| | November 20159UTLOOK Healthcare Tech HTtrack footsteps, offer a reminder to take a medication, even detect a fall.In keeping with this trend, 24 states have passed laws requiring insurers to cover telemedicine that delivers the same services already covered if provided in-person. Such virtual house calls enable physicians and patients, via apps for smartphones and tablets, to maintain relationships over distance.So far, the results are promising. Outcomes for chronically ill patients at home improved, at lower costs than face-to-face visits, after virtual visits from skilled home health care nurses, found a study by researchers at the University of Minnesota Medical School. Indeed, tele monitoring may equip primary care providers to detect health issues early, better predicting potential hospital stays, showed a study by the Mayo Clinic and Purdue University.After all, the more the home health team knows about our elderly lady­the fluctuating variables in her health status as well as such often overlooked nuances as the level of family and community support she receives­the better it can manage her care effectively and efficiently. The intended outcome: recovery from an acute hospital stay is facilitated and further hospitalization prevented.Now comes the hard part. Patient information still needs to be better understood and more aggressively deployed. At issue is how. Clearly, organizations that deliver health care to the home­like much of the health care field­have yet to fulfill this potential. We information technology professionals, in close collaboration with clinicians, have to figure out how best to choose among, and then adapt to, and ultimately take full advantage of, the capabilities of telemedicine that are increasingly available.There are obstacles to effective adoption. But here is some basic advice that might point us in the right direction:1. Health care IT must do more than merely collect and report data­it must also analyze it and mine it for "actionable" insights that can identify potential solutions and, importantly, guide decision-making. 2. IT professionals should maintain focus more on the "I" than on the "T." In other words, the ends­which data we glean, what information really matters, who needs to see what information, and the insights yielded­are more important than the means.3. Telemedicine must measure standard vital signs to accurately assess status and progress, but it must also keep tabs on quality of life indicators. Has the patient recently visited a friend? Taken a walk? Started smiling more? Sometimes these so-called intangibles are actually telling factors.4. For home health professionals to deliver the best care, they should cast a wider net to capture certain pivotal details that recent research indicates are important. Where did her physician attend medical school? How have patients with similar conditions in the same location fared? What type of hospital is she being discharged from?5. Contrary to the widely accepted consensus, effective health care IT costs less and requires less personnel. 6. Achieving simplicity is complex, but the technology platform that functions best is the simplest and most transparent; fewer parts means fewer problems and lower costs.7. Health issues at home, as in other settings, must be dealt with in real time­a capability that only remote patient monitoring makes possible. 8. For patients at home, health care technology must be tailored to support the performance of nurses and the best interests of our patients above other concerns.As a first step, I propose further research on patients receiving health care at home. The health care and technology professions are in a perfect position to collaborate on longitudinal studies. Because post-acute care lasts much longer than the average hospital stay­months, even years, versus days or weeks­it present a unique opportunity for long-term evaluation. The future­using IT to improve care and enable higher acuity care in the comfort and safety of home­has arrived. We just have to use it"Martin Howard
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