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Chronically Ill Need Telehealth But Face Hurdles

Several recent studies highlight the importance--and challenges-- of utilizing IT to help manage chronic illnesses.

Several recent studies highlight the importance--and challenges-- of utilizing IT to help manage chronic illnesses.A new report released this week by the Asthma Regional Council of New England found that New England has the highest rate of asthma in the nation. The disease is poorly controlled, resulting in scary and costly trips to the E.R., as well as other health complications, such as sleep deprivation and lost time on the job.

While New England has the highest rate of asthma in the U.S., the disease is a constant health worry for millions of Americans, young and old.

Obviously, with a chronic illness like asthma, many factors--having nothing to do with IT--can contribute to flare-ups, ranging from environmental causes, like pollution, dust mites and mold--to economical issues, such as the cost of medications, and other problems, like cold viruses and stress.

However, for some patients, the assistance of remote monitoring by clinicians might help address some of the behavioral and other issues that factor into disease management by asthma patients, as well as the complications faced by patients with other chronic diseases, such as diabetes, hypertension or heart failure.

In the case of telehealth applications to help asthma, there are programs that allow patients to use peak flow meters at home, having the readings electronically sent via the web to remote clinicians who can watch for low measurements that could indicate an impending flare up.

Also, a study by the U.S. Army a few years ago used video web cams for asthmatic kids to record themselves using their inhalers. Remote case managers provided feedback to the kids on tips to improve their inhaler techniques.

That brings us to the set of issues faced by many chronically ill patients who could otherwise benefit from the aid of telehealth programs.

A recent survey conducted by Pew Internet Project and California Healthcare Foundation, found that Internet use among adults with chronic illnesses is significantly less than Internet use by healthier individuals.

Socioeconomic reasons were key in the non-use of the Internet by individuals with chronic illnesses, especially among patients who have more than one chronic condition. Statistically, patients who have chronic conditions are often older, have lower incomes, and are less educated. Access to or use by the Internet tends to be lower among those individuals as well.

While these findings aren't exactly surprising, they underscore some of the issues of why the opportunities afforded by telehealth programs are underutilized.

But in time, perhaps much of that will change. Children with chronic illnesses today are statistically a prime target user for telehealth programs if you assume younger people are more comfortable using computer technologies than older patients, and assuming the kids' families can afford web access from home.

Also, as today's Baby Boomers age--again, assuming many more of them are already users of IT in the home and workplace--that demographic also seem ripe for promising new telehealth programs to deal with chronic illnesses that will crop up in the years to come for these patients.

Finally, the expansion of affordable broadband access and the push for e-medical records' use by healthcare providers--and giving patients access to their health records online--also sets up the stage for more widespread use of telehealth programs and exciting new health IT innovations to help keep all individuals healthier.

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