From The Editor | October 28, 2010

A Surge In Home Healthcare?

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By Ken Congdon, editor in chief, Health IT Outcomes

Health IT Outcomes has published several articles over the past year that cover the effect clinician shortages will have on the healthcare industry in the reform era. A few of these articles are listed below:

HIT Staff Shortages: A Potential Barrier To Meaningful Use
Prepare For The New Patient Influx
Is Telehealth The Answer To The Pending Patient Surge?

While these articles focus on the need for clinicians in traditional healthcare settings (i.e. hospitals, private practices, clinics, etc.), an increasing demand for a clinical workforce dedicated to delivering home-based care is also beginning to emerge. Several factors are driving the demand for home healthcare including an aging population, widespread chronic disease, rising healthcare costs, and, of course, advancements in technology. Key technologies promoting the advancement of home healthcare are mobile computing devices (e.g. handhelds, tablets, notebooks, etc.), remote patient monitoring devices (e.g. wireless body sensors, body area networks, etc.), and telehealth/telepresence solutions (e.g. videoconferencing devices, vital sign/blood level measuring devices, etc.).

Not only have mobile computing devices themselves become more advanced — many including bar code and RFID capabilities for remote patient tracking and medication administration ? but higher bandwidth options are providing these devices with the power to access hospital data networks at remote locations. For example, today's 3G and 4G cellular networks can provide a physician making a house call or a traveling nurse with broadband access to the same EMR system in use at the local hospital or doctor's office. Some mobile computers today are even equipped to support mobile ultrasound or X-ray devices, allowing home healthcare clinicians to perform routine medical imaging procedures at a patient's home rather than requiring the individual to go to the hospital.

Remote monitoring devices and telehealth solutions are providing a convenient and effective way to manage and treat chronic illnesses remotely. For example, patients with diabetes, COPD, or congestive heart failure can regularly submit their glucose levels and other vital signs to area doctors via measurement devices that are kept at their homes and remotely linked to physician data networks. Doctor's can then regularly remotely monitor the conditions of these patients remotely and intervene or prescribe additional treatment when and if a patient's vital signs become abnormal. Further detail on patient conditions can also be provided via videoconferencing solutions that provide physicians with visual evidence of disease complications, such as diabetic limb infection. Once potential issues are identified, a home health provider can often deliver the follow-up treatment for many of these patients instead of a traditional physician.

The growth of home health delivery has the potential to cut healthcare costs by eliminating repeat hospital and office visits. This movement would also help free up traditional physicians to focus their efforts on the sickest patients with the most immediate needs. Home health care will not mature to this point over night. Instead, the industry will likely slowly transition much of this care from a centralized model over time. Moreover, the payer model will also need to change to provide adequate coverage and compensation for home health devices and treatment. However, the pieces are beginning to fall into place for home healthcare to play a much larger role in the future landscape of the healthcare industry.

Ken Congdon is Editor In Chief of Health IT Outcomes. He can be reached at