Technology enables shifting |of care from |hospital to home

But now, we find that this approach leads to high cost, along with hospital-related complications such as infections. 
This has prompted a world trend towards community-based or home care.
Some examples are the "virtual hospital" initiated by the health department of Victoria, Australia, with 500 beds and no bricks and mortar, which counts 33,000 admissions each year, and the "hospital at home" project of New York's Icahn School of Medicine at Mount Sinai. 
Another is "The Five Year Forward View" from the UK's National Health Service, which encourages the provision of healthcare outside of a hospital. There are many more home care efforts around the globe.
One reason home care is becoming a trend is that its quality has much improved in recent years due to technological advances. 
In this article, we will explore further what technology we need to achieve high-quality home care.
Telehealth is a platform supporting disease management between patients and providers. It includes a wide variety of applications for various diseases.
 For example, there is an app allowing patients to communicate with their providers via text messaging or video calls. And an app that helps patients control their blood sugar.
Personal health records (PHRs) are applications allowing patients to manage their health information and access some provider services such as appointments. 
The idea is to keep medical records with patients instead of with providers. Patients can get treatment from any provider and still access their medical record. 
PHRs can be "tethered" or "standalone". The former means the app has to fetch data from providers. The latter means patients have to fill in the data themselves. 
In Thailand, Health at Home at www.healthathome.in.th developed a standalone PHR for monitoring its patients. They would probably connect with hospitals in the future.
Smart homes and IoT (Internet of Things) devices are popular topics nowadays. These devices can be categorised into active and passive monitoring. 
Active monitoring is when users have to take some action, such as recording blood pressure or measuring blood sugar. 
Passive monitoring is when devices do their jobs automatically - for example, sensors measuring patients wandering around the house, or wearable devices. 
These technologies enable patients and providers to get a stream of health data over time rather than just snapshots at care visits.
Most importantly, all these technologies have to run on the same information infrastructure. This is the role of various standards at several levels. 
For example, to connect between a PHR and a hospital's electronic health record, both sides have to use at least the same data structure (syntactic interoperability). 
If they want to connect with more meaningful information, they have to use the same terminology, such as ICD-10 or SNOMED-CT, or the same information model.
Healthcare is transitioning from hospital care toward home care. This trend needs many technologies that are relatively new in Thailand. 
It's a challenge for the home care industry in general, but also an opportunity to be the pioneer of the technologies in the country.

Dr Rath Panyowat is co-founder of Health at Home, part of batch 4 of DTAC Accelerate.