Australian doctors expect IoT to boost healthcare but also costs
More than half of Australian healthcare professionals and the general public believe integrating the internet of things (IoT) into healthcare will increase costs, according to a Future Health Index study by Dutch electronics company Philips. The study revealed that this perception is slowing the adoption of "connected care technology", despite 84% of healthcare professionals in the country believing the technology is important in "improving treatment and diagnosis of medical conditions". A study by the Commonwealth Scientific and Industrial Research Organisation suggested a national telemonitoring initiative could save up to AUD3bn ($2.3bn) a year.
Misconceptions about the cost of IoT is inhibiting its uptake in Australia's healthcare sector, according to a recent study by Dutch technology company Philips.

Philips' Future Health Index, which surveyed more than 33,000 individuals across 19 countries, found that while 84 percent of Australian healthcare professionals (HCPs) believe "connected care technology" is important in improving treatment and diagnosis of medical conditions, the nation lags behind when it comes to adoption of such technology.

Kevin Barrow, managing director at Philips ANZ, suspects there are two key reasons for this: The first is there is a perception among 55 percent of HCPs and 53 percent of the general population that the integration and adoption of connected care technology will drive up the cost of healthcare in the long term; and the second is because government funding models don't support the delivery of care via IoT technology.

"The reality is the utilisation of healthcare drives up the cost; technology has been reasonably stable," Barrow told ZDNet.

"Often we're spending huge amounts of money flying patients around the state or interstate to deliver their care; and whilst the infrastructure investment in terms of connectivity might be significant, when weighed up against the costs of transportation, it's probably much less so."

He added that around 5 percent of hospital patients account for 40-50 percent of hospital expenditure, because chronically ill patients are being managed "episodically and not continuously".

"I think the problem in the hospital is activity based-funding so they get reimbursed or funded according to the treatments that are taking place within the hospital. So while the hospital can see that keeping these patients out and managed well in their home and not in hospital is better for both of them, for cost, and for the community, the funding system doesn't necessarily support that," Barrow said.

Philips' study found that 59 percent of Australia's healthcare professionals believe the majority of their time and resources should be focused on preventing illness, indicating the need for a shift from reactive to proactive healthcare.

"The way to achieve this is to seek out efficiencies through improved integration and adoption of connected care technologies, to empower people to take more preventive measures, and to proactively manage their health," Barrow said.

"While some of it is clinical, at other times it's just related to lifestyle or the way a house is set up. One example that comes to mind is where a lady in the US frequently revisited hospital with respiratory distress, but when they went out to her house, the carpet was damp and mouldy and that was causing the issues. When you deal with the root cause, it's not always the most scientific ... in a case like this, ripping up the floorboards might work."

Numerous studies by the Commonwealth Scientific and Industrial Research Organisation (CSIRO) have shown connected care technology not only improves patient outcomes, but also reduces healthcare costs by delivering better support mechanisms for continuous -- rather than episodic -- disease management.

A few years ago, CSIRO ran a national telemonitoring trial of patients with chronic illnesses who had two or more unplanned hospitalisations in the prior 12 months.

The 18-month trial was performed across six sites in Tasmania, Victoria, Canberra, Sydney, and Queensland, where more than 280 elderly patients were provided with telehealth devices that measured their heart rate, spirometry, blood pressure, oxygen levels, lung volume, body weight, body temperature, and other biometric information. This was then transferred to care coordinators for assessment and intervention where needed.

The telemonitoring trial showed a 24 percent saving on Medicare Benefits Schedule expenditure over 12 months. This was achieved through reduced GP and specialist visits and procedures carried out -- the mortality rate was also reduced by 40 percent.

"Our research showed the return on investment of a telemonitoring initiative on a national scale would be in the order of five to one by reducing demand on hospital inpatient and outpatient services, reduced visits to GPs, reduced visits from community nurses, and an overall reduced demand on increasingly scarce clinical resources. This could equate to savings in the order of AU$3 billion per annum to Australia's healthcare system," CSIRO stated in its report.

The other problem, according to Barrow, is the lack of interoperability of systems used by HCPs.

"If you look at the individual systems that we have in place in both primary care and from a hospital perspective, the failing appears to be that they're almost systems in silos. They don't necessarily connect the right people with the right information at the right time to manage their care," Barrow said.

"Recently I was trying to get my vaccination records from 10 years ago because I needed to go up to Papua New Guinea. You know I'm sure there was a little book somewhere of some colour that I had everything in, but my GPs couldn't connect to other GPs or the travel medicine doctors with my record. That's crazy."

The idea that interoperability would enable easier communication and collaboration between healthcare practitioners in different jurisdictions is already reflected in the Strategic Review of Telehealth in NSW report [PDF].



"If you look at the concept of secure messaging, how did we end up with seven secure messaging service providers all running on what's effectively different rail gauges? It's a bit like building a railway system, but none of the gauges line up," Dr James Freeman, founder of HCF-backed telehealth startup GP2U, told ZDNet previously.

"Secure messaging is fantastic, but everybody's got to be able to talk to everybody, so we need a standard format."

Barrow believes it will be of "tremendous help" for the advancement and adoption of connected care technology when the National Broadband Network (NBN) has been rolled out across Australia.

When asked whether he considers the execution of the NBN a hindrance -- complaints to the Australian Telecommunications Industry Ombudsman about the NBN have more than doubled -- Barrow said it's more a "frustration".

"A faster rate of change would be good," he added.

Barrow said he sees Philips playing an important role as one of the many stakeholders in a "quite complex healthcare system" by providing evidence to demonstrate that technology will drive costs down in the long run, despite the significant initial monetary outlays.

"We see that we need to play a role in providing evidence so that policymakers can make change -- maybe more visionary change than incremental change because ultimately we all know what people are constrained by on both the political and administrative areas," he added.