Home Health Informatics Case Study

Home Health & Informatics

In 2014, there were 12,400 home health care agencies and in 2013, 4.9 million individuals received home healthcare (CDC, 2016). Home healthcare is provided to patients in their home, offering convenience and efficacy, while also costing less (Medicare.gov, 2017). Services provided include woundcare; patient/family/caregiver education; IV medications and hydration; and monitoring of conditions. As with most sectors of healthcare, home health can be improved using health informatics.

Health informatics can play an important role in care coordination, which is an important component of home care (Bates, 2015). Cost analyses have shown that the majority of healthcare costs happen in post-acute settings. Problems,

A medical home is not a location, so much as it is a philosophy of care (AHRQ, 2017). The medical home provides: comprehensive care; patient-centered care; coordinated care; accessible services; and quality and safety. A medical home encompasses all components of a patient's health, including home health care, and allows for a smooth transition from setting to setting. Bates (2015) describes four important domains for EHR in care coordination: reconciling medications; tracking laboratory/test results; cross-setting communication; and facilitating interdisciplinary communication. Additionally, EMRs can be helpful in coordinating referrals and consultations. Across the board, EHRs are being underutilized for these purposes, though if used appropriately, they could revolutionize the healthcare system. Currently, EHRs still require a significant amount of leveraging and "high touch" human involvement, which reduces its usefulness. What this means in a home care setting is that essentially home care providers are acting in a knowledge vacuum. The information may be available in EMRs associated with specific hospitals or private practices, but it is not available to the home provider. Therefore, a home nurse is caring for a patient without all of the pertinent information needed for appropriate and safe care. If an EMR

Zheng, et.al (2014) provided an overview of potential technologies, as well as possible uses for them. These wearable devices or devices that can be incorporated into an individual's environment can allow providers to monitor patients in their home setting. What is particularly elegant about these technologies is that patients do not need to be aware of them for them to be effective. This allows data to be collected while the patient is comfortable and acting naturally. For a patient with cognitive issues, technologies like this can allow for families and providers to monitor the patients without being intrusive. Often, home health care revolves around collecting data and these technologies can collect real-time data and transmit it to home health care providers or prime care providers. For example, sensors could be implanted in a client's bed to obtain ECG, photoplethysmographic (PPG) sensing (which uses light to measure multiple vital signs, such as SpO2), heart rate and blood pressure. Eye glasses can be designed that can complete PPG sensing over the bridge of the nose. To get even higher tech, tattoo biosensors can be used to measure lactate levels in human perspiration. This technology could be used on any patients, but they could be particularly useful for homebound seniors who either cannot come into offices for testing or who do not have the