19 research outputs found
Assessment of a Business-to-Consumer (B2C) model for Telemonitoring patients with Chronic Heart Failure (CHF)
Background: The purpose of this study is to assess the Business-to-Consumer (B2C) model for telemonitoring patients with Chronic Heart Failure (CHF) by analysing the value it creates, both for organizations or ventures that provide telemonitoring services based on it, and for society. Methods: The business model assessment was based on the following categories: caveats, venture type, six-factor alignment, strategic market assessment, financial viability, valuation analysis, sustainability, societal impact, and technology assessment. The venture valuation was performed for three jurisdictions (countries) - Singapore, the Netherlands and the United States - in order to show the opportunities in a small, medium-sized, and large country (i.e. population). Results: The business model assessment revealed that B2C telemonitoring is viable and profitable in the Innovating in Healthcare Framework. Analysis of the ecosystem revealed an average-to-excellent fit with the six factors. The structure and financing fit was average, public policy and technology alignment was good, while consumer alignment and accountability fit was deemed excellent. The financial prognosis revealed that the venture is viable and profitable in Singapore and the Netherlands but not in the United States due to relatively high salary inputs. Conclusions: The B2C model in telemonitoring CHF potentially creates value for patients, shareholders of the service provider, and society. However, the validity of the results could be improved, for instance by using a peer-reviewed framework, a systematic literature search, case-based cost/efficiency inputs, and varied scenario inputs
Extending the Business-to-Business (B2B) model towards a Business-to-Consumer (B2C) model for Telemonitoring Patients with Chronic Heart Failure
Purpose: We describe and perform an initial evaluation of the extension of the Business-to-Business model to a Business-to-Consumer model for telemonitoring of patients with chronic heart failure.
Design/methodology/approach: We explored the problems in implementation of telemonitoring via the B2B model by means of a root cause analysis, including the 5-whys method to help us understand the shortcomings of the B2B approach, and then the 5W1H method to explore whether the B2C is a better strategy. The extension of the model was executed in the Business Model Generation framework. By using qualitative content analysis techniques, we supported our argumentation with findings from other studies.
Findings: The B2C model is based on the interplay of agents – healthcare provider, equipment manufacturer, payer/regulator and distributor/promotor – all working together to improve patient outcomes. In our opinion, the success of the extended model in telemonitoring CHF patients hinges on two entities – the Telemonitoring center and Telehealth nurses – being repositioned in the out-of-the hospital setting.
Social implications: Penetration of mobile telehealth via B2C model will allow for greater availability, access and equity in healthcare.
Originality/value: We introduced a fourth pillar to the existing B2B model (i.e. distributors and/or promotors). The B2C model we propose might allow for scalability, generalizability and transferability of telemonitoring currently unattained with the B2B model.  
Strategic Intelligence Monitor on Personal Health Systems (SIMPHS): Market Structure and Innovation Dynamics
Personal Health Systems (PHS) and Remote Patient Monitoring and Treatment (RMT) have the potential to alter the way healthcare is provided by increasing the quantity and quality of care. This report explores the current status of PHS and, more specifically of the RMT market in Europe. It addresses the question of how these technologies can contribute facing some of the challenges standing in front of the European healthcare delivery systems causes by higher demand pressures through chronic diseases and demographic change combined with diminishing resources for health care. An uptake and diffusion of these services would potentially lead to benefits through a reduction in death rates, and avoid recurring hospitalisation in a cost-effective manner. Yet the report identifies different categories of barriers hampering a full deployment of RMT in Europe. In the concluding part the reports provides a number of tentative policy options specifically aimed at fostering EU-wide deployment of RMT/PHS.JRC.DDG.J.4-Information Societ
Telehealthcare for chronic obstructive pulmonary disease
BACKGROUND: Chronic obstructive pulmonary disease (COPD) is a disease of irreversible airways obstruction in which patients often suffer exacerbations. Sometimes these exacerbations need hospital care: telehealthcare has the potential to reduce admission to hospital when used to administer care to the pateint from within their own home. OBJECTIVES: To review the effectiveness of telehealthcare for COPD compared with usual face‐to‐face care. SEARCH METHODS: We searched the Cochrane Airways Group Specialised Register, which is derived from systematic searches of the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, CINAHL, AMED, and PsycINFO; last searched January 2010. SELECTION CRITERIA: We selected randomised controlled trials which assessed telehealthcare, defined as follows: healthcare at a distance, involving the communication of data from the patient to the health carer, usually a doctor or nurse, who then processes the information and responds with feedback regarding the management of the illness. The primary outcomes considered were: number of exacerbations, quality of life as recorded by the St George's Respiratory Questionnaire, hospitalisations, emergency department visits and deaths. DATA COLLECTION AND ANALYSIS: Two authors independently selected trials for inclusion and extracted data. We combined data into forest plots using fixed‐effects modelling as heterogeneity was low (I(2) < 40%). MAIN RESULTS: Ten trials met the inclusion criteria. Telehealthcare was assessed as part of a complex intervention, including nurse case management and other interventions. Telehealthcare was associated with a clinically significant increase in quality of life in two trials with 253 participants (mean difference ‐6.57 (95% confidence interval (CI) ‐13.62 to 0.48); minimum clinically significant difference is a change of ‐4.0), but the confidence interval was wide. Telehealthcare showed a significant reduction in the number of patients with one or more emergency department attendances over 12 months; odds ratio (OR) 0.27 (95% CI 0.11 to 0.66) in three trials with 449 participants, and the OR of having one or more admissions to hospital over 12 months was 0.46 (95% CI 0.33 to 0.65) in six trials with 604 participants. There was no significant difference in the OR for deaths over 12 months for the telehealthcare group as compared to the usual care group in three trials with 503 participants; OR 1.05 (95% CI 0.63 to 1.75). AUTHORS' CONCLUSIONS: Telehealthcare in COPD appears to have a possible impact on the quality of life of patients and the number of times patients attend the emergency department and the hospital. However, further research is needed to clarify precisely its role since the trials included telehealthcare as part of more complex packages
Toward a Discourse Community for Telemedicine: A Domain Analytic View of Published Scholarship
In the past 20 years, the use of telemedicine has increased, with telemedicine programs increasingly being conducted through the Internet and ISDN technologies. The purpose of this dissertation is to examine the discourse community of telemedicine. This study examined the published literature on telemedicine as it pertains to quality of care, defined as correct diagnosis and treatment (Bynum and Irwin 2011). Content analysis and bibliometrics were conducted on the scholarly discourse, and the most prominent authors and journals were documented to paint and depict the epistemological map of the discourse community of telemedicine. A taxonomy based on grounded research of scholarly literature was developed and validated against other existing taxonomies. Telemedicine has been found to increase the quality and access of health care and decrease health care costs (Heinzelmann, Williams, Lugn and Kvedar 2005 and Wootton and Craig 1999). Patients in rural areas where there is no specialist or patients who find it difficult to get to a doctor’s office benefit from telemedicine. Little research thus far has examined scholarly journals in order to aggregate and analyze the prevalent issues in the discourse community of telemedicine. The purpose of this dissertation is to empiricallydocument the prominent topics and issues in telemedicine by examining the related published scholarly discourse of telemedicine during a snapshot in time. This study contributes to the field of telemedicine by offering a comprehensive taxonomy of the leading authors and journals in telemedicine, and informs clinicians, librarians and other stakeholders, including those who may want to implement telemedicine in their institution, about issues telemedicine
Aplicación del e-Business en las organizaciones inteligentes
Currently, the Industry 4.0 revolution causes organizations to face not only new opportunities, but also challenges related to identifying their role in creating a modern intelligent world. For this reason, it is intended to analyze the components of the systems that show capacity in the detection and resolution of problems in an effective way together with the type of business adapted to the technological development known as e-business, related to the use of Information Technologies and Communication (ICT). For this, method used was the bibliographic search, which was composed mainly of articles published in journals of quartile 1 and 2 of the last five years. On the other hand, the data found from the variables chosen for the research were analyzed, explaining that the effectiveness of e-business within intelligent organizations is due to team learning and good leadership, as well as its model of business and the implementation of digital marketing. However, the complexity of its insertion is discussed, since it must be accompanied by good staff training and constant modernization to be able to transmit information safely in internal administrative processes. Despite this, it is possible to guarantee that e-business is a fundamental part of intelligent organizations, as it positively influences most of their operations and provides high rates of return.En la actualidad, la revolución de la Industria 4.0 ocasiona que las organizaciones no solo se enfrenten a nuevas oportunidades, sino también a desafíos relacionados con la identificación de su función en la creación de un mundo inteligente moderno. Por ello, se pretende analizar los componentes de los sistemas que demuestran capacidad en la detección y resolución de problemáticas de forma eficaz junto con el tipo de negocio adaptado al desarrollo tecnológico conocido como e-business, relacionado con el uso de las Tecnologías de Información y Comunicación (TIC). Para ello, se empleó el método de búsqueda bibliográfica, el cual se compuso mayoritariamente por artículos publicados de revistas de cuartil 1 y 2 de los últimos cinco años. Por otro lado, se analizaron los datos hallados de las variables escogidas para la investigación, dando a explicar que la eficacia del e-business dentro de las organizaciones inteligentes es debido a un aprendizaje en equipo y un buen liderazgo, así como por su modelo de negocios y la implementación del marketing digital. Sin embargo, se discute sobre la complejidad de su inserción, puesto que esta debe estar acompañada de una buena capacitación al personal y constante modernización para poder transmitir información de forma segura en los procesos internos administrativos. Pese a ello, es posible garantizar que el e-business es una parte fundamental de las organizaciones inteligentes, pues influye positivamente en la mayor parte de sus operaciones y le brinda altas tasas de rentabilidad
Developing methods to improve usefulness of economic Decision Analytical Models: case study in COPD telehealth monitoring
Background: In the light of a scarcity of health resources and the growing needs of the population, there is considerable interest in the potential of telehealth technology to assist patients in self-management of chronic conditions, such as Chronic Obstructive Pulmonary Disease (COPD), heart failure (HF), and diabetes. However, despite ongoing support for this technology from the UK government, the uptake of the technology has been slower than anticipated, with the research suggesting the lack of evidence for the cost-effectiveness of this technology is one of the major barriers. Economic modelling is one of techniques that could facilitate deeper understanding of the long-term consequences and financial outcomes of telehealth interventions.
Objective: This thesis documents the process of doctoral research into the methods to enhance the use of decision analytical models in the NHS, using a case study of COPD telehealth. This research is predicated on understanding and challenging assumptions around the methods by which decision models are developed, used, disseminated, and evaluated. The study proposes the ‘end-user mode’ of model dissemination as an alternative to currently used practices.
Methods: During the model development process, the conceptual modelling was undertaken using the existing conceptual framework. The framework was altered to suit the needs of the research, with 29 qualitative interviews conducted to elicit stakeholders’ requirements. A usability evaluation of the model was conducted with end-users in a series of 16 tests, with both qualitative and video data analysed. Finally, when the model was released in Open Access, the stakeholder satisfaction was evaluated, using the end-user satisfaction questionnaire to conduct seven further qualitative interviews.
A number of specific requirements for the model were elicited during qualitative interviews and fed back to modellers during model development process. The usability evaluation resulted in several problems being identified and eradicated in consecutive phases of development; and the study led to the development of a decision tool that was well-received by NHS stakeholders. The user satisfaction evaluation revealed high satisfaction with the model.
Conclusions: The findings suggest that the ‘end-user mode’ approach is viable in the development and the dissemination of a decision model for telehealth. Importantly, several potential areas for future research were identified, including the need to develop methods to improve the uptake and the use of modelling in the NHS, and the development of the concept and instruments for end-user satisfaction in modelling and simulation domain