Enhancing Home Healthcare Through Telemedicine

The way that most healthcare services are provided to people is part of the cost problem that every day consumers face. Hospital Care represents 31.1% of all health care prices and is extremly pricey. The average cost for 1 day in the hospital in 2002 was $1,290, almost double the average cost from 1990, and since 2002, hospital prices have grown by more than 50%. All of those services are provided onsite, in facilities and environments which are expensive to maintain and where costs are increasing quickly and represent more than 68% of the total health care cost in the US in 2007. The Centers for Medicare and Medicaid Services reported that in 2009 US healthcare spending rose 5.6% to $2.47 trillion and represented 17.3% of the US economy. The increase from 2008 to 2009 is the biggest jump in health care spending since 1960, and it’s extraordinary that in per year in which the US economy contracted by 2.4% healthcare and the federal government were the only sectors to demonstrate an increase. This growth can also be happening from a high base, starting at a level 30% to 50% higher than most industrialized nations, and is unsustainable.

However, cost is only a part of the problem in the centralized model of healthcare. Disorder is known to be caused by those in hospitals, doctor offices, clinics, and nursing homes. In accordance with a February 2003 article in The New England Journal of Medicine between 5% and 10% of all patients admitted to an acute care hospital obtained one or even more infections. The CDC estimates that there are 1.7 million hospital acquired infections each year resulting in about 99,000 deaths, various sources have estimated that these terminal instances alone result in over $6 billion in healthcare costs each year. These economical costs pale in comparison to the pain, anguish and loss of life resulting from these diseases.

This healthcare model also provides a setting that is impersonal and dehumanizing. By design the institutional feel of hospitals, clinics, doctors offices and nursing homes can boost the physical suffering of patients through raised rates of stress, disorientation, helplessness and maybe even depression. Also the very nature of such institutions entails interruptions at peculiar hours by staff and other patients and a constantly changing cast of care providers that further add to the discomfort of the patient.

Treating patients in the home is much less costly and supplies a familiar setting for the individual. The patient is much more comfortable in their home and is not introduced to other infections and diseases that other patients bring into the setting. The difficulty is that up until now much of the technology for cost and accessibility reasons needed the focused model to work.

Telemedicine includes the utilization of telecommunications either through phone networks, both landlines and mobile, or the internet to diagnose, treat and track patients across substantial distances. Early use has focused on telecardiology and teleradiology where EKG and X Ray advice is transmitted over communication lines and tracked and analyzed at locations remote from your patient. Recently, new procedures now enable surgeons to perform certain procedures remotely and many hospitals have implemented remote nursing stations that can monitor patients from many facilities from one centralized place.

Telemedicine is also used in the home healthcare setting to give crisis alerts through private emergency response systems as well as the monitoring of patients vital signs for example heart rate, blood pressure, cholesterol and glucose level. The newest improvements in home health care telemedicine have been in the area of medication management, which given the costs of poor medication compliance represents an enormous opportunity to not only save costs but to additionally substantially improve medical outcomes and save lives.

More than 50 million people in the US are on three or even more prescriptions. While many of these medications are critical to improving the well-being of the patient the typical compliance rate by using their medication program is only 50%. Poor medication adherence based on the Center for Disease Control signifies an important healthcare issue resulting in increased costs and inferior medical outcomes. The current poor rate of drug adherence results in 10% of all hospital entrances (30% of all hospital admissions for aged), 22-40% of all Skilled Nursing Facility admissions, 125,000 deaths per year and from $150 billion to $300 billion in yearly cost/waste.

And this issue is only going to get worse as longer life spans and relatively low birth rates boost the country’s typical age over the coming years. The older we get, the more drugs we require and because the number of prescriptions increases so also does the number of non-compliance. Consequently, the price to the health care system due to poor adherence is climbing significantly.

There really are numerous methods to enhance conformity which have been tested by the health care community. Adherence rates may be significantly enhanced through better instruction, the tracking of patients in the home, and enhanced medication management. Drug management devices help by arranging dosages, providing reminders to take pills and sending alerts to care givers when dosages aren’t taken. Telemedicine based drug management apparatus significantly enhance compliance rates by utilizing all three of those strategies.


photo credit: @alviseni cc



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