Across Australia there are small populations of chronically unwell people who are using Telehealth Home Monitoring Service to support them in the home to improve selfcare, reduce avoidable hospital admissions and improve both their mental and physical health (LiveBetter 2018).
A short video found on Youtube youtube.com/watch?v=szsT_OzcWX4 demonstrates how home monitoring works.
It is known that telemonitoring with videoconferencing empowers older people to understand and manage their own health better and has been demonstrated to be associated with improved health outcomes and reduced service use. Having regular, daily access to a Telehealth nurse was shown both to reassure participants and to trigger changes to services and behaviour that are likely to have positively affected patient outcomes (Nancarrow, Banbury & Buckley 2015).
The results speak for themselves. Some of the programs are reporting over a 50% reduction in emergency department presentations and up to a 28% reduction in potentially preventable hospital admissions. These cohorts are self-reporting increased confidence in both self-care and improved mental health scores. Similar programs are reporting reductions across the cohorts in blood pressure, blood glucose levels and resting heart rate as well as improvements in oxygen saturations and management of heart failure weight fluctuations (Barlow et al. 2007; Polisena et al. 2009; Inglis et al. 2011; Purcell, McInnes & Halcomb 2014).
The anecdotal feedback from our patients is they have never felt more in control and better than they currently do.
Others have simply stated “Telehealth home monitoring has saved my life”.
But despite these wonderful results, there is still no sustainable funding model for this model of wellness and care. For some reason governments are still happy to pump money into treatment for this population once they are admitted into hospital, funding them with long stays in Emergency Departments, Intensive Care Units and the specialist and general wards in our already bursting at the seams tertiary healthcare system.
So the challenge for the future healthcare policy makers must be how do we change this? How do we move the model of funding to a proven wellness support, illness prevention model, aimed at keeping people at home and cared for in the community sufficiently to reduce hospital bed days, whilst concomitantly improving their physical and mental health?
The solutions to our ever-growing chronic disease burden are everywhere, we just don’t fund them yet.
References
Barlow, J., Singh, D., Bayer, S., Curry, R. 2007. A systematic review of the benefits of home telecare for frail elderly people and those with long-term conditions. Journal of Telemedicine and Telecare;13,172–9.
Inglis, S.C., Clark, R.A., McAlister, F.A., Stewart, S., Cleland, J.G. 2011. Which components of heart failure programmes are effective? A systematic review and meta-analysis of the outcomes of structured telephone support or telemonitoring as the primary component of chronic heart failure management in 8,323 patients: abridged Cochrane review. European Journal of Heart Failure; 13 1028–40.
LiveBetter Telehealth Home Monitoring. 2018. Telehealth [Online] livebetter.org.au/services/telehealth/ Accessed 7 February 2019
Nancarrow, S., Banbury, A. & Buckley, J. 2011. Evaluation of a National Broadband Networkenabled Telehealth trial for older people with chronic disease Australian Health Review 40(6) 641-648
Polisena, J., Tran, K., Cimon, K., Hutton, B., McGill, S., Palmer, K. 2009. Home telehealth for diabetes management: A systematic review and metaanalysis. Diabetes Obesity Metabolism 11, 913–30.
Purcell, R., McInnes, S., Halcomb, E.J. 2014. Telemonitoring can assist in managing cardiovascular disease in primary care: A systematic review of systematic reviews. BMC Family Practice; 15: 43
Author
Ben Chiarella RN, MN (Sydney), MBus (Sydney) BEd (Sydney) is Acting Team Leader Community Care & Telehealth Home Monitoring Program Lead, LiveBetter Community Services in Orange, NSW
