High-Tech Home Care

What's next in technology-enabled home care services? Are you convinced the future will bring changes to service and standards of care? How many home care providers will seize these new business opportunities to create a more valuable niche in the nation's health care delivery system?

Before you answer, take a look at the following scenario involving home care for a congestive heart failure patient. It demonstrates how providers can participate in new value-producing services and the new standard of care.

A Look into the Future

The patient requires periodic home health support, continuous infusion and oxygen therapies, multiple oral medications and equipment to assist with ambulation. Services are also provided by pharmacies, physicians, hospitals, laboratories, etc. Data on our CHF patient is submitted continuously to the patient's electronic medical record from:

• Portable devices carried by clinicians during home visits.

• Devices and information systems capturing data at the pharmacy, lab, physician's office and acute care facility.

• Billing and claim information databases.

Continuous monitoring data also flows into the home care provider's office from the following electronic devices and patient interactions:

• Biometric devices and monitors (multiple measurements and pictures).

• Oxygen and medication delivery devices (pumps).

• Patient communication devices — data, voice and visual.

An expert system generates an alarm whenever in-office continuous patient monitoring indicates that oxygen saturation falls below preset levels. For our patient, the frequency of the alarms is increasing, causing the HME provider to generate a graph of oxygen flow rates and saturations over time. In addition to the frequency, the alarms are occurring more often at certain times of the day.

The HME provider does three things right away: (1) reviews the patient communication record to see if questions or problems have been submitted that may indicate compliance or equipment problems; (2) reviews other vital sign records for changes in medical condition or changes in care, such as changes in medications or dosages; and (3) sends a question to the patient asking if he is aware of any changes.