With the ever increasing demand for caregivers and the limited amount of trained and certified associates both professional caregiver organizations and individuals can turn to tele-medicine solutions as a way to improve at-home care.  At-home care technologies (or tele-medicine solutions [blog]) are fast becoming recognized as an effective way to provide quality care while lowering costs.

We've seen that we can reduce admissions and it's a sound business decision to invest in services that help lower cost and improve care." Says Ethan Johnson, eCaregiver Director of Customer Care. The cost-effectiveness of telemedicine technologies [products] is just beginning to reshape the healthcare industry. Medicaid traditionally does not pay for less expensive alternatives to nursing homes, including in-home and community based care. That is starting to change with Medicaid waiver programs that help elders remain in their homes with assistance from visiting nurses and homemaker aides. For example, through South Florida's "Channeling" program, one of the state's first waiver programs in 1986, home health care costs about $26 per day, while institutional care would cost at least 5 times that much.

At the same time, home health care visits to monitor weight, pulse, blood pressure, and oxygenation are also expensive. For patients with congestive heart failure, clinicians must be aware of even slight weight gains, which don't often occur in sync with regular office visits. Regular trips to the doctor can be difficult and expensive for patients with mobility and transportation difficulties. Some visits cost as much as $500, including accessible van transportation services. For these reasons, insurance and managed care companies place limits on office and home healthcare visits. (Baker, 2001)

State and Federal Initiatives

Some 20 states have begun conducting projects to explore the effectiveness of telemedicine. The Veterans Administration is testing the concept through programs in Connecticut, Florida, Georgia, Maryland, and Texas (Baker, 2001).

The federal government is also taking an active part in studying the effectiveness of home healthcare technologies and services. Rehabilitation Engineering Research Centers (RERC's) on telemedicine at Catholic University in Washington, D.C., and The Shepherd Center in Atlanta, GA, are funded by the National Institute on Disability and Rehabilitation Research (NIDRR).

Many federal agencies, including the Department of Defense, Food and Drug Administration, National Library of Medicine, and the Public Health Service are taking an active role in development and regulation of telemedicine and other home health care technologies.

Today and Tomorrow

Home health care technologies such as blood pressure monitors, glucometers, and fetal monitors have given patients more information and more responsibility for their own care. The advent of telemedicine has added a new dimension of interaction between the health care provider and the patient. As a result, patients today have unprecedented access to medical information, and more and more (especially aging baby boomers) are taking advantage of it to become directly involved in their own health care.

eCaregivers' Drew Zabrocki sees Interactive Healthcare Services as part of this healthy movement toward healthcare that is both patient-centered and cost-effective. "This is a new approach, and payers are very risk-averse. But with the average hospitalization of a heart failure patient costing $5,000-10,000, technologies that can help avoid the need for re-admissions quickly pay for themselves", Zabrocki observes.

Tomorrow's elders, patients who have grown up with technology, are sure to be more receptive and demanding of health care technology. As these and other telemedicine technologies increase patients' abilities to actively participate in their own care, caregivers will find themselves adjusting to far more proactive customers - perhaps even the word "patient" will have to be changed.

Also See:

• Medication Compliance Research and Resources for Caregivers
• Concerns About Distant Caregiving and Medication Compliance
• The Real Drug Problem Is Forgetting to Take Them: Medication Compliance Adherence Statistics & Resources