Home health care providers have had to answer a unique challenge following the arrival of the novel coronavirus in the United States: How do you provide care to a high-risk population without being able to treat them in person, all while complying with physical distancing restrictions?
On the surface, the answer might seem obvious, especially considering that advances in technology have made it easier than ever to connect virtually both on a personal level and for health care services of all sorts. In fact, between 2014 and 2018 the use of non-hospital-based telehealth grew by 1,393%, and physician adoption of telehealth grew 340% from 2015 to 2018. State and federal legislation and regulations have broadened access to telehealth services. And with social distancing requirements driving a further surge in telehealth use, remote care is becoming a mainstream tool for providers and patients.
For all of those advances, though, the population most likely to receive home health care services is also among the least likely to take advantage of telehealth offerings.
According to a Kaiser Family Foundation poll conducted as COVID-19 was beginning to spread in the United States, 68% of adults age 65 or older have a computer, smartphone or tablet with internet access, but only 11% had conducted a video visit with a doctor or health care provider in the two weeks before the poll was taken. Further, just 38% of seniors had conducted a video chat with family or friends in that period, compared to 71% those ages 30 to 49.
That technology gap means that seniors, who are at risk of isolation in the best of times, may find themselves even more cut off now that the spread of COVID-19 has made in-person visits a health risk. Unfortunately, isolation causes problems beyond missed doctor's appointments. For starters, isolation and loneliness have been linked to increased risk of conditions such as high blood pressure, heart disease, obesity, a weakened immune system, depression, cognitive decline, Alzheimer’s and even death.
A Receptive Audience
The barriers to engaging older patients with telehealth services are not insurmountable, however. And it turns out seniors are a receptive audience for solutions that allow them to connect with more than just health care professionals. Several home health care providers that shifted to a telehealth-based service model in the early days of the COVID-19 public health emergency found that their patients recognized the danger associated with the pandemic and welcomed a solution that allowed them to receive care without the need for an in-person visit.
Even health care providers, who are not always quick to embrace new technology, have been won over by the ability of telehealth tools to connect with their patients. For example, higher-quality video visits allow providers to see how patients stand and move and to understand their condition in a way that wouldn’t be possible with a traditional phone call. Even better, telehealth technology makes it easier for providers to conduct family care conferences and supports broader participation by family members and other caregivers.
How can home health care organizations integrate telehealth into their existing services without disrupting the quality of care and personal touch that patients and family members have come to rely on? Here are a few key tips to consider:
- Find the right device. The cell phones and tablets that most people use simply don’t work for a senior population. A multitude of functions and complex interface tend to mystify older adults who are not familiar with technology. In addition, people over the age of 75 often have difficulty using the capacitive touch screens because the skin loses moisture over time, which is essential for the pinching, expanding and swiping movements in most mobile technology. Computers are an option, but nearly 50% of seniors lack home internet. Home health providers should look for a device that is powerful enough to connect seniors to the outside world but intuitive enough that someone unfamiliar with smartphones will be able to navigate the interface.
- Go beyond video calls. Video is a powerful tool for telehealth visits. Home health care companies that have adopted the technology have found that it is a reliable and effective extension of their current service offerings. However, a video camera can’t record a patient’s heart rate or weight or tell you much about their activities during the course of the day. Health care companies should look for senior tablet solutions that, in addition to video calling, offer connected device capabilities that allow you to monitor and collect health and well-being data.
- Make security a top priority. Connected technology is great, but like anything connected to the internet, a device that brings telehealth to seniors also carries the risk of hacking or phishing scams. Make sure the device you choose is as locked down as possible. Seniors need a device that connects them to their caregiver and to friends and family—on their terms. Look for a device that allows your team to control who a patient can connect with, and vice versa. Devices should also be HIPAA compliant.
- Start slowly. To ensure a successful rollout, it helps to limit the technical features until your clinical team and patients get acclimated to the technology and how it impacts the clinician-patient interaction. Ideally, the device you choose will allow you to bring patients and staff along at a pace that will drive quick adoption and reliable engagement. Introduce them to the basics, then open up additional capabilities once they’re comfortable.
- Opt for personal support. Even with the best devices, sometimes there’s no substitute for a helping hand. When choosing a partner, look for a device company that offers end-user customer support as an integral part of their service or product offering. Avoid platforms that rely solely on interactive voice response systems for tech support to minimize frustration for older patients and to ensure your staff gets timely responses to their needs.
- Engage all stakeholders. A shift to telehealth requires adjustments from everyone involved. Be thoughtful of all stakeholders along the way, from field clinicians to call center employees to IT staff. Be intentional in thinking about how the integration of new technology affects your employees, and make sure you understand their concerns and answer their questions before you move ahead.
There’s no doubt that telehealth has great promise as a tool to care for patients of all ages, but especially in the midst of a global pandemic it has become an essential part of health care for homebound seniors. And don’t forget, it’s not just about collecting biometrics and monitoring care routines. By selecting a device that is easy and fun to use, you can increase engagement, which in turn amplifies the success of your telehealth program.