Yesterday we talked about Telehealth and Non-Medical Home Care as a critical need in provision of home care to our clients with chronic medical conditions. In many ways, the concept is simple. Some of the technology is already in place and companies like Care Innovations and others are working hard to bring new technology to the medical marketplace.
The Center for Technology and Aging published Technologies for Remote Patient Monitoring for Older Adults. It is discussed in the study we introduced yesterday, but the original publication is worth reading on its own merits.
The Center for Technology and Aging publication includes a graphic on the information / work flow involved:
Collection and transmission of data – and perhaps application of algorithms –
is the task of technology. Assisting the patient (our home care client) in use
of the technology can be performed by a caregiver, either family or professional, with training, if necessary, from medical or technology professionals. The absence of medical professionals in the patient’s / client’s home should not be allowed to become an obstacle.
Evaluation of the data, after transmission, is clearly a clinical task. Those of us in non-medical home care have and should have no role in that part of the cycle.
Once the clinicians have evaluated the data and made decisions as to any actions needed, notification of those decisions and actions to be taken are transmitted to those who need to act. That may include the patient, other clinicians, family or professional caregivers or other parties.
It is at this point that, in many cases, obstacles occur. Some of those obstacles are still being worked on by the technologists and take us beyond remote monitoring to remote procedures. Other hurdles are the result of real or artificial boundaries between the medical professionals and caregivers.
Ironically, those boundary difficulties are sometimes worse between the clinicians and professional caregivers, such as Certified Nurse Assistants (CNAs) or Certified Home Health Aides, than they are between medical professionals and family caregivers. CNAs are not permitted to perform a number of actions that any family member can, even though the CNAs have a higher level of training.
The basic issue is that the restrictions on such professional caregivers stem from conditions in place prior to the evolution of telehealth / telemedicine. CNAs are not and should not be seen as medical professionals or clinicians. However, the roles and responsibilities have defnitely begun to blur a bit, without the necessary dialogue taking place to make proper adjustments.
We will talk more about this issue in future articles. In the meantime, keep the technology coming!
Best wishes, Bert