Chronic conditions

Philips has focused on medical grade trackers that can, via the internet, monitor patients with chronic medical conditions. The company's Intensive Ambulatory Care program, launched in the US, is already the type of telehealth solution once only seen in National Broadband Network promotional videos, hoping to keep patients at home where they would rather be, rather than in hospital emergency rooms. Philips claims this can reduce a patient's hospital admissions by 30 to 40 per cent.

Professor Leeder is still wary about the limits of remote monitors, particularly if they're seen as a replacement for nurses and doctors. "I've seen what happens with patients who have got chronic respiratory problems who wake up at 2am breathless. And the machinery is of very little comfort – 24/7 human connectivity is what's required."

He says a phone call to an on-call doctor could help the patient deal with their condition, and avoid an admission to the hospital.

Barrow agrees clinicians cannot be left out. "The devices are great and we have seen a lot of advances in that area, but human beings deliver the health care and the reason we have an excellent health system is the doctors that work in it."

Leeder acknowledges technology supporting the clinician "seems to work well" in the case of diabetics who use a monitoring device that transmits to a central location, or patients with chronic respiratory problems who blow into a device each morning, with the data reviewed by a clinician remotely.

Dr Tony Bartone, the vice-president of the Australian Medical Association, also emphasises the continuing importance of a doctor-patient relationship. He sees the best results from telehealth devices as those that allow clinicians to "fine tune or regulate a patient's care, for example blood sugar – this is where the future of technology will come into healthcare".

New South Wales health minister Jillian Skinner sees a financial role for government to promote the use of technology, and has established a medical device investment fund, based on her "very great respect and admiration" for hearing implant manufacturer Cochlear. She admits, however, that currently "it's only a small amount of money".


Level of accuracy

There's no doubt that technology is not the only challenge for connected health to overcome. There's a natural conservatism amongst some on both sides of the stethoscope. Leanne Wells, CEO of the Consumer Health Forum of Australia says "digital solutions are clinical extenders. Some people may be apprehensive about using [such devices]... same with the clinicians. We need to teach them."

While connected devices are useful for those with serious chronic illnesses, Wells sees monitors with the right level of accuracy also as tools to improve health literacy.

She cites findings by the Australian Commission on Safety and Quality in Healthcare that 60 per cent of the community had "low" literacy, namely "they struggle to self-manage … to act on good medical advice about how to prevent or take preventative steps."

Short political horizons also must be overcome. Professor Leeder says while he's "delighted" with NSW Premier Mike Baird labelling childhood obesity as one of his government's state priorities – one in five of the state's children now qualify as overweight or obese – "You would be very hard pressed to find a health outcome there in under 20 years. I'm not putting him off … I'm just saying, we've got to be prepared because there will be pushback from other portfolios who say "what the hell?"

Says Skinner: "Our investment in things like IT … it's not necessarily going to make it cheaper, but it's going to get you better outcomes and prevent those more costly deteriorating patients later on.

"It's a long-term vision. It's not going to save you money during the life of a government necessarily."