Finger on the Pulse

Baldwin Louie — Mon, 10 Apr 2000 18:00:00 -0400

There are few things more troubling than a child with an acute medical condition. Vicky Wehner knows. The Kirksville, Mo., mother and registered nurse deals daily with 17-year-old daughter Brianne's asthma.

Brianne - a competitive swimmer - had prescriptions to control her attacks, but they weren't helping. So Brianne's respiratory therapist suggested monitoring her condition more closely, "so they would be able to fine-tune her medications and make it easier for her to manage her own asthma," the elder Wehner says.

The therapist recommended LifeChart.com, a medical-monitoring system that lets subscribers take readings on a monitoring device and upload results via a phone line to a confidential database. Caregivers and medical personnel can access the information via a password-protected, secure Web interface and immediately view the effects of medications and track their performance.

After only a few months, LifeChart's instant reporting provides a measure of comfort for Wehner and her daughter. For starters, Wehner says, Brianne can test herself before swim meets and concentrate on her race instead of her asthma.

Online medical-monitoring services are a small but growing feature of the health care landscape. Their appeal is that they let patients and caregivers actively manage an illness and gain a more precise picture of a patient's health. The goal is "to basically empower the individual," says LifeChart President Hans Ehrnrooth. The Mountain View, Calif.-based company serves about 5,000 individuals, who pay about $10 each per month. It monitors asthma sufferers in the U.S. and Europe and will expand to include diabetes in the U.S. later this year. Similar programs run by Health Hero and LifeMasters monitor heart and lung conditions and diabetes in the U.S.

Health Hero, also based in Mountain View, collects, downloads and stores patients' data by a process similar to LifeChart's. Health Hero's customers include HMOs, hospitals and "disease-management" companies - organizations that educate people with chronic conditions and help them manage their conditions. These companies review patient data and, if it indicates that someone is at risk, alert the doctor, caregiver and/or patient via fax or e-mail. Each customer's contract covers 1,000 to 10,000 individuals. Fees vary, but the cost is about $1 per day, per person, says Director of Marketing Shawn Hopwood.

LifeMasters offers patients the option to use more Web-based interactivity; they can enter their data online and get personalized health information from LifeMasters' doctors and nurses. With patients' permission, their regular caregivers and doctors can view their health information online. The Newport Beach, Calif., company has contracted with various managed-care organizations to cover any of the 15,000 managed-care subscribers who have illnesses suitable for monitoring, says CEO Christobel Selecky.

LifeMasters nurse Casey Hobbs explains that the system automatically aggregates data from her patients on her desktop computer. She makes weekly contact by phone or e-mail with each of her assigned cases. Outside of that, if the data indicates a problem, the monitoring nurse receives an automatic computer alert. The nurse then telephones the patient to discuss his condition. "Depending on the outcome of that call, we would send information to their doctor," explains Hobbs.

Online monitoring systems appeal to tech-savvy baby boomers who are responsible for aging parents or dependent children, Selecky says. Say you have an aging diabetic mother in Florida and you can't check in with her daily. Online monitoring eases worry all around. "The Internet allows caregivers who may be removed from an elderly patient to participate in their care," says David Williams, VP of AgeNet.com, an online resource for older people and adult children.

Oliver Mittermaier, COO of CareGuide.com, agrees. CareGuide, an Internet-based resource for those caring for the elderly, has partnered with Health Hero to offer monitoring services. Not only will monitoring systems increase long-distance caregivers' ability to stay in frequent contact, says Mittermaier, they can also ease the "guilt factor" of being apart from loved ones. "It's the ability for that segment of the population to use the Internet to provide better care or be more at peace with the situation they're in," he explains.

In times of crisis, caregivers enter the situation armed with a medical history and up-to-date information. "People like me who are distant from our parents can get the peace of mind that not only is their nurse caring for them, but also we have access to their medical information if we need it, should there ever be an emergency," says Selecky, whose mother lives on the East Coast and is enrolled in LifeMasters programs for diabetes and high blood pressure.

Despite the interest in Web-based caregiving, there are drawbacks. Chief among them is access. E-mail isn't dependable for time-critical messages, says Ron Moran, president of MedPrompt, a Houston company that markets phone-based pager prompts to remind patients to take their medication. "The technology isn't there yet." Moran adds that a significant percentage of MedPrompt's customers aren't computer-savvy.

Demographics are one reason more Web-based innovations for caregivers don't exist, but they're not the only reason, says Gomez Advisors analyst David Steele. First, consumers have to be sure their medical information is secure - a concern organizations like the American Medical Association (dossier) are working to address.

And because people are most likely to hear about innovations from their health care providers, Steele says, medical institutions need to sell their doctors and staff on the new technology's benefits. "A lot of these services are tied to doctors' offices," he explains. "Companies need to demonstrate a superior product that will improve care, save them time and save money."

Insurance companies are singing the show-me-the-money refrain. "It's a matter of who's going to pay," says Steele. "If you say the insurance company is going to pay, you have to convince them it's going to save money."

Steele expects a viable security solution next year, followed by a rollout of technologies to insurance companies and physicians. Then look for an onslaught of companies to propose solutions to caregiver dilemmas.

Meanwhile, Wehner will be watching the Web, even after her daughter goes off to college next year. That is, unless Brianne changes her LifeChart password.

Lain Chroust Ehmann is a Boston writer who specializes in health and technology.

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