What is Telehealth ??

According to Mosby's Medical Dictionary, 8th edition, telehealth is “the use of telecommunication technologies to provide health care services.” After the prosperity of telecommunication technologies, telehealth will become a popular business in the next ten years. Health professionals discussing one case via telecommunications is one kind of telehealth. Besides, transmitting medical or surgical information or images to provide clinical care is also one kind of telehealth, but it is usually called “telemedicine.” By the way, it is easy to confuse telehealth with telemedicine. Telemedicine is one kind of telehealth, but telemedicine particularly refers to providing clinical care. We will need more efficient ways to take care of the elderly such as telehealth, because the population of the elderly are growing. As a result of a large amount of data from people’s vital signs, health service providers need to spend a lot of time reading an extremely huge group of people’s data. Telehealth is a good way to deal with the health of the elderly. Moreover, by using telehealth, it is easy to increase the health awareness of the elderly. The elderly would follow the good health guidelines, and they will become more healthy. In addition, by using telehealth, it is easy to train and educate the elderly how to have a healthy body. To sum up, telehealth will become a hot trend because the number of elderly population who want to have good health are going up.

Who Will Buy the BabyBot (Telehealth Device)?

Consumers will not buy the BabyBot without service providers because it is a meaninglessness. So, customers of BabyBot are health care service providers. The National Taiwan University Hospital, who is one of BabyBot’s customers, is worth of telehealth service providers because their business model is innovative. Most important is a few consumers willing to pay they for the telehealth service. First, their consumers are not normal people. Patients who have a cardiovascular disease, a heart failure disease, or a chronic disease are their customers because they need telehealth device to record their vital signs and to send the data to the National Taiwan University Hospital. The medicine staff can monitor the data of patients’ vital signs in the hospital without going to the patients’ house. Moreover, the telehealth package includes a telehealth device and a telehealth service. The National Taiwan University Hospital rents BabyBot to the customers and they provide health care service to the customers. Then, they will charge the total monthly fee. In 2010, they provided only package that included all of BabyBot devices and the total monthly fee was NT5’000. In 2011, they provide five packages. One of the packages includes a sphygmomanometer and a ECG recorder and the total monthly fee is NT3’900. To sum up, health care service providers are the customers of BabyBot.

Telehealth Center of National Taiwan University Hospital
http://www.ntuh.gov.tw/telehealth/default.aspx

What is BabyBot (telehealth system)?

BabyBot was a telehealth system that is developed by a new start-up company. It is assembled by a computer box that connects several with medicine devices such as sphygmomanometer, blood glucose meter, blood oxygen meter, scales,thermometer, ECG, and PF meter. Moreover, the users’ vital signs can be measured by each medicine device, and BabyBot gathers the data through USB lines, and the data will be sent to BabyBot’s platform. Doctors, users, and users’ families can see the data through a browser any where. BobyBot is assembled by a computer box, but it have no keyboard or mouse. It can be controlled by a remote control, so it is specifically designed for the elderly who are unfamiliar with computers. This seems to be an innovative design. To sum up, BabyBot was created by a telehealth system company that has powerful development skills.

The Start of Telehealth in Taiwan

M-care project, which is one of Mobile Taiwan Applications promotion projects (M-Taiwan), is one of the beginning telehealth projects in 2006. I joined the M-care project in Tatung company. At that time, M-care project was an absolutely innovative project in the world. The purpose is to deliver health care into remote country by WiMAX network (Wireless Internet). In order to improve residents’ health in remote areas.



Hualien county was the best choice to run the M-care project. Most of the social resources are concentrated in Hualien City, so most of hospitals and clinics are located in the city. And, there are few hospitals or clinics in countryside. Besides, it is extremely inconvenient going city for Hualian county residents because some geographical barriers are located in Hualian. As a result, the people who have chronic diseases are not easily tracked their conditions. We hoped that the Internet would be capable of delivering health care services in remote areas. For example, the vital signs of users who use the M-care project service could be uploaded to the server of care centers by The Internet. Health service providers could see the users’ physiological condition on the platform, and they could also take care of users’ health by video telephone.

Who Will Buy the BabyBot (Telehealth Device)?

Consumers will not buy the BabyBot without service providers because it is a meaninglessness. So, customers of BabyBot are health care service providers. The National Taiwan University Hospital, who is one of BabyBot’s customers, is worth of telehealth service providers because their business model is innovative. Most important is a few consumers willing to pay they for the telehealth service. First, their consumers are not normal people. Patients who have a cardiovascular disease, a heart failure disease, or a chronic disease are their customers because they need telehealth device to record their vital signs and to send the data to the National Taiwan University Hospital. The medicine staff can monitor the data of patients’ vital signs in the hospital without going to the patients’ house. Moreover, the telehealth package includes a telehealth device and a telehealth service. The National Taiwan University Hospital rents BabyBot to the customers and they provide health care service to the customers. Then, they will charge the total monthly fee. In 2010, they provided only package that included all of BabyBot devices and the total monthly fee was NT5’000. In 2011, they provide five packages. One of the packages includes a sphygmomanometer and a ECG recorder and the total monthly fee is NT3’900. To sum up, health care service providers are the customers of BabyBot.

下一波：老人消費市場

最近在網路上找有關於老人家的資料，老人家居住與收入來源的調查。

就目前的型態大部分的老人的居住安排都跟子女居住，生活費來源主要是主女的俸樣。引起我興趣的除了這理所當然的部份現在慢慢的減少了，有變少就會有變多，什麼變多了?

就居住型態來看，獨居和與配偶居住的情況增加了；就生活費來源，政府救助與津貼的情況也增加了。

Online Care Coming

在網路上面可以交友結婚、可以購買日常用品、可以當個大明星......，接下來可以看醫生，夏威夷醫療服務保險公司(HMSA)推出一個Online Care 的平台，讓病人與醫生可以在此平台上有良好的互動，讓網友可以在平台上看醫生。接下來看看HMSA 怎麼做，以及台灣可以怎麼做呢??

HMSA’s Online Care 為HMSA 推出的網路上看診的線上服務，平台的開發者是由American Well。Online Care 有24小時的線上門診服務，而且是立即看診不需要預約掛號，最適合那種一直找不到時間看病的大忙人；不管你在哪裡只要能上網都可以上來看診，也適合那種偏遠地區的民眾，為了就醫需要千里迢迢路遙遙的那種居民，以夏威夷來看，每個小島分散而醫療資源集中更突顯出Online Care 的方便。除此之外，對美國人還有另外優勢就是隨時都可以看專科醫生，剛好有不舒服的狀況的時候，馬上有醫師可以諮詢，對小疾病病人而言減輕病患當下的憂慮感，對急症病患把握時間即時就醫，這項優勢在台灣不強烈，因為台灣大小醫院診所林立，當天掛號當天就可以看到專科醫師，稍微有點小病痛就可以有各科醫師為台灣人服務。

有社會支持，死亡率降低

心理學上有很多的實驗都顯示『社會支持』(social support)世人在逆境時，渡過難關最重要的因素，他對健康有直接的關係。

這種福禍共享、患難相助的感覺，正是最能激發大腦中，跟正向心情有關的多巴胺(Dopamine)等神經傳遞物質及激乳素等荷爾蒙(Hormone)。

實驗者發現：「社會支持」可以減少心臟血管方便的疾病，快樂的人較長壽，所以他們在統計數字上就突出了。

工業化的水泥叢林社會中，我們必須創造自己的「社會支持」，每一個人若能伸出自己的雙手助人，別人回報你的手，會以等比級數上升。

要抵抗憂鬱症、老年痴呆症（Alzheimer's disease，簡稱AD）等慢性疾病，「社會支持」大概是最有效、最節省社會成本的方式了。

From 洪蘭 2008.03.31聯合報