Companies experimenting with low-tech telemedicine
April 1, 1997 4 minutes read
Companies experimenting with low-tech telemedicine
Initial results show fewer hospitalizations
Private duty providers may equate telemedicine services with high start-up fees, but that’s not necessarily the situation, says a researcher who has written a comprehensive, 230-page report on the industry.
The report, Home Healthcare: Wired and Ready for Telemedicine, focuses on systems that are minimally invasive into the home, explains Audrey Kinsella, author of the report and research director for Information for Tomorrow, a firm based in Portland, OR.
The report is a planning guide to help clinicians and home care or managed care agency administrators identify resources such as telemonitoring equipment, software, Internet sites, and other tele-tools that can be used to provide more cost-effective care in the home, particularly to chronic care populations, she says.
While some systems use high-tech components, the systems in Kinsella’s report are geared more toward equipment that's already in the home, such as the telephone and television.
Kinsella says she was surprised at how low-tech some of the equipment was. The designers are aiming toward minimal training for both the providers and the patients. They want a simplistic design basic yes/no, on/off switches.
"In addition to having this easy design, manufacturers are making sure the training is minimal," adds Kinsella. "They are trying to make it seem like you already know how to do these things. For example, you can already use the stethoscope or a blood pressure cuff. This is just an electronic way of doing it. Its another way of sending information out of the home."
No technophobes here
Another finding of Kinsella’s research is how accepting both patients and providers were toward the technology. "You always have this idea of these newfangled machines it’s not like my nurse,’" she says.
Instead of the equipment or the technology replacing the nurse, the technology has been an adjunct to that care. Patients can get care more frequently, which I think is a boon for home health care. "These people, as a rule, are chronic diseased patients, and the more care they can get, even if it is just a telephone call, the more they seem to thrive, especially the elderly," Kinsella says.
The patients also did not seem to mind if the video quality on their systems was poor or nonexistent.
"You can have video over [a standard] phone line; its just not good quality", Kinsella explains. Both providers and patients, though, have said the images are as good as they need.
A physician who helped develop one of these systems said that patients just want to see that the nurse is there. They want to see movement.
Kinsella interviewed about 150 people for the report, including representatives from home care agencies, managed care organizations, and insurance companies.
According to her research, the focus of most telemedicine projects is the disease management of chronically ill populations. Eight percent of these providers dollars are going to treat those people, she says.
The initial results of the projects show fewer hospitalizations and doctor visits, Kinsella notes. "You don’t see an immediate savings, but overall particularly when providers look at expensive long-term patients such as diabetes and congestive heart failure providers are noticing and tracking how much they are saving on an annual basis."
Kinsella says the cost of making a telemedicine visit ranges from $8 to $20 a visit, considerably less than what a regular nursing visit might cost. Substituting a nursing visit with a telemedicine visit when possible, therefore, could result in significant savings.
Pinning down the cost of a system was a little more difficult. High-tech machines can cost $25,000 or more. Kinsella says she was quoted amounts such as $3,000 and $8,000 for the lower-tech machines. Prices do vary according to what features are added to each machine.
If your private duty agency has a number of chronically ill clients, telemedicine may be a care option. Be sure, though, to first consider the needs of your agency, cautions Kinsella.
"How many people do you want to train? Not every nurse in your agency is going to want to do this, and not every patient is going to want to have it," she says. "What part of your patient population and your nursing staff do you want to reserve for telemedicine care?"
Agencies also should be prepared to set up their operations to be a 24-hour receiving end. Information is going to be coming in all the time, says Kinsella. There always has to be someone looking at it.
Continual patient information will help the private duty agency better plan patient care. That’s the key getting more information out of the home.
Telemedicine also is a good way to bring information into the home, Kinsella says. It can be a useful training tool. For example, if a diabetic patient has a question about giving an injection, two-way video might allow a nurse to demonstrate the correct procedure.
Telemedicine, in some fashion, is being incorporated into much of today’s medical equipment, she adds. "I’ve talked to at least 100 manufacturers. There’s no one who’s not incorporating telemedicine capability into their equipment. This equipment includes infusion systems."
"People say telemedicine is the wave of the future. You can’t survive in the next couple of years without having that capability."
[Editor’s note: For more information about the report Home Healthcare: Wired and Ready for Telemedicine, call Audrey Kinsella at (800) 506-6587.]
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