Home Care in the 21st Century
by Holly E. Russo
This article first appeared in the November, 2000 CARING magazine
Health care is moving closer to the patient-where home care has been all along. Technology advancements will offer home organizations even more ways to have an impact on an individual's ability to take a more active role in his/her health. Whether technology is used to automate processes; access, analyze, and distribute data; or allow more frequent interaction and monitoring of clients, its use will enhance the opportunity for improving care with limited resources.
Process management holds the key to improving efficiency and decreasing variation in the system. Health care organizations of the future must analyze which functions can be automated to facilitate more efficient use of resources-people, time, money, and so on.
Health care organizations have collected data for decades. However, access to this data has been less than ideal. With the advent of decision support tools, clinicians and/or managers will have just-in-time access to all types of data that will enhance their decisionmaking abilities.
Ubiquitous computing is closer than we think. Smart technology built into everyday living is advancing rapidly. Enhancements such as voice recognition and similar technology afford clinicians the ability to tailor technology to suit their individual needs where and when they need it.
Interactive video systems and biosensors are encouraging alternative approaches to health care delivery. Technology in this area has focused on the chronic disease populations who have recurring needs and incur high costs to the health care system. However, in the future we will see increasing use of these devices in the fight to prevent disease.
All of the activity in the clinical technology world has enormous value in creating a customer centered health care system. However, most home care organizations are still wrestling with the cost of purchasing or leasing technology packages and how to evaluate the value of doing so. Over the past several years an untold number of people and organizations have dedicated an infinite number of hours in helping the health care community, including home care, understand the many roles technology can play as well as the impact on our ability to deliver services.
In general, organizations have set out after federal or foundation funding that required some sort of organized plan, design, implementation, and evaluation of programs to answer certain needs and problems. Whether successful or not the lessons these organizations learned and their implications for the rest of the home care community are invaluable. The struggles they encountered have led to interest by others in how we can overcome many of the barriers faced in implementing the use of technology-licensure, user friendliness, reimbursement, security, and confidentiality.
Individuals and organizations have created Listservs, chat rooms, publications of lessons learned, summary reports, journal and magazine articles, and both formal and informal presentations to share information and develop guidelines on the use of technology among health care organizations. For example, Joanne Kumekawa, who works for HHS and collaborated with me to produce the July issue of CARING, focuses on the legal questions, security concerns, and confidentiality issues associated with the burgeoning business of health information on the web.
Home care providers have witnessed a huge effort to increase access to and make valuable flexibility in service delivery to allow more consumer choice. Federal and state agencies, foundations, associations, legislators, and other interested parties have created a virtual network to brainstorm about ways to decrease barriers and increase access. Also worth mentioning is the help that many of the technology manufacturers/vendors have given. Although many see this as their way to get their foot in the door-they are taking enormous risks in doing so with their time and money and no guarantee of return on investment.
I hope that you will join me in saying thank you to all of these parties for their past and future efforts on our behalf. I would especially like to urge you to learn about the issues at hand and what you can do to make a difference. Get in on a conference call on an area of interest, attend an educational session, or speak to your Congressman. Don't sit on the sidelines. We can accomplish many things if we just take a little bit of our energy and focus it on new opportunities.
About the Author: Holly E. Russo, RN, MS is a former telecommunications policy analyst focused on health care at the United States Department of Commerce. She can be reached at 561/622-5099 or via e-mail at hollyeve@prodigy.net.
http://www.ctl.org
http://www.atmeda.org
http://www.astp.org
http://www.ntia.doc.gov
http://www.hctr.be.cua.edu/HCTWorkshop/HCTW_report.htm
http://tie.telemd.org
http://www.telemed.okstate.edu/Webpages/Planning/homepage.html
http://www.rwjf.org
http://www.benton.org
http://www.health-infosys-dir.com/htmcat.html
http://www.witcapital.com/research/researchbody.jsp?Report=ehlt_2000013
grantsinfo@nih.gov
http://www.ahcpr.gov
http://www.rhc.universalservice.org
http://www.usda.nal.usda.gov
http://www.hcfa.gov/medicaid/telemed.htm
http://www.telemedtoday.com
http://www.cpri.org
Telehealth Improvement and Modernization Act of 2000 (S 2505), (HR 4771)
Medicare Access to Telehealth Services Act of 2000 (HR 4841)
Equal Access to Medicare Home Health Care Act of 2000 (S 2766), (HR 4727)
Promoting Health in Rural Areas Act of 1999
Western Governor's Association Telemedicine Action Report
Telemedicine Report to Congress