So it seems that
with even the most
basic motivators
(money), it’s possible
to both reduce costs
and improve health for
a relatively large and
diverse population.

[ 8] LaRusso, N.
“Imagine Solutions:
Transforming health
care through a patient-
focused delivery
system.” Naples Daily
News, 20 February
2010; http://www.naple-
snews.com/news/2010/
feb/20/imagine-
solutions-transforming-
health-care/
November + December 2010

[ 9] Auchincloss, A. H.
et al “Neighborhood
Resources for Physical
Activity and Healthy
Foods and Incidence
of Type 2 Diabetes
Mellitus.” Archives of
Intern Medicine 169,
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http://archinte.ama-
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interactions

Another recent study conducted by Kauffman Foundation and Brookings Institution economist Robert E. Litan predicts the U.S. could save $197 million from implementing telehealth systems to help treat chronic ailments like diabetes, congestive heart failure, chronic obstructive pulmonary disease, and chronic skin ulcers.

Current home health monitoring products are mostly dismally designed. For example, the Health Buddy, a popular telehealth device, communicates to its (mostly elderly, sight-impaired, arthritic) users entirely with small, center-aligned text, which is clearly not as readable, let alone as engaging, as it could be. These products also suffer from the same issues that plague many existing solutions around proactive engagement: They are not already integrated into a person’s daily routine. For example, given the prevalence of television watching among the chronically ill, it seems that the cable-TV box would be a much more useful platform than a standalone “medical device,” which is as easy to ignore as the blood pressure pump itself.

The Mayo Center for Innovation (CFI) has been working on a program to design a “patient-centered medical home” that provides a better connection between patients and their healthcare providers beyond the in-person visit. According to the CFI, it is “exploring ways to implement unobtrusive systems into a patient’s daily routine—perhaps a coffeemaker or refrigerator that records blood pressure or glucose levels— without disrupting their busy lives” [ 8]. While this certainly points in the right direction, it is the tip of the iceberg. Whether it’s in a coffeemaker, the television, or PC-based social media, there is a huge opportunity for designers to imagine how home healthcare monitoring and telehealth can more seamlessly fit into people’s daily lives.

Using technology to provide better care beyond the walls of hospitals and doctors’ offices need not be limited to monitoring chronic-disease patients. Many routine trips to a doctor’s office might easily be replaced by a videoconference or even an email exchange. This, of course, would be especially beneficial to patients in rural settings.

Centralization of specialized
resources seems to generally be
a good thing in the organiza-
tion of a healthcare system. It’s
more cost-effective and easier
to standardize care (and thereby
improve quality) to deliver car-
diac care in a single large facil-
ity in a metropolitan area than
in a number of small facilities
spread around. However, a huge
downside to this approach is
the increase of travel time—
and decrease in access—for
patients. Telehealth provides
great opportunities to mitigate
these problems by allowing
patients to access the expertise
at specialized facilities from
far away. And not only ought
our new healthcare infrastruc-
ture better support remote
clinician-patient interactions,
but because of this trend to cen-
tralize specialization, healthcare
providers will also increasingly
need information systems to
support non-collocated col-
laboration between clinicians.