Bringing Healthcare Home

They say in each person's lifetime they will spend hundreds of hours waiting in line. Waiting to get on a ride at an amusement park. Waiting to buy tickets for a movie. Waiting at the doctor's office. However, imagine not having to wait at the doctor's office. Thanks to the work done by University of Hawaii, Professor of Electrical and Computer Engineering Dr. David Yun, a few diabetes patients here in Hawaii no longer have to wait.

Diabetes is a disease in which the human body does not produce or properly use insulin. Insulin is a hormone that is needed to convert sugar, starches, and other food you eat into the energy needed by your body every day. Today, there are over 16 million diabetic patients in the United States. More alarmingly, each year 800,000 people are newly diagnosed with diabetes and it is reaching into the ever-younger age groups (some are rising at the scary rate of 75% annually).

Dr. Yun with his creation, OhanaHealth.

Dr. Yun, in conjunction with medical doctor, Dr. Joseph Humphry, is developing OhanaHealth, a prototype to deliver remote health care services to diabetes patients via the Internet. This ability to diagnose symptoms over the Internet or other forms of communication is called telemedicine, of which Dr. Yun happens to be recognized as one of the top experts.

Telemedicine has been around for decades. A patient calling a doctor over the phone is a form of telemedicine. "A doctor helping another to read and interpret a chest x-ray or a skin lesion image is another common practice of telemedicine," Dr. Yun said.

However, today's telemedicine isn't like your dad's telemedicine. Thanks to the Internet, today's telemedicine involves a whole lot more and doctors can diagnose patients more efficiently.

Diabetes is an illness that needs constant monitoring, to prevent deterioration into more serious problems like blindness, amputation and kidney failure. Dr. Yun's research, which is sponsored by the Hawaii Medical Service Association (HMSA) Foundation, allows patients to self manage their long-term battle with the chronic disease by taking measurements with devices at home and transmitting the data regularly via the Internet to a secure server, where the individual conditions can be analyzed and any problems can be alerted to the doctors for prompt actions. This way, doctors, like Dr. Humphry, can take care of many patients more effectively and efficiently.

Dr. Yun and his group created an automatic advisory system, based on Staged Diabetes Management (SDM), which is a internationally accepted best-practice guidelines for managing diabetes. What this means is that when patients input their test results, they can automatically get a response if their glucose levels are too high or too low and the effect of their medications are also monitored to give them better healthcare.

How the OhanaHealth system works.

All the patient conditions and test results, taken at home, at the doctor's office, and at medical laboratories, are posted online and analyzed by the central computer continuously. "This allows both the doctor and the patient to track their progress, as if there is a healthcare assistant that watches the conditions and changes often. The ability to check medical records online also allows patients to check things like how much medication they need to take, and more importantly how well they are doing," Dr. Yun said.

In a one-year, 22-patient trial of OhanaHealth, there was a significant 86 percent of patients putting their disease under control and 50 percent showing improvements of their diabetic conditions.

However, the patients are not the only ones who benefit from OhanaHealth. With the OhanaHealth system serving as a watchful assistant that never sleeps, it can help doctors monitor a large number of diabetes patients at one time, which saves the doctors' time. Also, because it allows less doctor visits, which can be very expensive, medical insurers also save money. "The most important benefit, of course, is the maintenance and improvement of each patient's health conditions and the prevention of those dangerous complications," Dr. Yun said.

Although OhanaHealth is currently only available to qualified patients in Hawaii, including the remote patients of Hana, Maui, in the future it will be made available to many more diabetes patients across the World Wide Web. When that happens, diabetes patients will probably say OhanaHealth was worth the wait.


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