Furthermore, economic benefits were observed in all pilots. This means that from a financial perspective, hospitals and other care organizations can save money with this approach, mainly due to early discharges and less emergency room admissions.
However, the willingness to review the way care is being delivered must be clearly present, as well as the acceptance of re-allocating some professional roles. This reflects one important lesson of the pilots: the process of incorporating the mobile monitoring solution is more of socio-technical nature. Technology alone is not enough - it requires the right perception and use by the users to drive a change. New approaches to treatment and follow-up of patients were adopted. This undoubtedly maximised the benefits that mobile monitoring systems brought about. This meant: (a) Normalisation of care pathways (appropriate use and frequency of the monitoring services), (b) Reallocation of professional roles, (c) Specific patient education on the disease.
This has to have a clinical sense (based on established guidelines) but also should not add extra costs that could make the whole design unfeasible.
A note on insurance companies: HealthService24 Project pilots showed a financial interest from the hospitals point of view in terms of cost savings. But there is also another side of it, namely reimbursement from the insurance companies. Insurance companies in general see the value in the approach, but:
- Long term results are needed in order to build a case
- Payers/Health insurers should be properly included in validation scenarios to secure health economic outcomes
- Statistics available to the insurance companies only show "Diabetic patients" or "Cardiac Patients", but do not provide the detail to identify the patients that would benefit from such an approach.
- The identification has to be done in collaboration with the doctors
- There is no practice for telemedicine evaluation today. This make is difficult to introduce telemedicine solutions in a routine setting
A note on legislation: Up to today, there is a lack of a European Union wide framework:
- Teleconsultation is still not reimbursed in a number of countries in some countries, e.g. the Netherlands, legislation is changing in favour of telemedicine
- No legislation available on liability
- Privacy and security of patient data
- Reimbursement is dependent on the healthcare system in respective countries (some have a joint National Health System (e.g. UK), others are very diverse (e.g. Germany))
As long as this is the situation ruling, we see low opportunities for implementing the HealthService24 concept on a nation-wide or even European-wide scale. Still, hospitals in charge of their own profit and loss will see economic benefits.
Concluding remark: The HealthService24 concept improves the quality of life of the patient and provides a higher rate of empowerment. At the same time, it was possible for the professionals to provide better care and lower care costs (up to 38% savings on direct costs were achieved). Using the HealthService24 concept is not disruptive - rather, integration into existing systems and processes is possible and adds value. However, technology itself is not enough - a successful implementation is much more subject to organizational matters such as re-design of conventional care delivery, both concerning the hospitals as well as to the insurance policy and the legislative situation.
For further information, please visit or download:
- HealthService24 Project home page;
- HealthService24 Project presentation and the deployment plans (link to .pdf file);
- Available commercial solution!;
- HealthService24 Final Project Report (link to .pdf file).