Picking up Telehealth, Again


In our posting of March 24th, I cited a study published by the Center for Technology and Aging.  That study includes some statistics that bear considerable focus:

  • 80% of older Americans are dealing with one or more chronic illnesses, such as diabetes, asthma, heart disease, COPD, …
  • 60% of deaths worldwide are attributable to chronic disease
  • 75% of direct health care expenditures in the U.S. are due to chronic disease
  • People with chronic disease cost 3.5 times as much to serve compared to others, and account for 80% of all hospital bed days and 96% of home care visits.”

If the cost associated with chronic disease is going to be reduced, it has to be from providing better and much less expensive care (medical and non-medical) for the patient (our home care client) at home.

The opportunity to accomplish that is real, in a number of ways.  Another study, by Coye, Haskelkorn, and DeMello, “Remote Patient Management: Technology-Enabled Innovation And Evolving Business Models For Chronic Disease Care,” was published in Health Affairs in 2009, is cited as pointing to six roles that telehealth / remote patient monitoring can play to help reduce cost – and increase quality – of care:

Functional Role Benefits
Early Warning System Prompts early intervention when health status deteriorates.
Care Integrator Integrates a complex web of caregivers who might not otherwise communicate and collaborate for the health of an older adult.
Progress Tracker Promotes evidence-based health care and self-care. Reduces duplication of health services.
Confidence Builder Reinforces self-efficacy and confidence that selected health behaviors will lead to selected health goals.
Capacity Builder Increases the capacity of individuals (patients and lower-skilled informal and formal caregivers) to provide more highly skilled care. Enables less centralized and more distributed care.
Productivity Amplifier Increases the ability to do more with less and to avoid duplication of services.

The major focus for us – for non-medical home care providers – is the “Capacity Builder” role.  The power of telehealth technology is that it can empower “lower-skilled informal and formal caregivers” to provide a new level of services by providing clear direction, oversight and monitoring.

Does that mean Certified Nurse Assistants (CNAs) are transformed into RNs?  It absolutely does not.  What it does mean that fewer trips to clinics or hospitals should be necessary and fewer RN visits – extremely expensive and often simply not practicable – are needed in the home.

So, I repeat the message from the last posting, with a bit of a twist:  The time for a dialogue on medical versus non-medical home care roles is well past due, and a huge part of that dialogue needs to be the incorporation of telehealth technology.  Any takers?

One quick note on how sad the current situation is – when I run spell check in my WordPress blog, it does not recognize telehealth, COPD or CNA.  Frustrating.

Best wishes, Bert

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