4 Steps for Matching Home Health Patients with a Telehealth Solution

Home health providers already are improving outcomes and reducing costs by using patient monitoring technology, but administering a “technology readiness assessment” might help them maximize results, researchers said this week.

A potential framework for these assessments stems from an investigation into how a Michigan-based home health provider utilizes a monitor called Cardiocom, Paul Freddolino, Ph.D., said at the American Society on Aging annual conference in Chicago.

McLaren Health Care Corporation’s home care division successfully deploys Cardiocom to patients, according to a small and ongoing study conducted by Freddolino and research assistant Marianne Caddy, both of Michigan State University’s School of Social Work.

They have so far interviewed 13 patients who have used the Cardiocom device. It involves a blood pressure cuff and a simple interface to capture vital signs and send them to a third party, which monitors results and alerts McLaren to deviations from normal levels.

All the participants reported that using Cardiocom was a positive experience. They cited benefits such as an increased sense of security, cost savings from not having to make trips to the doctor, and increased self-sufficiency and involvement in self-care. For instance, some wrote down the readings that the device provided to more actively track their health status, and some said they would have liked the device to offer suggestions on steps they might take to improve their condition.

In reflecting on why Cardiocom is an effective telehealth tool, Freddolino and Caddy noted that it fits the profiles of the McLaren patients, in terms of their comfort and habits around technology usage. Health care providers likely could benefit from a way to assess patients’  technology readiness to create good matches between patients and in-home tools, especially as more options become available, the researchers surmised.

“We rarely have any questions about the technology they have at home and what their technology skills are,” Freddolino said, referring to screening as patients transition into home care.

An assessment might follow this four-step framework:

  • Ask patients what technology they already have in the home and what they use and like. A number of the McLaren patients owned computers but never used them, Freddolino noted. Certain people might use both a computer and tablet, but prefer the tablet.
  • Ask how comfortable they are with new technology. Only seven of the McLaren patients reported being “very or somewhat comfortable” with new technology, the researchers noted. Cardiocom was simple enough to learn how to use that it overcame this potential barrier.
  • Determine what training and ongoing support are needed to sustain use of the health tool. There was little need for additional training once the patients learned how to use Cardiocom, which made the tool sustainable both from McLaren’s and the patients’ perspectives. This might essentially be a cost-benefit calculation for more complex tools that would require more ongoing support but could offer more sophisticated information.
  • Based on all the gathered information, determine what tool will be a good fit. A higher-end tool might offer benefits, but only to those patients who are “totally ready, totally at ease, skilled and knowledgable in technology,” Freddolino said.

While such an assessment has yet to be tested in a controlled trial, Freddolino and other industry members at the ASA conference foresee that it could be beneficial when deployed at the health system level. A discharge planner could administer the questions and use the information in guiding the patient’s transition from a higher acuity setting to the home, bringing providers with appropriate telehealth tools into play.

There are those who believe an assessment could have value, but perhaps not for a decade or longer, as a more tech-savvy generational cohort ages. Pew research indicates that tablet and smartphone usage has not topped 40% for seniors, noted David Inns, CEO of GreatCall, a company that provides senior-friendly smartphones, activity monitors and similar “active aging” solutions.”

The statistics suggest that technology simply must be simple to gain meaningful traction with today’s seniors.

“Otherwise, you’re relying on human behavior change to get the solution to work properly, and that’s where these solutions break down,” Inns told HHCN.

And good technology products all should be simple to use, Inns believes.

“Any technology that isn’t simple is probably a bad idea for anyone, let alone this market,” he said.

Written by Tim Mullaney