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Idea Home telehealth

By Joel Reich | 02 Dec, 2014

Idea submitted by: Joel J, Reich, MD

Home Telehealth has tremendous potential for patient engagement and activation. While it is currently quite helpful in the home management of patients with COPD, HF, and diabetes it has much untapped potential for home, skilled nursing facility, and assisted living facility use.

To fully derive its value several things need to be implemented:
1. Continuous monitoring (via wearable sensors) vs. the current interval monitoring.
2. Easy-to-use algorithms to efficiently filter data to enable useful & appropriate alerts (texting, phone call, email, EHR, etc.) to be sent to the patient, family members/caregivers, home telehealth staff, and possibly physician.
3. Improved collection and filtering of data to create meaningful information in the EHR.


A/Prof. Terry HANNAN Advisor Replied at 5:20 PM, 2 Dec 2014

Joel, your posting elicits the need for lateral thinking on these topics. On a posting today into this discussion I have made some comments relevant to these three topics. I believe interface design for the end user is particularly critical as they (patients & carers) are the "new clinicians". To add to this discussion I am adding a 2 slide PPT presentation with how HIT (eHealth/mHealth) can be successful in the enhancement of end user use of these new technologies.
Permissions have been granted from the authors of these slides. Terry

Attached resource:

Maxim Topaz Advisor Replied at 8:58 PM, 2 Dec 2014

Thanks for this idea Joel! Indeed, telehealth holds many promises, especially for care provided in patients homes. Recently, we held a conference on the topic titled "Health IT in homecare and hospice", Check it out for more insights. One of he issues that were raised by homecare providers and researchers alike was the lack of incentives for telehealth in homecare. More efforts are critically needed to provide financial incentives for this, simply put, tlhealth needs to be paid for by the payers. So looking for a potential financial model for telehealth sustainability looks to be one of the keys to success.

A/Prof. Terry HANNAN Advisor Replied at 9:48 PM, 2 Dec 2014

Maxim, if I am correct there were no specific funds set aside in the USA-ehealth reform activities and meaningful use (MU) for aged, chronic and? hospice care. I recall reviewing a paper on this topic and was surpassed by the lack of Federal funding for these two major areas of health care delivery. Is this correct? Terry

Joel Reich Replied at 11:19 PM, 2 Dec 2014

Terry and Maxim:
Thank you for replies.
I am not sure we will ever see the full cost of home telehealth paid for in the fee for service world...but we are seeing great potential in the value based world.
Are the H3it presentations available for viewing?

A/Prof. Terry HANNAN Advisor Replied at 11:57 PM, 2 Dec 2014

Joel, please see the attached poster a colleague and I had accepted for a meeting. I am in total agreement with your statements on the full cost of Telehealth for home care. The Poster attached is based on consultations (reimbursable under out national health scheme for Specialists). What the surprise findings were those related to carbon emissions.

Attached resource:

Maxim Topaz Advisor Replied at 8:09 AM, 3 Dec 2014

Yes Terry, you are right. No specific funds are set for telehealt under the MU or other initiatives. Moreover, there are no MU incenetives for homecare/ hospice at all yet. So there is a long way for health IT in homes in the US. Joel, we accepted abstracts to H3IT- let me know if you have interest in any particular one and I will gladly share.

Joel Reich Replied at 8:34 AM, 3 Dec 2014

I would appreciate seeing the tele-homecare abstracts. Sorry for public posting....but I m new to ghd and didn't see a way to private email.

Maxim Topaz Advisor Replied at 5:10 PM, 3 Dec 2014

Sure Joel- I am attaching couple of interesting references on telehealth for you!

Attached resources:

Jordan Harmon Advisor Replied at 9:54 PM, 3 Dec 2014

Joel- Thanks for the idea submission. I very much agree with Maxim that reimbursement for specific tele-health visits needs to change in order to incentivize individual providers. However, I think the larger point that you should focus on (and are maybe trying to make) is the ability to provide more at home services to patients and provide complete population health management. As more payers begin to offer incentives for providing the continuity of care, the three points that you mention above will become even more important for organizations to develop. Some health systems have already developed clinical teams to focus on patients with chronic diseases when not in the hospital and to help manage these risks through technology. I would challenge your idea further by asking how we can further develop links between EMR systems and home health technology to provide a more comprehensive care model?

Jordan Harmon Advisor Replied at 5:52 PM, 4 Dec 2014

I thought this recent article would also be helpful for the discussion.

Joaquin Blaya, PhD Advisor Replied at 2:22 PM, 13 Dec 2014

I agree that continuous contact with the patient is a good thing, especially if they have chronic diseases, but one thing I found missing from your initial explanation is initial interaction with the patient to see how they feel they are doing or what they feel are there needs. In other words, you posted that you would monitor the patient electronically and send them or others alerts if necessary, but I think there should also be a way for the patient to request information or a system that asks different questions to see what the patient needs. That's what led us to create this system which calls and sends SMS to patients to follow up on their chronic disease management

This Community is Archived.

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