An Experience of Trial Telehealth Service

The following is a brief of an old woman who used a telehealth service. Mrs. Wang-Lin is 70s years old and she has heart disease. She lives with her son, her son’s wife and children. She started to use a National Taiwan University Hospital telehealth service that included BabyBot machine in 2011 September. Before using the telehealth service, her health was not well and she has gone to ER several times. Then, she received a 2 weeks free trial of telehealth service. After the free trial, she continues to use it for one month.

The following are summary Mrs. Wang-Lin’s experience of using the telehealth service. I visited her several times during her trial. At beginning of trial, she told me that she hoped this service could help her health becoming more stable. She thought the expense of ER was higher than the telehealth service fee, so she thought telehealth service was a good choose. Besides, in order to take care her body, she was willing to learn to use BabyBot. After one month, she gave up using the telehealth service because it was not worth of NT3900 per month. First, she does not need medicine staff to tell her “the data of your blood pressure is a little higher than usual”. She said she takes blood pressure every day so she has already known what her normal blood pressure is. It is meaningless to send the vital sign to the hospital and to tell her something that she has already known. Second, she said if the blood pressure data is unstable, she will go to the closest hospital immediately. She doesn’t need anyone telling her. Finally, she said that she needed her son to assist her in operating BabyBot. Besides, she still cannot operate BabyBot by herself after one month trial.

In my opinion, the telehealth service still has two problems. First, the telehealth machine still difficult to use for the elder. Even though BabyBot has an innovative remote control, the elder can’t still use it by themselves. The most important, the telehealth service is less useful than consumers expected. Or the service is too general for consumers. I suggest telehealth service providers to think deeply what kind of services are consumers’ needs.

我們來玩 Apps 吧!

文/ 林洺呈、李曉恩

同步刊登：ITI電子報第45期ePAPER Vol.45

What Apps?

為了讓這次分享的主題比較聚焦，我們將這次主題的 Apps 專注在隨身存取裝置上面的應用程式。就如同我們在智慧型手機或平板電腦上面運作的遊戲或是行事曆相關軟體。

Why Apps???

相信大家一定覺得為什麼生技社團這次活動要討論 Apps。平板電腦與智慧型手機的盛行，我們發現開始在上面運作的軟體中，有越來越多健康管理的服務透過 Apps 投遞給使用者，此外有許多醫療器材接上了智慧型手機或平板電腦；這些軟硬體的相關產品出現之後，我們也注意到販售的營運商業模式跟以往不太一樣，甚至是非常創新的商業模式。我們認為這是未來的機會，所以帶到這次活動來討論。

Medical Tablet PC: MioCARE

MioCARE, which was launched on 5 September, is the first medical tablet PC. It was designed by MiTAC International Corp., MitTAC Informational Corp., and National Yang-Ming University. It is equipped with 320 million pixels camera, 6-inch touch screen, and wifi. Besides, medical staff can sterilize it with 75% alcohol. Now, it is running in Taipei City Hospital, and some medical staff use MioCARE for their daily work.

MioCARE has three medical systems. The first thing is the long-term care system. There are a lot of long-term care assessment scales in the system such as comprehensive geriatric assessment(CGA), activity of daily living(ADL), and instrumental activity of daily living(IADL). The second thing is the hemodialysis care system. The staff of hemodialysis center can record the vital signs of patients in the MioCARE, and the manager can over view all of patients’ vital signs. The third thing is the chemotherapy drug delivery system. Medical staff can use MioCARE’s camera to read bar code of the patient and his medicine for making sure the patient follows his prescription, and they can use it to read the patients’ prescription.

MioCARE has three core functions such as reading & writing, reminding staff, and checking prescriptions. First, medical staff can read or write some information on MioCARE. Second, MioCARE can remind medical staff to follow the SOP or to deliver medicine to patients. Third, medical staff can use MioCARE to quickly make sure the patient follows his prescription.

When medical staff implement some of MioCARE features, it stops the necessity for paperwork. However, staff must use this, instead of paper. Unless hospitals have a policy to reduce the use of paper, it will be useless. Moreover, MioCARE makes medical staff can get real-time information, but only few care services need real-time data. Although, the some features of MioCARE are pretty good. One is that it can be sterilized by 75% alcohol. Another is that medical staff use it to quickly make sure the patient follows his prescription. To sum up, I think these are core advantages in a medical market.

Reference：MioCARE醫療平板 健康智慧全Hold住！
http://www.sogi.com.tw/newforum/article_list.aspx?Topic_id=6174405

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.

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。

We will Healthier Together

As the world’s medical resources are not well distributed in society, many people have not received proper health care. I would like to establish a platform for all mankind to take care of each other, to maintain the physical, mental and social well-being. By that community we care for each other. By the training to people without medical background to expert to provide the simple healthcare. The love will be passed to one by one. The world is full of love and hope.

全球醫療資源分配不均，社會上有許多人沒有接受足夠的健康照顧，我希望以互助的精神建立一個提供全人類互相照顧的平台，維持心理上、生理上、社會關係上的健康；藉由社群大家互相關心，以及訓練非醫學工作者成為高手提供簡易的照顧，人與人之間的互動化解隔閡，將愛心一個一個的傳遞，讓世界充滿愛與希望。

~~~ Full text ~~~

Health Care deliver by Internet ( M-care )

In October 2006 to May 2007, I was the partimer in Tatung company. The M-care project is one of Mobile Taiwan Applications promotion project (M-Taiwan). The purpose of M-care project is deliver health care by WiMAX network (Wireless Internet) into remote country. In order to improve care service of residents in remote areas.

The most of societal resources is concentrated in Hualien City, besides there are barely clinic in countryside. Hualien county is mostly mountain terrain, so people living in countryside are inconveniently go to Hualien city. As a result, the person didn't receive care service at beginning. Making patient become more severity. We hoped that the Internet capable of delivering health care services to enhance the quality of service in remote area. For example, user's daily physiological information can upload to Internet by sensor network. The healthy services provider can understand the user's physiological state on platform, and can also concerned about user's health by video telephone every day. Beside, the doctors of mobile medical service can use Internet connect the hospital to strengthen the ability of medical care.

People always care their friends, family, etc. No matter where they are. The M-care is one of the tools connect people to people. People can easy to give social support on M-care platform. They would talk health issues or something on this platform. the social actives will bring long term and stable usage. One day, we help people more health not only the physiology health but also psychology health.

P.S.

Hualien is on the East coast of Taiwan, on the Pacific Ocean.

• Area: 29.41 km²
• Population: 110,000 people in 35,000 households
• Geographic coordinates: 121°36'23 East, 23°58'20 North
• Average annual temperature: 24°C

Social support is the physical and emotional comfort given to us by our family, friends, co-workers and others. It is knowing that we are part of a community of people who love and care for us, and value and think well of us. Social support is a way of categorizing the rewards of communication in a particular circumstance. An important aspect of support is that a message or communicative experience does not constitute support unless the receiver views it as such.

Healthy culture in internet

雖然我希望為大家解決健康的問題，創造更健康更有品質的生活，表面看起來跟文化產業沒什麼關係，怎麼跑來法藍瓷的地盤坐坐，在此文化創意產業協會又能給予我什麼呢？

尋找人類行為上的共同性「文化」；人類的集體行為就是文化，很多人在一起做共同的事情稱為文化。
由於人們的生活品質的提升，開始培養自己品味的人生，久而久之產生出個人的品格，這就是陳立恆先生所謂的三品；我開始對這句話的衍生，生活品質提升希望可以身體健康萬事如意，對生活的追求養生、環保、天然...等品味，在健康飲食上面衍生出「慢食文化」(slow food)，不只愛吃更要挑吃，選擇優質(good)、乾淨(clean)、公平(fair)的好食物，讓口腹之慾不會造成其他人的負擔，產生出人們對食物美味的格調。
新的技術帶來新的產品，新的產品影響人類的行為，接者影響人們的文化；網際網路帶來的許許多多的新產品(skype, blog, wiki, youtube, etc)，也正巨大的影響人類的行為，聚集了一群網路上的人，創造了網路社群，創造了許許多多的網路文化。
我們可以預期的網路上出現健康的文化，透過網路來做健康上面的服務，像是遠距醫療(telemedicine, telecare)、或是透過SNS(social network service)提供人們心靈的溝通給予幫助像是SixDegrees.org (Kevin Bacon) and Network for Good，Google Health 提供會員與自身健康相關(自己病歷)的健康資訊，一群美國內科醫生在網路上組織網路社群Sermo，Sermo is aimed at advancing the available universe of medical knowledge.” 不外乎需要提到我之前服務的大同公司M-care計劃，網路上的健康文化已經悄悄的崛起了，如何讓這文化變成有價值是我們所期待的。
我始終相信「使用者不在乎使用的技術多厲害，產品最重要的是要能帶給人們價值，在網路上人們為了要與大家互動，希望多關心親朋好有，才會出現分享上傳，使用者才會生產內容(UGC, user generate context)」開創網路健康的文化價值在於關心他人感動他人；現在的環境如此的競爭，如何找到感動人的故事？如何創造符合市場需求的價值？
陳先生強調以下是商業機密...................
-----(以下文章經加密處理，留言後方可取得秘方)-------
求同存異
求同---觀察共同的價值，尋找古今中外保留至今的文化，從古典文化找出眾人喜愛的顏色、圖騰、故事，因為這些元素是人們歷代的共同感動所在，就因為可以感動千年以來的人們，才能保留到今日，相信往後的數千年依然可以感動許多人；從東西方文化中尋找共同點，這些共同的文化元素能夠感動東西方民族，相信這樣子的元素也可以符合東西方的市場。
存異---在共同元素的基礎上創造有價值的特點，南方溯先生提到人們都有「微小差異症候群」，創造了人們希望與眾不同的行為，希望在共同相似中尋找與別人一點點的不一樣，這樣子的行為創造了不少的慾望，透過微小差異來滿足人們的慾望。
我也開始在翻出以前的書本，尋找古代聖賢的著作在閱讀，我們朋友們也可以告訴我什麼古典書籍，大家互相交流。

Free Health Care

Image via Wikipedia

在台灣有民間社會福利團體、地方政府社會局…等經營老人照顧事業，而在照顧產業(Healthcare Industry)中做得有聲有色大多都是非營利組織(NPO)，但這些團體也揹負著沈重的財務支出，我發現需要照顧的人經濟基礎多半不好，然而提供照顧的組織礙於資源有限無法滿足所有需要的人，因為社會存在這樣子的問題，所以我們希望帶給人們生命的價值，使更多人可以被照顧被關心，而創造「"免費"的照顧服務」(Free Health Care)。

現在的市場上已經不是只有買賣雙方，而是具有三方關係，第三者(需要照顧的人)受到免費的誘惑而加入，並因而創造出待價而沽的商品「以廣告為例，這項商品就是廣告主所購買的眼球數」； 讓大部分的照顧服務(caring service)都是在網路上，因為網路基本上就是建立在免費的基礎上，網路的邊際成本(marginal cost)幾乎等於零，將許多工作轉向軟體，數位化的結果使得效率提高，讓產品的定價更彈性，因而降降許多成本，再透過免費送出某樣東西，而賣出另一樣東西「將健康照顧送給消費者，而賣出長期而穩定的需求：三餐與日常生活所需」，這個商機可大的多；最後，提供給消費者身體心靈的健康，使消費者產生信任感，增進會員的黏著力，創造長久經營的事業。

There are many groups dealing in the healthcare industry in Taiwan. Non-profit organizations always operate well in the healthcare industry, but these groups also bear a heavy outlay. I find the economic ability of the most people needing the healthcare is not very good. However, the groups providing healthcare service do not satisfy all of people in need because of limited resources. Because the community has this problem, I want to create "Free Healthcare" for taking care of more people. Markets is not as a two-way relationship between buyers and sellers, but a three-way relationship where the third party（people needing healthcare） can be drawn in by something free that creates the product to be sold. In the case of advertising, this "product" is the fabled "eyeballs" that advertisers buy. Putting the most of the services on the web, Internet service is based on free propagating the products. What the web's near-zero marginal costs encourage is for other industries to turn as many of their jobs as possible into software, so they can benefit from digital efficiencies, which gives them more flexibility over pricing. It has more business opportunities than traditional selling that to give away something to the consumer for free and sell other products. In this case, we give the healthcare to consumer for free and sell long-term and stable requirements, like diet and daily necessaries. Finally, to provide to consumers with physical and soulful health, consumers would trust in us more, and this could promote the member’s adhesion force, so it could create long-term enterprise.

Reference:
Chris Anderson
a flight across Europe for $10 is indistinguishable from magic

大同M-CARE影片

這是大同建置M-CARE個案過程的影片
埋感人的 分享出來



影片中的玉里 芭崎 文蘭 都是花蓮蠻偏僻的角落
甚至ADSL網路都到不了
無線網路做到了

intel 感人影片

感人影片