Is the Future of Senior Housing @ Home?

Home As The Site of Care: Redesigning Health Care For the 21st Century

An emerging philosophy in senior care emphasizes the need for Home TeleHealth, and to be put simply – keeping health care recipients in their home and improving opportunities to heal chronic illness. The components to consider are:

1. Identifying changing demographics and characteristics of the chronic disease population
2. Defining the components and implementation strategies that centers care delivery at home
3. Advocating and evangelizing the importance of evidence-based research and evaluation of the Home TeleHealth industry, to provide safe and cost effective care in the home
4. Demonstrating how patient choice and patient satisfaction are fundamental to the success of all Home TeleHealth programs
5. Defining clinical, technical and business elements necessary to sustain a successful HomeTeleHealth program
6. Providing a unique opportunity to network with industry thought leaders, clinicians and technology providers

Twenty-first century health care redesign has been achieved by identifying changing demographics and characteristics of the chronic disease that makes the home the most appropriate place to deliver care. Centering patient care in the home has clearly impacted patients enrolled in the program and Community Care Coordination Services has changed the clinical course through care coordination in the home environment, illustrated in specific patient cases.

What does Community Care Coordination mean for seniors?

The mission of Community Care Coordination is: coordinating the right care, at the right place and at the right time. The vision is that the residence is the place of care. The target market is the senior population with chronic conditions, high users, frequent system users, high risk (clinically complex) users, and high cost (over $25,000 per year) users. The program seeks to understand cost effectiveness, efficiency of care, the quality impact to patients and care givers, patient / provider satisfaction and best practices.

With this approach, patients' empowerment can be achieved by allowing independence from caregivers and the hospital. As one patient put it – who wants to go to the hospital and be away from familiar surroundings in the home? When patients take responsibility for their care, they enjoy feelings of pride and security. It enhances their quality of life by bringing the caregiver to the home and builds a bridge between the patient and their caregiver. No longer are visits performed in a rush, and with strangers. Outcomes are improved, often with results that are superior and in shorter duration. In some cases, lives were actually saved by quicker and more accurate results. Reduced hospitalizations were achieved by improved care and attention to the chronic conditions. And even though some seniors have been characterized as resistant to change, there were high levels of satisfaction with the care and technology. Indeed, Home TeleHealth is improving the quality of life for seniors and in some cases, has saved lives by being available all the time!

Training is a critical element if the technology and care are to be successful. Clinicians must prepare an assessment of the needs and issues with the interest of the patient clearly emphasized. All the staff and patients must buy-in to the process. Early champions must be willing to think outside the box to overcome problems and obstacles and not be techno phobic. The first population must be respected by their peers and patients. Staff and patients must trust the technology and their ability to use it. Patient instructions must be clear, concise and include installation and orientation information. Of course there must be a patient instruction checklist for equipment maintenance, including such basic items as no food, liquids, cleaning materials on the equipment, keeping the equipment out of the reach of children and not adjusting the equipment unless instructed to do.

Some of the more typical equipment features include cameras, video monitors, speakerphones, an interface to a communication line and monitoring equipment. The technology should be evaluated in terms of Home TeleHealth priorities such as the patient's needs, provider's needs, the agency requirements and ease of technology implementation. The technology should not be invasive of the patient's needs and care, and in fact, if that is the case, it should be discontinued from use. However, with the success of the equipment, this is not the case with practitioner and patient attention and approval

It is clear that with the tremendous success of various pilot programs, this is a model which should be carefully evaluated and followed by other members of the private and public health care provider community. It has dramatically reduced the cost of providing care to the chronically ill and provided immediate quality of life benefits to the patients.

BB