Increasingly, chronic illness and disease management will rely on home-based programs, including telehealth, remote monitoring, and support for non-clinical carers and families. Caregivers will become more involved and trained to support their loved ones (for family caregivers) and clients (for professional caregivers). The following links provide insight into how this is being rolled out in a number of places, along with the potential challenges.
This following article looks at a Canadian program launched in Alberta which aims to improve health outcomes for seniors with chronic illness by integrating Primary health providers to remotely connect with their patients.
https://www.businesswire.com/news/home/20230906374483/en/Expansion-of-Home-Health-Monitoring-for-Alberta-Seniors-With-Chronic-Illness
The following article describes the experiences of the Hamilton Health Care System in North West Georgia, particularly looking at 3 of the most important conditions in terms of the potential burden they place on Emergency Departments and Hospitals, Chronic Heart Failure (CHF), Chronic Obstructive Pulmonary Disease (COPD), and Diabetes. Home health and Home care agencies will increasingly need to respond to clinically complex patients to improve outcomes and prevent hospitalization.
https://homehealthcarenews.com/2023/05/home-health-providers-adjusting-operations-to-care-for-more-clinically-complex-patients/
This article looks at the increasing use of “hospital in the home”. While this can have substantial benefits in terms of delivering services at lower costs and greater convenience to patients, it inevitably results in increased stress and commitment from family caregivers and support workers. Despite the benefits, it will, therefore, require increased training and commitment from family and professional caregivers.
https://www.npr.org/sections/health-shots/2023/07/18/1188058399/hospital-at-home-caregivers-family-stress
Heart Failure
This is an article about how Maine General in Augusta reduced its Chronic Heart Failure readmission rate to 0% compared to over 20% using remote monitoring and home outreach (2022)
https://www.healthcareitnews.com/news/mainegeneral-hits-congestive-heart-failure-readmission-rate-0-using-rpm
Not Your Average Home Visit: How a Paramedic-Led Program Is Changing the Homecare Landscape
This article describes how a local ambulance service developed a home care service to help Chronic Heart Failure (CHF) patients reduce exacerbations and prevent ED visits and hospitalization. The Mobile Integrated Health (MIH) department within Arrow ambulance service in Urbana, Illinois, by working closely with cardiologists, paramedics received enhanced training (more like a cardiology crash course), allowing them to assess situations and initiate treatment and, if necessary, shift into first-responder mode for paramedic-level intervention and transport initiation. This provides a great example of utilizing existing professionals to expand disease management out of the hospital and into the home. It is not hard to envisage caregivers also receiving such training to better understand and respond to the needs of their patients with heart failure.
https://www.jems.com/mobile-integrated-health-and-community-paramedicine/not-your-average-home-visit/
Chronic Obstructive Pulmonary Disease
In the US, about 800,000 patients are hospitalized for Chronic Obstructive Pulmonary Disease (COPD) annually, making it among the leading reasons for hospital admissions—with about 20% discharged and readmitted within 30 days. Frequent readmissions are not only distressing to patients but also costly to health systems. Better management at home, with support to families and caregivers is a critical factor in addressing this.
https://www.homecaremag.com/august-2022/hospital-at-home-copd-patients
This is an example of new technology being employed in the home to manage COPD. This new device incorporates cloud connectivity and real time oximetry and spirometry to identify exacerbations early, allowing for family, caregiver, and nursing intervention to manage without ER/hospitalization.
https://www.medicaldevice-network.com/news/vapotherm-ventilator-care/?cf-view&cf-closed
Another example of utilizing home care in COPD management from a program in Scotland in late 2023, where the Scottish government looked at its winter resilience plans with a focus on avoiding hospital admissions.
https://www.bbc.com/news/uk-scotland-edinburgh-east-fife-67080220
A Mayo Clinic study completed in 2022 of nearly 400 patients in Florida and Minnesota showed positive results and improved outcomes in home-based COPD. Results being published
https://www.medscape.com/viewarticle/982647?form=fpf&scode=msp&st=fpf&socialSite=google&icd=login_success_email_match_fpf
Stroke
An article by Yotam Drechsler, CEO & Co-founder, BrainQ Technologies. This is at the forefront of new technologies looking at AI and the actual interface between the brain and computers to aid in stroke and spinal cord injury recovery. Despite this being in very early stages, the potential for this to impact these conditions is immense. At present many stroke and spinal cord injury patients live out their lives in facilities and specialized care homes. The potential for them to return home and live with their families is amongst the most exciting of new developments in this field.
https://www.forbes.com/sites/forbestechcouncil/2022/07/20/why-connected-home-care-is-the-next-frontier-for-managing-chronic-diseases/?sh=6fe6955669be