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Kent E. Dicks

Kent E. Dicks, MedApps, Inc., Scottsdale, AZ, Founder and Chief Executive Officer

Good Morning Chairman Michaud, Ranking Member Brown and Distinguished Members of the House Committee on Veterans’ Affairs, Subcommittee on Health.

My name is Kent Dicks, Founder and CEO of MedApps, a small business enterprise located in Scottsdale, Arizona.  On behalf of the Team at MedApps and the veteran-owned enterprise that manufactures our devices here in America, I would like to thank you for the opportunity to present this testimony.

We are here today to speak about overcoming rural health care barriers through the use of innovative wireless health technology solutions.  I am here today to speak about innovative digital wireless communications technologies, like those produced by my company MedApps, which are quickly becoming a key component in the delivery of healthcare and services across America, via Wireless Remote Patient Monitoring. 

Medical devices, health sensors and their applications rely upon mobile broadband functionality and interoperability to transmit raw data, diagnostic health information, critical aspects of care, emergency services and related health information.  These services are at the forefront of a revolution in the provision and delivery of healthcare in America; a revolution which collapses time, space and distance to more effectively monitor patients, develop analytical trends, maximize strained medical resources and save lives.  

First, a word on the nomenclature surrounding wireless health.  There are many terms loosely used today to describe the differing and often confusing aspects of wireless health information technologies.  Terms such as mHealth, e-Health, telehealth and telemedicine are but a few of many descriptive names being used in the wireless health space.  Some terms have industry meaning, others are regulatory terms with strict federal definitions and criteria. 

For purposes of today’s hearing I will use the term “eCare”, which is the term used by the Federal Communications Commission in Chapter 10 of the National Broadband Plan for America.[1]  eCare is the electronic exchange of information — electronic data, images and  video — to aid in the practice of medicine and healthcare analytics.  eCare encompasses technologies that enable remote monitoring or “store-and-forward” transmissions over wireless fixed or mobile networks.  eCare is not a substitute for healthcare providers, physicians or clinicians – it is intended to augment the good work of medical professionals and improve patient care by making important information available to patients, their loved ones and care providers anywhere, at anytime.

In a landmark comprehensive pilot with 17,000 veterans, the Department of Veterans Affairs demonstrated that by implementing remote patient monitoring they experienced a reduction in hospitalization by 25 percent and an average cost of $1,600 per patient per year for remote monitoring compared to annual costs of $13,121 per patient for primary care and $77,745 per patient for nursing home care.  

Amazingly, those encouraging results and statistics were achieved with first generation of wired systems that are typically more costly, proprietary and are tethered to a point of care, lacking mobility.   If the pilot program was able to achieve those encouraging results for patients using this technology, imagine the potential wireless eCare technologies would hold? 

eCare technologies like wireless mobile solutions drive down costs and improve care by closely  monitoring patients wherever they may be.  Thus, they allow healthcare to be practiced in a more “Proactive” manner, rather than in a “Reactive” manner, and can possibly head off a patient going to the emergency room or hospital setting in the first place.

In my hand is an example of the technology that I am talking about.  This is called the HealthPAL.  The HealthPAL’s sole purpose is to allow a patient to stay connected with their “Electronic Health Record” and ultimately their caregiver.  The HealthPAL is FDA cleared and communicates wirelessly (or wired) with other medical devices designed for use outside the hospital, such as this Nonin 9560 Pulse Oximeter.   

A doctor may ask a veteran with chronic obstructive pulmonary disease or congestive heart failure to take a reading once a day in order to make sure that they are staying within the safe zones.  And as you can see, the Pulse Oximeter reading went over automatically to the HealthPAL without the patient having to press any buttons whatsoever (hands off), using Bluetooth wireless technology.  It’s that simple.

The HealthPAL, like the one that I am holding in my hand, has mobile phone technology embedded into it directly, using a technology called “Machine 2 Machine” (M2M).   This 3G mobile broadband chipset by Qualcomm is about the size of a U.S. quarter, which is embedded in the HealthPAL, and is the  key to connecting our Veterans to their healthcare providers, in an efficient and economical manner.

You will be hearing a lot about M2M services and mobile chipsets in the near future, in relation to healthcare and smart grid technologies, in particular.  Mobile chipset powered modules allow us to connect ubiquitously to cellular and mobile broadband networks throughout the U.S., and globally.  According to the Federal Communications Commission nearly 96 percent of the U.S. population is covered by a mobile broadband network and 99 percent of the non-rural U.S. population and nearly 83 percent of the rural U.S. population is so covered.[2]  At the heart of science, medicine, energy and engineering, mobile wireless and broadband technologies are reliably and invisibly working in the background on economical rate plans.

Innovative technologies like the HealthPAL are targeted towards 10 percent of the population that consume 70 percent of the healthcare resources; the sickest of the sick.  Often this population is older, and does not have access to “state of the art” technology or Internet access.  

The HealthPAL works as an agnostic hub or central device that connects to various medical devices and sensors and then transmits their data to a secure central server.  The HealthPAL comes packaged together, including mobile wireless connectivity straight out of the box and ready to use.  Nothing complicated to setup, provide or maintain – everything is done remotely, including software upgrades, much like popular “Kindle™”.[3]e-reading devices.

Let me be clear about what we are trying to achieve in using “off the shelf” devices and mobile wireless technology.  It is not to over engineer a gadget for the sake of fancy bells and whistles.  Rather, it is about creating a sense of accountability and reliability between the patient and the caregiver, at the lowest cost possible.  If a patient is “connected” and accountable, then they are more likely to follow their doctor’s instructions, take their readings, take their medication, and thus stay out of the hospital. 

The MedApps solution is used in a variety of ways, by everyday people including David Jesse, a Truck Driver from Rural Ohio.  David’s erratic schedule makes it difficult to set up and keep appointments with his doctor – and his health suffered because of it.  David often had to produce log books to take back to his doctor at the Cleveland Clinic every couple of months and his doctor attempted to adjust his medication based on dated information.  Today David uses the HealthPAL in the cab of his truck, and has taken his readings throughout 47 states.  This technology has allowed David to substantially improve his health and need for medication. He no longer has to drive back to Ohio every two months to be checked by his doctor, who along with David’s wife can stay connected to him remotely while he’s on the road, making sure he is ok and his medical conditions stay under control.

At Meridian Health, a NJ based Health system, the technology is being used to help reduce re-admissions of congestive heart failure patients (“CHF”).  Typically across the country, 27 percent of congestive heart failure patients are readmitted within 30 days with the same condition.   An average CHF hospitalization is about $8,000.  At Meridian Health, the HealthPAL and a wireless scale are provided to a CHF patient upon discharge to monitor the patient for thirty days to ensure patients with signs of worsening conditions are seen by their physician for early, less resource intensive interventions. The equipment is returned to Meridian at the end of the 30 day period.  So far, out of 30 patients, Meridian has experienced no re-admissions due to heart failure within the 30-day period.

eCare made this possible – today.  The examination room of the future will be wherever the patient is located.  Underserved patients are not just those typically found in rural America or in geographic areas of low population density, but can be anywhere our Veterans live.  Now with an aging baby boomer demographic, more people will continue to place greater demands on the nation's healthcare infrastructure everywhere.  We need to provide the tools to help absorb those demands and make the provision of care available everywhere and at any time.

In conclusion, the VA could potentially extend its capacity for remote monitoring on a daily basis from 35,000 patients currently, to over 100,000 patients by utilizing innovative mobile enabled medical technologies.

Wireless mobile technology is a solution that is available today.  Robust mobile networks exist to start bringing care to those who so desperately need and, in fact, deserve it, no matter where they live.  The VA and US tax payers would save a significant amount of time, money and natural resources by using mobile wireless enabled medical technology.

Mr. Chairman, this concludes my prepared statement.  I would like to extend an invitation to you and the distinguished members of the House Committee on Veterans’ Affairs, Subcommittee on Health to observe a demonstration of this technology at a future time.  I would be pleased to answer any questions you may have and on behalf of the team at MedApps, I thank you for the opportunity to discuss these issues with you today.

[1]  See: FCC National Broadband Plan: Connecting America, released March 16, 2010, at Page 200.  See U.S. Senate Special Committee on Aging, Committee Hearing on April 22, 2010 “Aging in Place: The National Broadband Plan and Bringing Health Care Technology Home”

[2]  See: Bringing Broadband to Rural America, Report on a Rural Broadband Strategy, released May 22, 2009, at Pgs. 12-13. In making that finding, the Commission defined networks based on EV-DO and WCDMA/HSPA as constituting mobile broadband. The Commission used the same definition of mobile broadband in its annual reports on the state of competition in the US wireless market in 2009, 2008, and 2007. See Thirteenth Report, Annual Report and Analysis of Competitive Market Conditions with Respect to Commercial Mobile Services, WT Docket No. 08-27, DA 09-54, released January 16, 2009 at Pgs. 69, 73-74; Twelfth Report, Annual Report and Analysis of Competitive Market Conditions with Respect to Commercial Mobile Services, WT Docket No, 07-71, released Feb. 4, 2008, at Pgs. 8, 68-69; Eleventh Report, Annual Report and Analysis of Competitive Market Conditions with Respect to Commercial Mobile Services, WT Docket No, 06-17, released Sept. 29, 2006, at Pg. 54.

[3]  See: