Running head: TELEMEDICINE IN HOME HEALTH CARE 1

Telemedicine in Home Health Care

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Telemedicine in Home Health Care

The progress of healthcare has been exponential. However, several roadblocks have to

be managed in order to provide optimal health care to clients. This includes congestion in the

hospital and continuity of care in the community setting. Home health care is an effective

modality in dealing with this problem (Halvorson, 2013). However, the time it takes for the

home health provider to travel and the geographical scope, especially the distance, may prove

challenging. Added to this is the availability of home health providers that can render

services to a number of clients. Telemedicine enables the health care provider to provide

health care education, advice, and treatment regimen in remote settings. Hence, telemedicine

is an important technology that would benefit home health care in a variety of ways.

Home Health Care

Home health nursing care is an increasing field that has a lot of significance in today’s

health care situation. Home health offers a variety of healthcare services that can be given in

the client’s home for a certain illness, injury, or diseases. It is oftentimes less expensive than

hospitalization or admission to the skilled nursing facility. It also more convenient, since the

client does not need to travel, and are just as effective as hospitalization.

Home health care usually starts with the attending physician referring the client to a

home health services agency. Then, the home health agency will coordinate with the client to

schedule an appointment and then visit the client to perform a preliminary interview and

assessment on the client’s health status. Home health care involves holistic care and takes

monitor the client’s diet, vital signs, treatment, activities, and prognosis of the illness

(Medicare, 2018).

A home health nurse typically has a variety of roles and responsibilities. Aside from

taking vital signs and rendering health teachings, home health nurses may provide certain

treatment such as dressing changes, wound care, taking care of drainage tubes, administer
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intravenous and other parenteral medications. In addition, the home health nurse may include

assessment of the client’s home and community environment and planned out with the client

and family how to modify such in order to fit the client's needs and be conducive for healing

and recovery.

Although the home health industry is booming, it is not without its challenges and

difficulties. The boom in itself the cause of progress as well as the cause of the challenges

that a home health manager may face. In the United States, the aging population, who are the

top clients of home health agencies, will be estimated to be 17% of the entire population by

2020, which will be approximately 50 million (Halvorson, 2013). This would cause the

challenge of finding qualified staff that would fill in the need. This problem is not only

present in the United States, but also in other parts of the world. Finding adequate staff to

provide the services is a challenge that home health managers need to face (Ajlouni, Dawani,

& Diab, 2015).

Several solutions have been proposed in order to solve this crisis. Ultimately, it boils

down to hiring more qualified staff to fill in the gap. However, hiring process has been very

slow and tedious, especially the United States, and those who get hired after the long process

tend to leave after about three months (Shalv, 2018). As an administrator or manager of a

home health care agency, it is important to look for other solutions that will provide services

to the client, but are not dependent on hiring more staff.

Telemedicine

The concept of telemedicine started about fifty years ago when few hospitals begin

experimenting with this concept to reach clients in certain remote areas. With the

advancement of information technology, telemedicine has evolved into a complex system

utilized by hospitals, homes, clinics, and other healthcare facilities. The advancement

progresses at an exponential level, which brings with it affordabiltity and accessibility of

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telemedicine tools. Originally used to take care of patients in remote areas, telemedicine

today is also used to connect with patients who do not want to spend time in the waiting room

to get a doctor’s appointment, and get prompt care for urgent and minor conditions as soon as

they need it. These capabilities of telemedicine, coupled with the rising unavailability of

overburdened health care professionals, have paved the way for the rise of telemedicine

companies. (eVisit, 2018).

Several factors are to be considered in implementing telemedicine. One of the most

complexes is the human factor since it will include an intra- and inter-organization mix of

health care providers, support personnel, and administrator. There should be an utmost

consideration in the relationship between organizations, especially in home health care where

referral from a hospital or attending physician is usually the starting point when the client

will receive home health services (Dafoulas, Pierris, Martinez, Jensen, & Kidholm, 2017).

Another human factor that needs to be considered is usability. Telemedicine involves

technology, but most of the clients of home health services are those who are 65 years old

and above (Halvorson, 2013). Utilizing telemedicine in home health should first factor in the

fit between the client and the technology that would be used. Another aspect would be the

degree of trust that the patient will have on a system that has no human contact (Garg &

Brewer, 2011). The human aspect of health care cannot be neglected, and this will pose a

problem in the adoption of telemedicine, especially in clients who are used to human-to-

human interaction in health care.

Another factor to be considered is the financial aspect of telemedicine. Telemedicine

is proven to be successful in terms of patient satisfaction. However, there is no consensus as

to its financial viability and cost-effectiveness. Although the rise of technology has made

applications cheaper, the appropriate technology that would be used in telemedicine for

certain clients may not be that cost-effective at all (Squires, Boal, & Naismith, 2015).
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Therefore, as manager, it is very important to consider the financial aspects of the

organizations before adapting to novel technologies. This would ensure that the organization

can thrive while still providing the needs of the patients and clients.

Security, confidentiality, and privacy are equally important factors to be considered in

telemedicine. As a technology-based alternative to the usual health care services like

hospitals and skilled nursing facilities, telemedicine can suffer to the effects of poor security

measures and data breach. These security problems may include concerns such as

authentication, authorizations, and accounting, which are relatively common with other

industries that utilizes the advancement of information technology to enhance their services.

Aside from these, telemedicine also has its unique set of security-related concerns. This

would include its ability to detect physical safety, like remotely detecting fall risks of adults

at home. Thus, security in telemedicine does not only mean the security of data, but the

physical security of patients themselves, who are receiving care in the absence of direct

human interaction. Both patient’s physical safety and the safety of patient information are

critical aspects that would affect the trust and acceptability of telemedicine in the home health

care setting.

Conclusion

As a home health nurse manager, one will take into consideration the benefits that the

technology of telemedicine offers in the midst of starting crisis. However, before jumping

into the adoption of such, a good manager will factor in several concerns that would affect

the delivery of services. Careful consideration of human, financial, and security factors would

increase the effectiveness of the adoption of telemedicine in home health.

References
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Ajlouni, M. T., Dawani, H., & Diab, a. S. (2015). Home Health Care (HHC) Managers

Perceptions About Challenges and Obstacles that Hinder HHC Services in Jordan.

Global Journal of Health Science, 7(4), 121-129. doi:10.5539/gjhs.v7n4p121

Dafoulas, G. E., Pierris, G., Martinez, S., Jensen, L. K., & Kidholm, K. (2017). Adaptation of

the Model for Assessment of Telemedicine (MAST) for IoT Telemedicine Services.

Human Aspects of IT for the Aged Population. Applications, Services and Contexts,

10298. doi:10.1007/978-3-319-58536-9_27

eVisit. (2018). What is Telemedicine. Retrieved from eVisit:

https://evisit.com/resources/what-is-telemedicine/#1

Garg, V., & Brewer, J. (2011). Telemedicine Security: A Systematic Review. J Diabetes Sci

Technol, 5(3), 768-777. doi:10.1177/193229681100500331

Halvorson, C. (2013, June 13). To 7 Challenges Facing Home Health Care Agencies in 2013.

Retrieved from When I Work: https://wheniwork.com/blog/top-7-challenges-facing-

home-health-care-agencies-in-2013/

Medicare. (2018). What’s home health care? Retrieved from Medicare:

https://www.medicare.gov/what-medicare-covers/home-health-care/home-health-

care-what-is-it-what-to-expect.html

Shalv, A. (2018, March 7). Ideas to address the home health care nursing shortage.

Retrieved from Nurse.com: http://mediakit.nurse.com/blog/ideas-address-home-

health-care-nursing-shortage/

Squires, S. I., Boal, A. J., & Naismith, G. D. (2015). The financial impact of a nurse-led

telemedicine service for inflammatory bowel disease in a large district general

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hospital. Frontline Gastroenterology, 7(3), 216-221. doi:10.1136/flgastro-2015-

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