A national survey has found that American consumers are eager to use home health care electronics to monitor their own health.

Some devices available for home use include a wearable non-invasive glucose monitor for diabetics, an in-home hemodialysis unit, and do-it-yourself screening tests for conditions ranging from high cholesterol to blood-borne infections.

“Any screening device at home has pros and cons,” said Jean Ellis, RN, vice president of member services and business development of the Boston-based Visiting Nurse Associations of America. “If one self-diagnoses, then what? Do [patients] take that info to their physician who will then probably repeat the test and make treatment recommendations? Or will the consumer ‘sit on the information’ out of anxiety or lack of education?”

These questions gained new urgency in January as a national survey found that American consumers are “ready, willing and able” to use home health care electronics as a way to monitor their own health at home.

Many VNAs already use telemonitoring devices which, in essence, provide an “electronic house call,” Ellis said. These e-house calls usually are an adjunct to in-home visits. “The telemonitoring allows the nurse to know when an in-home visit is advisable, instead of just randomly scheduling a routine follow-up visit.”

In the case of many heart-failure patients, nurses often are scheduled to make a weekly visit to check on the patient’s status. Daily monitoring can prevent unnecessary emergency room visits and pre-empt crises, Ellis said.

Increasingly, the Internet is facilitating these daily monitorings. For the first time, the consumer electronics industry is seriously considering the benefits that broadband networks such as DSL and cable, in conjunction with home networks connected to health monitoring devices, can provide to patients.

“In the next five years, the Consumer Electronics Show exhibit floor will focus on what we call lifestyle solutions,” said Charles Roussel, a partner in Accenture’s electronics and high-tech industry group based in New York City. “One solution in particular is home health electronics. We’ve [received] a lot of queries from our clients about it.” A number of Accenture’s clients are a who’s who of consumer electronics companies.

In an Accenture study released in January, more than 80 percent of those participating in a 4,500-person consumer survey said that using home health care electronic devices would improve their overall health.

The survey also finds strong interest from those who care for family members and friends living with them or elsewhere. Roussel, who authored the study and serves on the executive committees of the Children’s Aid Society of New York and the Mount Sinai Adolescent Health Center in New York, mentions his own parents as examples. After his mother had a severe stroke a year ago, she is now on 15 medications. His father spends “a significant amount of the day figuring out how to give her the right medications at the right time,” he said. Between that and emergency room visits, there’s plenty of potential for high-tech help, Roussel said.

“If a patient is under a physician’s care for an existing illness, then the monitoring is part of a treatment plan,” Ellis said. “This model can also be used successfully for a relatively healthy elder who may be living alone to be monitored as an extra safety net and followed privately by a home care agency. In this latter scenario, the person would pay for these services out-of-pocket.”

Insurance companies and HMOs are cautiously optimistic that home health monitoring can improve care and lower costs.

“If an electronic approach is cost-effective and can avert overuse of emergency room visits or hospitalizations, then health insurers should be open to covering these alternative approaches,” Ellis said. “If, however, the services or products are in addition to other treatments being rendered and are redundant, then health carriers should not bear those expenses.”

The Accenture survey shows a mix of consumer opinion about who should pay for services. On the one hand, more than half of those surveyed would be willing to add new cable, phone or Internet services to enable home e-health care solutions. In addition, more than 30 percent would pay a modest monthly subscription fee of about $20 for such services. On the other hand, more than 70 percent surveyed believed their insurance coverage should pay for everything.

Whoever pays for it, the continuing crisis in health care, as well as an increasingly tech-savvy population, will spur development of home health care monitoring and treatment, Roussel said.

The American Medical Association may not be championing this move, but AARP is “an unbelievably powerful lobby” that could apply pressure for speedier approval of home [health] devices and services, Roussel said. “These have got to be Medicaid and Medicare-approved devices, or this industry goes nowhere,” he said. “It can’t be seen as an elitist thing.”

“The bottom line is, most health care practitioners would support these approaches if they are not in conflict with a physician’s plan of care,” Ellis said.

For more information:

Visiting Nurse Associations of America
Accenture

Source: “Home Healthcare Electronics: Consumers are Ready, Willing and Able,” Accenture, January 2003.