Home Telehealth Reduces Healthcare Costs

Abstract

The aim of this study was to determine whether home telehealth, when integrated with the health facility's electronic medical record system, reduces healthcare costs and improves quality-of-life outcomes relative to usual home healthcare services for elderly high resource users with complex co-morbidities. Study patients were identified through the medical center's database. Intervention patients received home telehealth units that used standard phone lines to communicate with the hospital. FDA-approved peripheral devices monitored vital signs and valid questionnaires were used to evaluate quality-of-life outcomes. Out-of-range data triggered electronic alerts to nurse case managers. (No live video or audio was incorporated in either direction.) Templated progress notes facilitated seamless data entry into the patient's electronic medical record. Participants (n = 104) with complex heart failure, chronic lung disease, and/or diabetes mellitus were randomly assigned to an intervention or control group for 6-12 months. Parametric and nonparametric analyses were performed to compare outcomes for (1) subjective and objective quality-of-life measures, (2) health resource use, and (3) costs. In contrast to the control group, scores for home telehealth subjects showed a statistically significant decrease at 6 months for bed-days-of-care (p < 0.0001), urgent clinic/emergency room visits (p = 0.023), and A1C levels (p < 0.0001); at 12 months for cognitive status (p < 0.028); and at 3 months for patient satisfaction (p < 0.001). Functional levels and patient-rated health status did not show a significant difference for either group. Integrating home telehealth with the healthcare institution's electronic database significantly reduces resource use and improves cognitive status, treatment compliance, and stability of chronic disease for homebound elderly with common complex co-morbidities.

Usability in telemedicine systems—A literature survey

“…It enables healthcare professionals to maintain or even improve an end-user's condition and quality of life, and at the same time reduce in-hospital costs [20][21][22][23][24]. But, for a successful implementation, it seems essential that the users experience a good usability of such systems.…”

Telehome monitoring in patients with cardiac disease who are at high risk of readmission

“…Because there are no published studies of the impact of telehome monitoring in patients with angina, comparisons cannot be made. Although both Noel et al 37 and Chumbler et al 38 studied mixed groups of patients, including those with heart disease, neither measured quality of life. Both did include measures of functional status; there were no differences between randomized groups in Noel and colleagues' 37 study, and intervention patients had better functional status than control patients in the latter study.…”

Telestroke in Stroke Survivors

“…Studies have also shown the effectiveness of telemedicine for a variety of chronic diseases care management such as: general health status monitoring (self-reported, or with home-based devices) with scheduled interventions such as nurse visit or GP consultation (video, telephone or physical attendance) [29,32,33,34,35,36]; medication compliance and modification, depending on symptoms and side effects, and the early detection of deterioration of patient leading to ‘just-in-time’ interventions, thereby preventing unnecessary admissions and escalating healthcare costs [37,38,39]. …”