By Suzi Birz, principal, HiQ Analytics, LLC
Telemonitoring services are a flow of communication between
health care providers and patients via telephone. Typically, these services are
used to interact with patients who are chronically ill or who have recently been
discharged. Now, one technology company is beginning to broaden the scope of
telehealth applications in the home by integrating a television into the
Philips has been piloting a new TV-based interactive health
care platform called Motiva. Motiva expands remote patient management to deliver
personalized education and motivation through a patient’s home television. John
Ryan, product and content manager at Philips Consumer Health Care Solutions
enumerated the potential value of Motiva, which he said can lead to “improved
patient outcomes, reduced hospitalizations, reduced medical expenses and
positive return on investment.”
What Is It?
Motiva allows information to be presented to a patient through
a cable box on their home television. Patients use a simplified TV remote
control to select the actions and input information.
“Patients are able to access personalized messages from their
caregivers, educational video content and health related surveys, plus vital
sign trend charts to track progress towards personal goals,” Ryan explained.
“The goal is to enable health care providers to deliver more effective care at
lower cost to a broader reach of patient populations by using a device with
which everyone is familiar—their TV.”
Ryan expanded, “We want to give providers a way to play a
small but crucial role in their patient’s lives, maybe five minutes, every day
or a few times a week, depending on the patient. We want to help the care team
do this in a way that is efficient for them, yet personalized, meaningful and
effective for the patient.”
How Does It Work?
“The goal is to encourage compliance with medical treatment
and promote behavior changes in patients by engaging them at home with video and
messaging from their health care team that is based on behavioral science,” said
Ryan. “We want to help the provider use proven health psychology approaches to
motivate the patient to make required behavioral changes and overcome the
obstacles they face to making those changes.”
The service might be supplied by provider organizations,
disease management organizations or health plans. The organization would
identify a patient for whom the service would provide beneficial. Philips
provides all the equipment needed at the patient’s home.
“We provide everything, including contracting for the
broadband service, installing all the equipment and training the patient,” Ryan
explained. “Meanwhile, the nurse that will be working with the patient is
developing a care plan that will be delivered through the television.”
A patient takes measurements at home using wireless monitoring
equipment such as a blood pressure cuff in the bedroom or weight scale in the
bathroom. That information is sent through a secure broadband connection to the
“The nurse’s assessment of these data as well as information
entered on the television is all considered when the nurse updates the care
plan,” Ryan noted.
Following a review by the health care team, information is
provided back to the patient through the television. The information includes
educational content, personalized feedback and motivational messages.
“These messages might include information about an upcoming
surgery, a scheduled test, new fitness goals and reminders about nutritional
goals the patient has set for him or herself with their care provider,” Ryan
said. “Other content delivered to the patient on their home television might
include an educational video, a quiz or more questions about health status. The
patient also has the ability to view charts displaying their vital sign data
over time to track progress towards goals. Plus, by reviewing biometrics and
patient inputs, the nurse can detect a patient at risk.”
Motiva also allows collaboration with other clinicians. The
technology collecting these data can be shared with the primary care physician
and specialists as well as integrated with the clinical record, home health
record, call center data or other information system the nurse might be using.
With respect to training the patients on the system, the
remote control is a familiar device.
“It is easy to train patients to use the Motiva remote
control. It has fewer buttons than the one that controls their television; the
buttons are larger, color-coded and they have pictures,” Ryan said.
Is it for Everyone?
Unlike other telemonitoring endeavors, Philips is addressing
one of the adoption challenges head on. Philips is arranging for the broadband
cable connection. In other attempts at telemonitoring and telemedicine, this
connection has placed an undue burden on the patients.
However, other barriers stand in the way. For providers, there
is no revenue incentive. This intervention is not reimbursable. However, with
improved care and potentially reduced trips to the emergency room or
readmissions, there are potential positive cost impacts.
While Motiva is in use in Spain and the Netherlands, it is now
getting its first trials in the United States.
“We want patients to become more educated, engaged and
involved in their own health, encouraging them to avoid risks to their health
and allowing them to feel safer, more comfortable and empowered to manage their
own care,” Ryan concluded. “We want to help them understand and feel that they
can make the behavioral changes that will lead to feeling better today. Those
same changes will help them live a longer and happier life.”
For more information visit the Motiva Web site.
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