Could home telehealth make nursing homes obsolete for baby boomers?

Rochester 24 January 2007Telephone, internet and videoconferencing technologies that Baby Boomers used throughout their careers are now being applied to the health care industry in a way that could potentially revolutionize the future of their own long term care services, saving them both time and money while preserving their independence. Home telehealth technologies hold the promise of increased contact with physicians with fewer trips to the doctor's office and prolonged independent living for the aging population. Lifetime Care, a home health agency in Rochester, New York, partners with Honeywell to utilize the company's HomMed technologies. The HomMed Health Monitoring System guides patients living independently in their homes through the process of taking their vital signs such as weight, blood pressure, heart rate, oxygen saturation, and temperature as scheduled. The system then asks the patient a series of pre-determined questions to assess his or her health for the day.

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The vital sign data and the answers to the questions are transmitted to a central monitoring station at Lifetime Care where a nurse determines the patient's status and takes appropriate action. Deviations from the acceptable vital signs and answers to the questions are highlighted and prioritized on the computer screen so that the nurse can address any issues immediately, and determine if a visiting nurse needs to be dispatched to the patient's home.

Lifetime Care has used the HomMed Monitoring System since 2000 to supplement in-person care rather than replace it. The staff at Lifetime Care also use the technology as an educational tool, teaching patients what behaviours effect their health, and ultimately, teaching them to change their behaviours in a way that could enhance their well being. Using the home telehealth technology at Lifetime Care has resulted in increased patient independence, fewer emergency room visits, fewer hospitalizations, and a general increased satisfaction among patients.

Patients' families also benefit from the technology as they can be notified of the status of a loved one when he or she sends a telehealth transmission. "This technology eases the minds of family caregivers and provides essential monitoring for those with chronic conditions such as diabetes, chronic heart or lung disease, who may otherwise need to be hospitalized", stated Patricia Bomba, M.D., F.A.C.P., geriatrician and medical director for MedAmerica Insurance Company. "There is great potential for enhancing patient independence and allowing aging patients to remain at home longer with home telehealth systems in place."

Many patients at Lifetime Care have experienced this enhanced independence first hand. One case study features an 80-year-old woman who lives alone with COPD, hypertension and Congestive Heart Failure who loves the monitor. She is very independent and uses the monitor daily to check her heart rate, often initiating contact with her physician on her own in addition to Lifetime Care's intervention. Prior to having the monitor placed, the patient was in and out of the hospital monthly. Now, with the exception of two recent hospitalizations, she has been out of the hospital for over a year.

While the benefits of home telehealth are obvious, the cost of the equipment needed to implement home telehealth is always a factor. In the future, more and more cutting-edge technologies will reach the market that are not covered by traditional long term care insurance policies on the market today that require patients to pay for services up front, and then submit receipts to the insurer for approval and, hopefully, reimbursement. That's why MedAmerica developed a new type of long term care insurance policy that guarantees a cash benefit for the insured to use however he decides throughout his benefit eligibility. MedAmerica's CareDirections Simplicity product is unique in that an insured could use benefits to purchase whatever is needed with no restrictions.

Lifetime Care and MedAmerica are part of the Lifetime Healthcare Companies. MedAmerica Insurance Company and MedAmerica Insurance Company of New York are the long term care subsidiaries of The Lifetime Healthcare Companies, a $5 billion not-for-profit health insurer that finances and delivers health care to more than 2 million people in New York State. With long term care insurance its singular focus, MedAmerica brings a depth of expertise to provide solutions for long term care financing by creating simple to understand and easy to use products, maintaining fiscal responsibility, shaping public policy and delivering on its promises.

Patricia Bomba, M.D., practised internal medicine, primarily geriatrics, for many years before becoming the medical director for MedAmerica. She is a member of the Review Committee of the National Quality Forum's "Framework and Preferred Practices for a Palliative and Hospice Care Quality" project, the New York State representative for the National POLST Paradigm Task Force, and the Physician's Advisory Panel of the Case Management Society of America. Dr. Bomba served as a New York State delegate to the 2005 White House Conference on Aging and is a member of the MSSNY Ethics Committee. She serves on the board of directors of the National Committee for the Prevention of Elder Abuse and is currently on the Executive Committee for the New York State Coalition on Elder Abuse. Highly regarded in her speciality, Dr. Bomba is considered to be a medical expert on the hidden epidemic of Elder Abuse and palliative care.


Leslie Versweyveld

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