health Buddy or these other services a reimbursable benefit if studies demonstrate they save money by keeping patients healthier and out of hospitals or nursing homes.
Already, there is some evidence that such devices work.
In a pilot program conducted by the Veterans Health Administration, 281 veterans with chronic diseases were given home health monitoring equipment, including the Health Buddy. The results showed that hospital admissions for the group fell 60 percent, according to a study reported in 2003 in Telemedicine Journal and e-Health.
In addition, the device was selected last month by the Centers on Medicare and Medicaid Services for testing by doctors and patients in parts of Oregon and Washington. The company expects to sign up 2,000 to 4,000 patients when enrollment in the three-year trial begins in January.
Medicare is interested in these technologies because chronic illnesses make up the bulk of the program's expenses.
An estimated 8 million of Medicare's 44-million beneficiaries with five or more chronic conditions account for about 66 percent of Medicare spending, according to a 2002 study by Partnership for Solutions, a policy research program at Johns Hopkins University financed by the Robert Wood Johnson Foundation.
One of the biggest challenges for companies such as Health Hero is to make equipment that's easy for elderly people to use. Many are intimidated by computers and other new technologies, and have physical limitations that make typing and reading small screens difficult.
"The goal is to keep it extremely simple. It provides a support system for people who are struggling with complex conditions and uses technology that makes sure they get the right care at the right time," said Health Hero's chief executive, Steven Brown, adding that it was designed so a "grandmother with trembling knuckles" could use it.
The device asks basic questions such as, "How do you feel today?" along with more detailed inquiries into blood sugar levels and specific symptoms. It also offers information on such topics as fall prevention, nutrition and depression. The questions and information are updated daily.
Health Hero is not the only company that makes home monitoring appliances with various functions, including some that simply transmit vital signs. One of its key competitors is Philips Medical Systems, a division of Royal Philips Electronics, that makes a product similar to the Health Buddy called Philips TeleStation.
Health Hero's Brown said he believes his model is different because of the health coaching and behavior modification information it offers in its programs. The cost for the device ranges between $50 and $200 per month per patient, depending on the type of program and services purchased.
Health Hero's Medicare pilot project in Oregon and Washington links patients with their medical groups. Brown said several medical groups in California are experimenting with the technology, but he declined to identify them.
While most Health Buddy users are monitored by health care providers, 73-year-old Barbara Brown is checked by case managers at the Council on Aging Silicon Valley. The nonprofit organization monitors about 400 elderly people, including about 30 who use a Health Buddy.
The Council on Aging first started spending grant money on the device about three years ago and has continued the service, which Medi-Cal reimburses.
"Many of them live alone and are isolated and frail. For that reason, they really do feel someone is looking in on them every day," said Lynn Villagran, case management director for the council. "They really do think of it as a friend."
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