Effective use of telemonitoring equipment can reduce the cost of providing home health care and increase revenues enough to ensure the fiscal health of this industry segment. Using telemonitoring as a basis, a home health agency can develop a disease management program, making it more attractive to managed care organizations. Telemonitoring offers home health agencies a means to partner with hospitals to help reduce length of stay and recurrent hospitalizations of patient with chronic illness.

Background: Telemonitoring is a developing technology that enables caregivers to monitor and assess a patient's condition from a remote location. The technology facilitates more efficient delivery of healthcare services by eliminating the need for caregivers to make unnecessary trips to visit patients who do not require a caregiver's physical presence, and by sparing patients the time and stress of unnecessarily being transported to a care site. Telemonitoring is particularly suited for home care, and indeed, several types of telemonitors designed specifically for home care are available in the market place. Typically, a telemonitor transmits data on a patient's vital signs via satellite from a patients' home to a central computer station where a registered nurse monitors the patient reports. One nurse can observe vital information of up to 250 patients at a time and effectively direct medical attention to those most in need. Daily use of the devices can catch medical irregularities before they become full-fledged problems.

Methods: This paper describes the technology and the potential benefits of its various applications.

Findings: The potential advantages of using telemonitoring technologies include: 1) facilitating the remote monitoring of clinical data by trained practitioners, enabling an agency to intervene quickly at even the slightest change in a patient's vital signs, weight, oxygen saturation or other monitored statistics. A nurse can then be sent to perform an assessment; 2) reducing hospital length of stay by discharging patients sooner; 3) improving patient quality of life by having patients engaged in their own plan of care and receipt of care in the comfort of their own homes; and 4) increasing the number of nursing visits and potentially addressing the upcoming home care nurse shortage.

Some potential concerns with using telemonitoring technologies include: 1) these technologies are not suitable for all patients and should be avoided if patients are not alert enough to remember how and when to use the monitors or if they are extremely anxious about using technology; 2) financial arrangements to procure and maintain the equipment; 3) acceptance by health care professionals; and 4) a central repository of patient data must be monitored daily by a nurse to track results and utilization requiring a full time employee with provisions for a backup.

Conclusions: Home telemonitoring programs may help home health agencies meet today's challenges of reduced payments and declining numbers of home health professionals. By facilitating daily monitoring of patient status, telemonitoring can help these agencies improve care delivery, and by requiring fewer patient visits by nurses, it can help reduce an agency's nurse salary and mileage expense per patient cared for. However before these potential benefits can be realized, concerns regarding how patients are referred, acceptance by patients and health professionals and the cost of the technology and the infrastructure needed must be addressed.

Reference: Averwater NW, Burchfield DC. "No Place Like Home: Telemonitoring Can Improve Home Care". Healthcare Financial Management. 2005; 59, 46-53.

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