The fastest growing segment in the US health care market is home health services. The use of hometelehealth technologies could provide alternative approaches to providing home care services. At the end of this study, participants who received some form of home-telehealth showed significant improvement in their functional and cognitive outcome measures.

Background: The fastest growing segment in the US health care market is home health services. The use of home-telehealth technologies could provide alternative approaches to providing home care services. This paper reports on a Veterans Health Administration demonstration project that examined the use of technology to coordinate home care more efficiently. The goal of this study is to reduce hospitalizations and unscheduled clinic and emergency room visits. The objective of this study was to explore differences in functional and cognitive outcomes between two groups of male veterans who were enrolled in a care coordinator/home-telehealth program or received usual care.

Methods: Participants were veterans who had two or more service visits and/or obtained care costing $25000 or more during the past twelve months and had a diagnosis of hypertension, congestive heart failure, respiratory disease, or diabetes. Participants received one of three interventions: 1) a proprietary hand-held in-home messaging device (Health Buddy); 2) a telemonitor with two-way audio-video and biometric monitoring (i.e., measurement and recording physiological measures); and 3) a videophone with two-way audio-video without biometric monitoring.

Functional and cognitive outcomes were measured by a variety of scales. Participants' results were matched and compared with a group of non-institutionalized disabled elders that received usual care. Data were collected at baseline and after twelve months.

Findings: A total of 226 patients participated in this study (111 in the intervention groups). At the end of the study, participants who received some form of home-telehealth showed significant improvement in functional and cognitive outcome measures. Most (88%) reported that the technology was easy to use and 92% thought the technology was helpful in managing their chronic condition(s).

Conclusions: Study results suggest that the use of home-telehealth technologies, enhanced by care coordination, has the potential to improve the functional and cognitive status of frail Veteran men. Although home-telehealth users showed improvement when compared with usual care in this study, this result only demonstrates that some care (i.e., home-telehealth) is better than usual care. The more salient question for decision makers is: To what extent is home-telehealth more cost-effective compared to usual home-care services for veterans?

Reference: Chumbler NR, Mann WC, Wu S, Schmid A, Kobb R. "The association of home-telehealth use and care coordination with improvement of functional and cognitive functioning in frail elderly men". Telemedicine Journal and e-Health, 2004; 10(2), 129-137.

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