An example of how this works: “mCare” supports soldiers with traumatic brain injury

	ATBI patient’s daily proactive care includes: Family members Clinic team members The patient himself using a cell phone

A recently launched Department of Defense and Veterans Administration project illustrates how home healthcare can benefit the health of the patient, as well as cut the cost of care. In both Iraq and Afghanistan the enemy’s use of improvised explosive devices (IED) has created a large number of returning military personnel suffering from the long-term effects of traumatic brain injury (TBI). Physicians have to monitor troops returning home with TBI to ensure they intervene before patients commit suicide or act violently.

Here’s how it works:

1. A clinical staff member enters a query or loads information into a Web-based interface
2. A clinical staffer accesses the response via the secure Website
3. The Web server sends scheduled messages to personal cell phones
4. The soldier receives information
5. Soldier responds

Daily interaction with the TBI service member includes evaluating the patient’s goal achievement and any necessary triage. Everyone communicates using a secure SMS line.

The following is a sample of veteran’s mCare Web portal dashboard that physicians can use to track the progress of their TBI patients.

Source: DOD / VA 2009 TBI study protocols

Now we are poised to embrace a patient-centric medical record. The new databases will house a vast amount of data that caregivers and patients can mine to support evidenced-based medicine. Technologies that encourage patient engagement are likely to foster sustained success compared to those that treat patients as passive players in their own care.

One important measure of success will be the impact those technologies have on creating and sustaining behavioral change. The system engages patients in their own care by providing them with an easy-to-use, intuitive way to have timely interactions with their care providers and receive relevant self-care education — helping to minimize time-consuming and costly office visits.

That is the goal: healthier patients and more appropriate use of resources, resulting in system-wide cost benefits.

John Hummel
Chief Technology Officer
Dell Services, Healthcare