Telehomecare: A Comparison of Three Canadian Models

Abstract

The delivery of health care is often segmented into sectors. In Canada, hospital care has traditionally been distinct from community care, and thus the transition of patients across sectors has been challenging. This paper focuses on the systematic development of an integrated model of care for children, for the purpose of smoothing the transition from hospital to home. The new service model uses emerging telecommunications technology to link hospital care providers to patients at home and is termed "telehomecare" (THC). Independent models of THC were developed for three sites across Canada through semistructured interviews and focus groups. Participants included health care providers and administrators from the hospital and community, and patient families. The resulting models were compared using content analysis to determine whether there was a core model of THC that was generalisable across Canada. A core model of THC was identified that includes the use of videoconferencing to enable the integration of hospital- and community-based care to support patients during the initial stages of the transition to home. Each site also articulated unique characteristics in their service model that were related to the nature of their health care delivery system and patient population. This paper describes the core model of transitional care, presents a synopsis of each of the three models, and compares the models. THC provides opportunities to address limitations in the current system and to improve upon equity of access to quality care for children making the transition from hospital to home.

Factors influencing death at home in terminally ill patients with cancer: systematic review

“…Worldwide, many initiatives target some of these factors: the three assessment tools developed in the UK documenting care progress and planning end of life care61 – 64; home based models of palliative care such as in North America where more than 90% of these services are provided at home; tele-homecare, used in the US, Canada, Japan, and Europe65 – 68; the inclusion of training in end of life care as mandatory for physicians; and the compassionate care benefits, in the form of a paid leave for carers of dying patients implemented by the Canadian government since January 2004.…”

A systematic review of telehealth tools and interventions to support family caregivers

“…Parental caregivers were mostly of paediatric cases including new parents after childbirth (5%), 23,24,54 parents of premature or low birth-weight infants (3%), 55,56 of children with chronic disease 18,57,58 or disability (asthma, 13,59–62 renal disease, 63 heart disease, 64 diabetes, 65,66 obesity, 14 brain injury, 10 hearing loss 22 and autism 12,67 ) (26%), of children with mental or behavioural disease (psychiatric disorders, 15,19,68 attention-deficit hyperactivity disorder (ADHD), 69,70 and oppositional or disruptive behaviour 21,71,72 ) (12%), of children in end-of-life care (2%), 73 and of preschool children (2%). 74 …”

“…The telehealth technologies used in the studies included: video (videoconferencing or videophone) (40%) (Table 1, see online archive), 10,13–16,18–20,22–25,30,35,42,43,48–50,54,55,57,58,62,64,69 telephone-based (phone call or text message) (31%) (Table 2, see online archive), 11,17,21,26,27,32–34,37,39,44–47,60,65,66,68,72,74 web-based information (18%) (Table 3, see online archive), 12,36,38,51,56,59,61,63,67,70,71,73 and telemetry/remote monitoring (electronic data collection) (11%) (Table 4, see online archive). 28,29,31,40,41,52,53 Video was the most commonly-used technology.…”

Telehomecare for Vulnerable Populations: The Evaluation of New Models of Care

“…1 Telehomecare has been defined as a new service model using emerging telecommunications technology to link healthcare providers to patients at home. 2 Telehomecare constitutes a means to facilitate access for several groups of patients who often lack home care services. 3,4 Numerous pilot studies have demonstrated a trend that telehomecare technology may improve patient outcomes through timely intervention and crises prevention, thereby reducing return visits to physician offices and hospitals.…”