Home-Doctor device allows a true medical clinic in the home


NSW-based distributor of telemedicine solutions TeleMedicine Australia (TMA) has released what it says is the world's first VoIP-based touch screen home-care device to the Australian market.

Originally developed in Korea, the Home-Doctor device has built-in video conferencing technology along with the ability to connect to any wireless, USB or Bluetooth-enabled medical device, including glucometers, otoscopes and dermatoscopes. It also has a built-in blood pressure cuff.

TMA CEO Ash Collins, who is also a practising GP in the Riverina town of Temora, said in addition to the Home-Doctor device, the solution includes a practitioners' portal which has been modified to suit the Australian medical system.

The portal allows healthcare practitioners to view measurements collected by the device over time in a graph, table or calendar. It also allows the clinician to send text messages directly to the device to communicate with the patient. A button on the device turns green to tell the patient they have a message, and as the device is touch screen and there is a video phone included, the patient can click on the video phone and a dial pad is opened, through which they can dial the number for the doctor.

“The actual device was developed in Korea as part of a government project in 2009, but the portal has been developed by myself and a team of software developers based on Australian guidelines on diabetes and heart disease from Diabetes Australia and the Heart Foundation,” Dr Collins said.

The Home-Doctor device can be purchased by patients and kept in their homes but it is also suitable for aged care facilities, Dr Collins said. Each household only needs one device as you can add a number of patients to each.

It includes functionality to set alarms to remind patients at home to take their medicine or to have a meal, but it also has full capability to do any number of tests at home, with the results collected without any data input from the patient. The results are hosted in the portal for later viewing by the clinician, but with the video conferencing capability built in, the results can also be seen on the practitioners' screen while they are doing a live video conference with the patient.

“In terms of the medical examination, the device collects information from peripherals and medical devices,” Dr Collins said. “They include blood pressure through the built-in blood pressure cuff, there is oxygen saturation, temperature and also a general exam camera can be connected to the device and record images if there is a wound, for example, or a dermatoscope can be connected to capture skin lesions or moles.

“It can also connect to an otoscope so a patient would be able to show the ear drum to the practitioner at the other end, and you can also attach a stethoscope, an ECG and a spirometer.

“In terms of the pathology investigation, the device is able to record and register readings from blood sugar devices, cholesterol, general or full blood count, urine analysis – all of the general pathology tests but also some more specific ones.”

Dr Collins said all of the readings are collected without any data entry or intervention from the patient. “The patient only has to do what they do normally when they take their blood sugar levels through a glucometer, for example. That's all they do – they don't type the results into the device.

“The device itself collects the information and then transfers it to a secure portal which is accessible by the practitioner – the doctor or nurse or the patient themselves. The portal has a summary about the patient, all of the results gathered from the patient, the patient's history like medication and past medical history.”

The solution also includes a medical-grade video conferencing system that comes with an application that allows the doctor to see the results at the same time they are talking to the patient, a feature that Dr Collins said makes it different to any other device on the market.

“At the time of the video consultation, the doctor can ask the patient to check their blood pressure through the blood pressure cuff. The patient measures the blood pressure and the blood pressure reading will appear on the doctor's screen,” he said.

“It's the same for any of the measurements with medical devices or any examination with the camera – at the time of consultation, those results will appear on the video conferencing application. The doctor doesn't have to go to the portal to check that. They can later on of course, but at the time of the consultation the results will appear on the application.”

Dr Collins has designed a number of purchasing options for the overall solution, which is called the Hi Care Home-Doctor solution. For aged care facilities, his team will provide the device and set up a portal that is accessible to regular healthcare providers and to the patient.

TMA also provides a complete solution, including the services of doctors, nurses and specialists, along with the device. Dr Collins said each device costs about $4000, with discounts for bulk orders, and there is a fee for the use of the portal, which amounts to about 50c a day for the patient and the healthcare provider.

However, for patients using the device at home, Dr Collins said he would generally wave the fee to the patient's GP and provide the provider application free of charge. “A GP might only have one or two patients so it's not significant – they are not using the software enough, so we are more than happy to wave that fee.”

He believes there are a number of markets for the device, particularly for rural people living far from medical centres and in the mining sector. “The device allows you to do a full medical history remotely, but also to listen to the sounds of the heart or the lung in real time, have a look inside the patient's ears, examine the skin moles, have a look at the retina, they can check blood sugar levels.

“It enables the initial medical consultation, investigations, monitoring and diagnosis – it's like having a full medical clinic in the home.”

The device was initially developed as a joint project between the South Korean government's departments of communications and health, with the assistance of Samsung Electronics. Samsung's subsidiary Insung Information has developed and manufactures the device itself, with Samsung supplying sensors and the individual test devices.

It is part of South Korea's $29 million Smart Care project, a three-year telemedicine trial that monitored 1000 elderly people living at home in Seoul, Dr Collins said.

“They are looked after by a group of healthcare providers including nurses, general practitioners and endocrinologists. The Smart Care centre accommodates the nurses and is located 200kms outside of Seoul. The idea is to provide healthcare services for Seoul but have the healthcare provider outside the capital city, providing employment for smaller towns.”

He said the three-year trial finished in 2012, and the results are due to be published in a diabetes journal in April this year. Dr Collins has been invited to the launch of the data in Seoul next week.

Dr Collins has secured the licence to the product for TeleMedicine Australia, but has also put in some work customising it for the Australian market.

“It is different to the technology used in Korea because their portal was in the Korean language and based on Korean guidelines,” he said. “I did the modification to make it more Australian and also we have a project going to add different kinds of guidelines to the portal.

“This year we will have COPD, cancer and asthma guidelines and some other chronic condition guidelines. That is all hosted in the portal – the practitioner logs in to the portal and sets the standards for each individual.”

Posted in Australian eHealth

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