As a home care & elder care company, we at Support For Home have a passion for helping folks live where they want to be — at home. The evidence that people are happier and healthier living in their own homes for as long as they possibly can is very strong. An article in The New York Times on Sunday makes the case quite eloquently.
The author, Dr. Jack Resnick, talks about the “Independence at Home Organizations” element of the recent health care reform act (2010). Regardless of how folks feel about the bulk of the new law, this effort to create a new approach to delivering health care could be a major improvement:
Independence at Home Organizations — groups of doctors and nurses who treat patients in their homes — and incentives to make that work appealing. The organizations can invest in extra services and home visits (for which Medicare typically will not reimburse them) because they will share in a cut of the savings that result from avoiding hospital visits and expensive procedures.
This element of the law is supposed to go into effect on January 1, 2012. However, Dr. Resnick is rightfully concerned that delay will happen, as the Medicare people are way behind in getting rules in place.
As Dr. Resnick points out, there is really no technical reason why bringing health care home can not proceed rapidly:
We have the technology. Electronic medical records can give a doctor with an iPad as much information as any institution. With hand-held machines and a few drops of blood, doctors can get test results in seconds at a patient’s bedside. Portable X-ray and ultrasound equipment can be wheeled into homes. Monitors can alert doctors to any change in a patient’s heart rate.
As a provider of home care — in our case, focused on Activities of Daily Living (ADLs) rather than medical treatment — we are very much aware of the great technologies already in place to make telehealth and health care at home both efficient and effective. Just check out what companies like Care Innovations and Phillips and others are doing in this space.
What may be harder to deal with is inertia, and Dr. Resnick points out some of those issue, as well:
The fact that this care is possible at home means that the role of hospitals must change. Acutely ill patients who need operating rooms or intensive care will still be brought to hospitals. But they should be quickly discharged to the care of the doctors and nurses who know them best.
I do not think any resistance on the part of institutions is driven by self-interest. I believe it is based on a sense of, “but that’s the way we have always done it.” Which is one of the reasons we need to break the mold.
Best wishes. Bert