"Electronic House Call" May Make Health Care as Accessible as Cable Television

Doctor's bag stays home with telemedicine

Computers, cable make medical house calls routine

Home, Hearth and Health

Technology lets doctors practice telemedicine

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The Electronic HouseCall Project

     The health care industry is undergoing fundamental changes in response to the need to control spiraling medical costs. A principal feature of these changes is the development of innovative service delivery approaches that can control costs while maintaining or improving patient access to high quality medical care. Many of the new approaches emphasize the enhancement of traditional primary, community, preventative and outpatient care as opposed to conventional inpatient care in hospitals. At the same time, rapidly evolving electronic, computer and communications technologies provide valuable tools for supporting new care delivery approaches.

     The Medical College of Georgia (MCG) established the first state telemedicine network in November 1991. In 1992, MCG was asked by the State of Georgia to develop, implement and manage the Georgia Statewide Telemedicine Program (GSTP) as a component of the Georgia Statewide Academic and Medical System. Today, the GSTP links hospitals, outpatient clinics, community and public health centers, and correctional facilities. In 1995, MCG, the Georgia Institute of Technology (GIT), and the Eisenhower Army Medical Center began a new telemedicine initiative to develop and evaluate a proof-of-concept system to allow care providers to remotely manage patients with chronic conditions by permitting in-home collection of key physiologic measurements and facilitating communication between patients and health professionals. This program, referred to as the Electronic HouseCall (EHC) program, required the installation of computer-based monitoring stations in the homes of volunteer patients and in one skilled nursing home in the Augusta, Georgia area. The patient units were linked to central monitoring stations at MCG and the Eisenhower Army Medical Center via bi-directional cable made available by Jones InterCable, Inc. The EHC system provides audio/video conferencing between a patient unit and the central monitoring station and includes equipment to assess a variety of patient physiologic parameters including heart and lung sounds, blood oxygen concentration, cardiac rate and rhythm, blood pressure, body weight and temperature.

Electronic HouseCall Patient System

     The EHC system permits patients to evaluate their medical condition and access health professionals when needed and enables the care provider to better manage the patient's condition through electronic visits that are low cost, and as frequent as necessary. We anticipate that this capability will help promote the patient's medical stability and reduce the need to access high cost in-patient and emergency resources. The system is designed to provide a wide range of capabilities and yet remain simple enough for non-technically oriented patients to use by themselves. Thus, the patient selects options by pointing at icons on a touch sensitive screen, and receives on-line video instructions whenever help is requested. The primary focus is on bringing medical care into the patient's home while reducing the need to send a care provider and enhancing the services that can be provided by home health nurses without increasing the number of costly in-home visits. Major funding for the pilot program was provided by the Georgia Research Alliance, the U.S. Army Medical Research Acquisition Activity, and MCG, with in-kind contributions from Jones InterCable, Inc.

     CyberCare, Inc. was founded as a Georgia-based start-up company to commercialize the EHC technology. Through a unique license agreement with GIT and MCG, a university/industry partnership was formed to capitalize on the tremendous opportunity available in home health and institutional care. As equity holders in CyberCare and recipients of on-going R&D funding, both universities will continue to play a key role in advancing the EHC technology and proving it in clinical environments. Although CyberCare's initial focus was on the home health care market, opportunities in institutional care, such as the prison system and assisted living communities, have become evident. The ability to provide quality care for our prison population and elderly citizens is of growing concern. The EHC technology will enable health care providers to cost effectively deliver quality care to these populations by projecting their resources to the point of need using advanced computer and telecommunications technologies.

Electronic HouseCall Patient Interface

ACKNOWLEDGMENT

This research was funded by the Army Medical Advanced Technology Management Office,  the Georgia Research Alliance, and the Medical College of Georgia. In-kind support was provided by Jones Intercable.