Telehealth: Home Healthcare Options Have Just Expanded

Do you have a loved one with one or more chronic health conditions? Managing diseases like diabetes and heart disease is an ongoing battle. Luckily, telehealth can help.

Continuous medical appointments and at-home symptom monitoring can be stressful. Travelling to hospitals and doctor’s offices is exhausting, inconvenient, and (in many cases) unnecessary.

On the other hand, being disconnected from healthcare providers can cause a lot of anxiety. How serious is your family member’s new symptom? Does it require urgent attention? Should she call her doctor, a specialist, or emergency personnel?

Telehealth (also known as telemedicine) can cut down on the confusion by delivering rapid, convenient, and personalized care.

Perhaps you’ve heard of telehealth before. The term refers to the use of telecommunications technology to deliver health and medical services. While the concept has received hype in the past, we believe that now is the time for this new model of care to shine.

This post will look at the evolution of telehealth. We’ll tell you how recent technological developments can improve the life of your chronically-ill loved one.

Making a Difference

Innovation can be overhyped. And it may be tempting to dismiss telehealth as just another healthcare trend. We think that would be a huge mistake.

Why do we believe telehealth technology is more crucial now than ever? To answer this question, let’s take a look back at history.

The long-distance transfer of medical information is nothing new. For as long as people have lived far away from doctors and medical centres, there’s been a need for telehealth. Believe it or not, some experts have traced its roots back to the ancient Greeks.

The development of the telegraph, the telephone, and even space exploration have all played significant roles in telehealth’s advancement. Of course, the internet has led to a whole new world of possibilities, which has led to some excitement in the media.

That said, there’s no doubt that telehealth technologies have helped rural patients connect to world-class healthcare resources.

Videoconferencing can connect patients in small towns to specialists in big cities. And information-sharing technologies make it easy for healthcare practitioners to transfer information across the country.

Patients need access to appropriate care. And telecommunications can bridge vast distances to provide this access.

But the technologies that make these connections possible don’t always provide complete solutions. Often, integral pieces of the care puzzle are missing.

In many cases, a patient with chronic conditions needs the support of an entire healthcare team. The usefulness of a videoconference will be limited unless every team member is aware of the developments that come out of it.

Today, creating a tightly-connected circle of care around each patient is critical. If your loved one has ongoing medical needs, you know what we’re talking about.

Luckily, telehealth is finally evolving to meet these new demands.

Telehealth: The New Era

Telehealth has been used to provide a higher standard of care in rural areas. But as chronic diseases become more common, these technologies are being used more often in other environments.

It’s no longer just about making services more widely available. It’s about providing better services.

Modern telehealth technology often integrates with mobile devices. Most of us carry cellphones, and learning to use electronic tablets is relatively easy. As a result, connecting patients, their families, and care providers has never been simpler.

How does better communication translate to higher-quality care for your loved one? Let’s do a comparison between telehealth past and present.

Imagine the following scenario. Your grandmother suffers from COPD. She also has severe arthritis, which makes it difficult for her to get around. In addition to help from you, she receives a few hours of home care services each week.

One night, her regular cough (a COPD symptom) becomes much worse.

Should she wait to discuss this symptom with a respiratory therapist? Should you call her doctor? If your worried, you might even consider driving her to the emergency room.

Here’s how telehealth might have helped in the past. If you decided against going to the ER, your grandmother’s home care worker might have brought a laptop to his next visit. Using this technology, your grandmother could have had a videoconference with her doctor instead of waiting for an appointment.

Today, more immediate answers are possible. By tapping the screen on a tablet, you can connect instantly to a medical provider you trust.

For her cough, your grandmother could use real-time videoconferencing to get instant advice. After her assessment, her care provider could add new information to her medical record. Everyone within your grandmother’s circle of care could access this information. Technology could also support her efforts to follow any new instructions she might have received.

From automated medication reminders to vital-sign monitoring devices, innovation can help patients stay as independent and healthy as possible.

The Big Picture: Fully-Connected Circles of Care

The example above highlights a few ways that recent telehealth technologies can make life easier.

For your loved one, the right innovation could mean continuous, on-demand support at home. It could mean fewer unnecessary trips to doctor’s offices. It could even mean preventing readmission to the hospital.

Say the grandmother in our example was able to catch a developing health problem during her videoconference. By following her updated medical instructions, there’s a good chance she could stop it from getting worse. As a result, she could prevent future hospitalization.

On their own, each of these benefits is impressive. But to understand the true value of telehealth, consider the bigger picture. When the right innovations are combined, a patient with chronic conditions has a complete support system.

Digital tools can connect everyone within a patient’s circle of care. Doctors, home care nurses, pharmacists, family members – all of these people should be in the loop.

With complete, up-to-the-minute information, everyone makes better decisions. Care providers can administer more-informed treatment. Families can provide better support. And of course, patients can take a more active role in their own care.

Needless to say, circles of care are important for the wellbeing of patients.

What can you as a family member do to improve these connections? Communicate clearly with your loved one’s healthcare team. If members of the team think it’s a good idea, embrace telehealth technologies.

Encourage your family member to use patient portals, keep digital appointments, and use any prescribed self-monitoring devices. If using technology doesn’t come naturally for your loved one, try to make learning fun. When you’re asked to provide input, consider apps and devices that are intuitive and easy to use.

The Evolution Continues

Managing chronic conditions isn’t easy. And the more support a patient has, the better her health outcomes and general wellbeing is likely to be.

Advanced telehealth technologies have enormous potential to help patients with chronic conditions. In some ways, healthcare providers are just now catching up. Faced with an influx of patients who need care at home, medical professionals are focusing more intently on telehealth.

By having an openminded attitude and asking the right questions, you can help your loved one make the most of these developments.

Feature image courtesy of Esther Vargas

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COPD Education – Onboarding

Objective

To complete a thorough needs assessment / initial evaluation for a COPD patient of an outpatient clinic

Actors
Patient, Educator (Nurse, RT, the Physician could also be the educator)

Timelines
One 60-90 min session with the Educator

Description
  • This protocol should be established for all COPD patients from a given clinic, independently of whether they are new patients or they are known to the clinic. This protocol is the basis to engage the patient into other protocols such as education, exacerbation follow-up, etc.
  • We need to identify patient goals/concerns to guide the interventions
  • A thorough evaluation is carried on, with the objective of understanding where the patient is on their disease journey and follow-up treatable traits: dyspnea, exacerbation or dyspnea and exacerbation.
  • It includes the use of objective questionnaires such as the mMRC, CAT, HADS, Frailty Scale, etc.
  • Identify if the patient needs to be referred to other resources (e.g. Physiotherapist, social worker, occupational therapist)
  • Once Onboarding is completed, the patient continues to the COPD Education workflow
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COPD Education – Continuous Maintenance

Objective 

To cover in depth all the necessary elements of self-management education as per the LWWCOPD, with priorities based on patient goals and identified treatable traits

Actors
Patient, Educator (Nurse, RT or Physician)

Timelines
A number of “Core” educational modules have been identified which cover the basic COPD education from the LWWCOPD program. Additionally, optional modules can be used to respond to patient needs. The timeline (frequency, number of modules to be covered at a given education session) is fully customizable, although we recommend to have education sessions every 2-weeks during the “active” phase of education. Once this is completed, the patient continues to the Maintenance Mode (see below).

Description
  • Launched at the onboarding protocol
  • Provide basic overview of COPD self-management based on LWWCOPD (medication adherence, inhaler techniques, PLB technique & energy conservation) up to the development of an Action plan for early exacerbation recognition and management.
  • Prioritize self-learning by the patient (e.g. watching videos, reading educational materials, completing homework) in addition to live sessions with the Educator. Educational materials are sent to the patient directly via the platform, and become the patient’s own library. The Educator can customize which “homework” the patient receives.
  • Educators have access to “User guides” to standardise their educational intervention. These user guides include: objectives, interventions, suggested questions, evaluation of self-efficacy, and learning contracts for each module.
  • Once the core education is completed, the patient can continue to the Respiratory Status Follow-up Workflow (run in parallel)

The Maintenance Mode
  • As soon as the maintenance mode is engaged, the frequency of visits Educator/Patient is reduced to once every 6 months.
  • During the Maintenance Mode sessions, the educator has access to all the education modules and can choose any piece of content that needs to covered with the patient. 
  • A streamlined evaluation (similar to the initial eval.) is done during each “maintenance” visit to identify any substantial changes on the patient’s needs that will require some adjustment. The patient could come back to an “active” education mode (more frequent education sessions, e.g. every 2 weeks).
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COPD Respiratory Status Follow-up

Objective

Monitoring of stable patients from a clinic in order to identify early any aggravation of symptoms (exacerbation) and implement an action plan

Actors
Patient, Educator (Nurse, RT or Physician)

Timelines
Scheduled regular automated follow-up to the patient symptoms. Intensity/Frequency can be adjusted by the Educator depending on patient needs (e.g. daily, every week, etc.). Ongoing through the year.

Description
  • Launch: Patients who have completed the Core Educational including setting-up an action plan.
  • Regular automated questions allow to identify any change in patient’s symptoms and severity.
  • If an exacerbation is detected the patient gets a reminder to engage their self-management strategies while waiting for the Educator to call back.
  • An alarm is generated for the Educator, so they immediately call back the patient. At this call they will evaluate any further intervention required and schedule additional follow-up.
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