Abstract
The healthcare delivery system in the United States is in crisis. Runaway expenditures and problems with access and affordability of care are plaguing the industry. Several chronic diseases, such as diabetes and hypertension, consume a disproportionate slice of healthcare services. By some estimates, chronic diseases account for over 70–75 % of direct healthcare costs.
Diabetes is one of the five major chronic diseases. It afflicts over 20 million people in the United States and accounts for almost $100 billion in medical costs. The prevalence of diabetes in the United States and worldwide is on the rise.
It has long been established that technology may play a role in contributing to a more efficient delivery of care that may also assist in controlling costs. Of particular interest is the potential use of wireless technology in the monitoring of diabetic patients that would contribute to more efficient management of the disease.
This chapter presents a discussion of an experiential study in which the use of cellular telephones was applied in the monitoring of blood glucose levels by diabetic patients in their homes and the transfer of this information to a central unit in the hospital. The diabetic patients were accustomed to daily measuring their blood glucose and recording the measures in a logbook; hence this technology intervention represented a significant change to their normal care path and pattern. They would bring the logbook to their regular visits to the hospital and also when any emergency occurred. This system of record keeping was flawed, as patients would neglect to record all entries, record wrong readings, and commit similar errors.
As the chapter discusses, with the application of wireless technology, the patient enters the blood glucose reading into his cell phone and the information is transmitted to the hospital. The medical staff then follows up and monitors the patient’s progress. This improved monitoring process engenders positive outcomes such as savings in time and cost and better management of the disease.
Much of the data used in this chapter came from a larger-scale project funded by an IBM grant awarded to N. Wickramasinghe and E. Geisler from the IBM Center for the Business of Government.
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References
American Diabetes Association. (2004). Medical management of Type-2 diabetes (5th ed.). Alexandria: ADA.
Barcelo, A. (June, 2001). Diabetes in the Americas. Epidemiological Bulletin, 22 (2), 15–23.
Bush, G. W. (2004). State of the union address. http://whitehouse.gov/news/release/2004/01/20040120-7.html. Accessed Dec 2009.
Centers for Disease Control and Prevention (CDC&P). (2006). Estimating the cost of chronic diseases. Washington, DC. (In cooperation with the National Center for Chronic Disease Prevention and Health Promotion, and the Agency for Healthcare Research and Quality).
Centers for Medicare & Medicaid Services (CMS). (2007). National health expenditing data. http://www.cms.hhs.gov/nationalhealthexpendata/.diabetes.niddk.nih.gov/…/statistics/index.htm.
Chalasani, S., Wickramasinghe, N., et al. (2011). Business and IT aspects of wireless enabled healthcare solutions. Proceedings of the 17th Americas Conference on Information Systems Detroit, 4–7 Aug 2011.
Dougherty, G., et al. (1999). Home-based management can achieve intensification cost-effectively in type I diabetes. Pediatrics, 103(1), 122–128.
Fraunholz, B., & Unnithan, C. (2007). Potential of telemedicine: A preliminary evaluation through the innovation diffusion lens. International Journal of Healthcare Technology & Management, 8(3/4), 315–332.
Geisler, E., & Heller, O. (1998). Management of medical technology: Theory, practice, and cases. Boston: Kluwer.
Geisler, E., & Wickramasinghe, N. (2009). The role and use of wireless technology in the management and monitoring of chronic diseases. Report prepared for the IBM Center for the Business of Government.
Geisler, E., Krabbendam, K., & Schuring, R. (2003). Technology, healthcare and management in the hospital of the future. Westport: Praeger.
Goldberg, S., et al. (2002). Wireless POC Device Component Summary. Internal INET documentation.
Hrejsa, R., Sauve, S., Stella, P., & Geisler, E. (2006). Vaccine crisis: Some issues in technology and national healthcare policy. International Journal of Healthcare Technology & Management, 7(6), 453–462.
Institute of Medicine. (2001). Crossing the quality chasm: A new health system for the 21st century. Washington: National Academy Press, Committee on Quality of Health Care in America.
Japsen, B. (2007, April 8). Firms gang up on diabetes. Chicago Tribune.
McCall, D., et al. (2004). Are low-income elderly patients at risk for poor diabetes care? Diabetes Care, 27(3), 1060–1065.
Montori, V., et al. (2004). Telecare for patients with type I diabetes and inadequate glycemic control: A randomized controlled trial and meta-analysis. Diabetes Care, 27(4), 1088–1094.
Montori, V., Gafni, A., & Charles, C. (2006). A shared treatment decision-making approach between patients with chronic conditions and their clinicians: The case of diabetes. Health Expectations, 9(1), 25–36.
Moore, T., & Wesson, R. (2002). Issues regarding wireless patient monitoring within and outside the hospital. Paper presented at the Proceedings of the 2nd Hospital of the Future Conference, Chicago, IL.
National Institute of Diabetes and Digestive and Kidney Diseases. (2005). National diabetes statistics fact sheet: General information and national estimates on diabetes in the United States. Bethesda: U.S. Department of Health and Human Services, National Institute of Health.
Parker, P. (2006). The 2007–2012 outlook for diabetes monitoring devices in the United States. San Diego: Icon Group International.
Rachlis, M. (2006). Key to sustainable healthcare system. http://www.improvingchroniccare.org. Accessed Jan 2011.
Schillinger, D., et al. (2002). Association of health literacy with diabetes outcome. Journal of the American Medical Association, 288(4), 475–482.
Smith, N., & Maynard, C. (2004). The burden of diabetes-associated cardiovascular hospitalizaitons in VA and non-VA medical facilities. Diabetes Care, 27(3), B27–B32.
Stratton, I., et al. (2000). UKPDS 35. British Medical Journal, 321, 405–412.
Suwattee, P., Lynch, C., & Pendergrass, M. (2003). Quality of care for diabetes patients in a large urban public hospital. Diabetes Care, 26(3), 563–568.
Thrall, J. (2005). Prevalence and cost of chronic diseases in a healthcare system structured for treatment of acute illnesses. Radiology, 235(1), 9–12.
Wendling, P. (2006). Home blood pressure monitoring redirects diabetes patients. Family Practice News, 36(23), 21–23.
Wickramasinghe, N., Geisler, E., et al. (2005). A framework for assessing e-health preparedness. International Journal of Electronic Healthcare, 1(3), 316–334.
Wickramasinghe, N., & Goldberg, S. (2004). How M= EC2 in Healthcare. International J. Mobile Communications, 2(2), 140–156.
Wickramasinghe, N., & Mills, G. (2001). MARS: The electronic medical record system: The core of the Kaiser galaxy. International Journal of Healthcare Technology and Management, 3(5/6), 406–423.
Zimmet, P. (2000). 21st century review: Globalization, coca-colonization, and the chronic disease epidemic: Can the doomsday scenario be averted? Journal of Internal Medicine, 247(3), 301–310.
Zuvekas, S., & Cohen, J. (2007). Prescription drugs and the changing concentration of healthcare expenditures. Health Affairs, 26(1), 249–257.
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Some of the literature cited in this chapter was gathered as part of a larger funded project by The IBM Center for the Business of Government, awarded in part to one of the coauthors of this chapter.
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Wickramasinghe, N., Goldberg, S. (2013). Using Wireless to Monitor Chronic Disease Patients in Urban Poor Regions. In: Bali, R., Troshani, I., Goldberg, S., Wickramasinghe, N. (eds) Pervasive Health Knowledge Management. Healthcare Delivery in the Information Age. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-4514-2_15
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DOI: https://doi.org/10.1007/978-1-4614-4514-2_15
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