Telehealth and Chronic Disease


We continue to be fans of telehealth at Support For Home Health Care, even though we believe the there is more potential than proof at this stage of its development.  Once in a while we find a very encouraging report of its success, as in the current issue of The Remington Report, in an article entitled, “Telehealth Case Study: Managing Complex Patients Across The Care Continuum.”

The Medically Complex Patient

Possibly the most import section of the entire article comes in one long paragraph that characterizes the medically complex senior – a topic we have touched on before [comments in brackets are added]:

Patients with chronic disease face tremendous challenges in the current fragmented health care system.

[The word fragmented should be in capital, bold letters.  All of the providers in the health care system, clinical and non-clinical, need to take responsibility to work together.]

Their disease trajectory is often unpredictable with episodes of exacerbations followed by periods of relative stability.

[That apparent stability is one of the reasons care is so disjointed.  Health care “loses track” of the recurring patient.]

Their condition can often change dramatically and very quickly.  They see multiple providers who do not necessarily communicate with each other.

[We are back to that fragmented health care system, again, with clinical not talking to non-clinical, or even hospitals not talking to PCPs.]

They are on multiple medications that they may or may not take or they may take incorrectly.

[This has been a topic in a number of articles.  Medication non-compliance / mismanagement is one of the leading causes of hospitalization – or worse.]

Their functional status is often compromised, their caregivers are taxed and their quality of life may be poor.

[Family caregivers wait too long to get help – clinical or non-clinical home care included – and they get no financial help from medical insurance or Medicare for non-clinical home care, which makes them delay help even longer.]

These are the patients that are the greatest challenge to the health care system, use the most resources and result in the greatest cost.  Often lacking any self-management skills or even the awareness that they have any control over their own health, patients with multiple chronic conditions are also the most difficult to manage.  This is not the result of the patient’s failing but of the system’s failing.

This is truly one of the best, concise descriptions of the medically complex senior that I have seen.  It lays out the challenges – and implicitly points to some of the needed solutions, as my comments try to reflect – to caring for that patient.

In the next article, I will talk more about the pure telehealth components of the article.

Best wishes.  Bert

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2 responses to “Telehealth and Chronic Disease

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