Remote Patient Monitoring or Telehomecare
Since CTeL’s founding in 1995, a lot has changed in healthcare delivery.  It has gradually shifted from acute hospital care to outpatient care to home care.  Home care, typically involves periodic visits by a nurse or other caregivers, and may require patients to maintain detailed records about their diet, and health.

The use of home care technology now makes it possible for advanced data collection systems working in conjunction with remote video and non-video communication devices to simplify home care practices for both patients and home care personnel. 

Telehomecare or remote patient monitoring can occur by two-way radio, plain ‘ole telephone system (called POTS in telehealth lingo), two-way interactive video, cable, WiFi or satellite downlink. 

Remote patient monitoring is an all inclusive term that encompasses a number of high-tech applications that involve providing remote care for people.  The applications can range from monitoring a person’s heart rate while working out on a treadmill in a fitness club to transmitting a patient’s telemetry readings to a nurse over the Internet.  There is a wide variation in terms of clinical conditions that can be monitored, how often they should be monitored, and whether they should be monitored real-time or periodically.

Remote patient monitoring systems can be used to collect and transmit the physiological data of patients with chronic diseases, such as diabetes, asthma, hypertension, and congestive heart failure (CHF) – some of the costliest and most prevalent chronic diseases in the US, and is being used very effectively for the individuals enrolled in disease management programs.
 
A high-resolution camera can be used to digitally bring a healthcare provider into the patient’s home, which is particularly beneficial in wound-care management and chronic disease monitoring requiring face-to-face interaction with a healthcare provider.  The technology also allows the healthcare provider to communicate with their patients and make changes to their behavior or diet on a real-time basis and then monitor their physical reactions to those changes.

The current trend toward healthcare consumerism, initiatives to reduce medical errors and improve healthcare quality, aging population, and an expanding technology infrastructure that is producing quick and dramatic improvements in mobile communications is a primary driver in the use of remote patient monitoring.  The potential for remote patient monitoring is astounding for use in:
  • First Responders who require emergency point-of-care solutions integrated with a variety of wireless medical devices and health care sensors to enable rapid collection and transmission of patient data in-the-field to the emergency physician at the receiving hospital.
  • Specialty consultations in which referring physicians or sonographers can transfer echocardiograph clips, videos, and images to a consulting cardiologist who in turn can provide timely consultations with diagnostic-quality echocardiograms without unnecessary and costly transports or providing ultrasound video and image capture, store, and distribution system in both real-time and store-and-forward modes, regardless of distance or physical location.
  • Tele-Rehabilitation devices that allow a health care provider to remotely monitor a patient’s progress with image and video analysis tools in order to conduct critical health assessments, e.g., stride measurement, range of motion, and wound closure.

Since implementation of Medicare’s Prospective Payment System or PPS for home care in 1999, home health agencies have been incentivized to find the cost-effective ways to provide care to their patients. PPS is a payment system that, in essence, provides a flat fee to home care agencies for providing care to eligible Medicare beneficiaries. Telehomecare is an effective way to deliver home care for many patients while enhancing both the quality of the patient’s care and of their life.

Benefits of Telehomecare:

  • Reducing the number of visits by patients to emergency rooms or physician offices,
  • Avoiding unnecessary and costly visits by health providers,
  • Providing patient education for symptom management, which often can’t be provided in the hospital given reduced length of stays, and,
  • Monitoring vital signs provides the opportunity for early intervention, thus, reducing hospitalizations.

Barriers to Telehomecare:

  • Lack of reimbursement,
  • HIPAA, privacy issues,
  • Resistance to technology,
  • Bandwidth limitation,
  • Access to capital for technology investment, and,
  • Lack of standards.

Center for Telehealth & E-Health Law
1500 K Street, NW, 11th Floor, Washington, DC  20005-3317
202.230.5090 Main | 202.230.5300 Fax | www.CTeL.org | info@ctel.org
 
Copyright © 2005, 2006.  Center for Telehealth & E-Health Law. 
 Information presented on this site is for information purposes only and should not be relied upon as legal advice. 
For information about your specific circumstances, please consult legal counsel.  Disclaimer.
 
WEBSITE MAP