Home Care Overview

Increase in Home Care
TeleHomeCare Applications

Increase in Home Care

The concept of a home care agency is more than a century old. In 1964, there were 1,100 home care agencies in the United States. Since World War II, however, home health care has been dwindling. This trend is the result of a number of factors:
  • Little or no physician compensation for home visits
  • Time constraints
  • Lack of physician training and exposure
But research shows patients prefer home visits. Recent changes in the health care industry are allowing home care to make a comeback. Several other factors are setting this recent trend:
  • Aging populations
  • Rising health costs
  • Increase in technology
From 1992 to 1994, the number of patients receiving home care in the United States increased by 53 percent, which makes home care one of the most rapidly growing fields in the health care industry.
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TeleHomeCare delivers patient care to the home via technology. It provides contact between the health care provider and the patient without either having to travel. But TeleHomeCare is not new. An article in Telemedicine Journal reveals "home telecare is as old as the installation of the first home telephone." Essentially, "telehealthcare tools and services enable more patient data to be transmitted from the home (such as blood glucose measurements and blood pressure readings) and more patient-centered information to be sent into the home (such as medication compliance reminders and patient education modules)." TeleHomeCare is the fastest-growing sector in the United States health care industry.

Several forces are encouraging the use of technology in home care.

  • Cost-effectiveness technology
  • Aging Populaton
  • Early Hospital Discharge
  • Managed Care Capitated Payments
  • Patient Demand
  • Patients moving toward Self-Care
  • Increased acuity
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TeleHomeCare Applications

X-Ray"Smart Homes and Telecare for Independent Living" details several applications of TeleHomeCare. Each application depends on the patient's needs.
First Generation TeleHomeCare
First-generation systems "include personal response systems, emergency response telephones and personal emergency telephones. They are generally used by older people and by high-risk patients who live alone." These systems are relatively simple and inexpensive.
Second Generation TeleHomeCare
Second-generation systems perform continuous monitoring of patients. The most common tool in a second-generation TeleHomeCare system is a sensor that can detect deviations from patient normal behavior and health status. "Medical sensors are intended to help monitor the condition, the physical activity or the location" of the patient.
Third Generation TeleHomeCare
Third-generation systems usually involve direct communication between the patient and the home care provider. This system provides "full-range of security, medical diagnosis, treatment, continual monitoring and personal communication outside emergencies, thereby helping to increase the prospects of autonomous living." Third-generation systems require broadband networks.
Fourth Generation TeleHomeCare
Fourth generation systems use the Internet to deliver TeleHomeCare services to the patient. Patients can access the Internet through a computer or television set, and thus TeleHomeCare services are expanded. Several services are offered via fourth generation TeleHomeCare.
  • Instant access to patient records
  • Prescriptions for Treatment
  • Follow-up care
  • Detection of potential dangers to the patient
  • Evaluation of patient's treatment and medication
StethoscopeAccording to "TeleHomeCare: Telemedicine for Homebound Clients," the following services can be provided via TeleHomeCare, depending on the applications mentioned above.
  • View patients
  • Assess conditions
  • Observe medications administration - oral or injections
  • Monitor vital signs
  • Check weight
  • Assess mental status, functional status and overall health status
  • Point-of-care clinical data: EKG, BP, Blood Glucose, Digital/Analog Stethoscope
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Bibliographic references for this page

By Daphne Landers

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