Telehospice

What is "telehospice"?

The term "telehospice" refers to the use of telecommunications and computer equipment to provide hospice or palliative care services to people who are at some distance from where the provider is located. The service can be given either to home caregivers or to other health care professionals needing specialty consultations. The two most common types of distance service used in hospice and home care are:

• Telemonitoring, or remote data collection, in which information such as weight or blood pressure are recorded by remote sensing devices. Some high-end home monitoring systems include various patient monitoring devices that are connected to a remote data capture center. Patient data is transmitted from the remote location and optionally may be stored in a computer system as part of a longitudinal patient medical record. Some systems of this type integrate the data with workflow management, data analysis tools, imaging systems, emergency alerts, and other report generation capabilities.
  
  
• Videoconferencing, in which people meet face-to-face using video cameras. This use directly addresses the interpersonal support needs of remote patient care in ways that data systems do not.

These two types of technology may be used together or separately.

Why the economics are compelling

When telemedicine got started, it cost a lot of money to build and operate. In the old days you had to build your own high-speed communications networks and buy expensive videoconferencing equipment. Today, you already have access to a high-speed network (it's called "the Internet") and you already have access to a powerful desktop communications system (it's called "your computer"). Today you can probably get 80% of the value of older telecommunications applications at very low incremental cost over what you are already paying for typical business Internet connectivity.

Guidelines for Telehealth

With the increasing use of telemonitoring technology in home care, it is essential to establish a set of universal principles that guide the development and use of this dynamic technology.

The Board of Directors of the American Telemedicine Association has adopted a set of clinical guidelines for the use of telemedicine for homecare. Members of ATA's Homecare Task Force prepared the draft guidelines, which includes criteria for patient care, health providers and technology. The Task Force is chaired by Kahlid Mahmud, MD, FACP. A special Guidelines Sub-Committee chaired by Barbara Johnston, RN, MSNL&M; prepared the guidelines. Members of the Subcommittee and the full Task Force, other members of ATA and the ATA Board of Directors all reviewed the guidelines and provided comments and suggestions prior to final action by the Board. The guidelines have been given to the Healthcare Financing Administration, National Association for Home Care and other bodies for their review. This article presents an overview of the first Telehomecare Clinical Guidelines, developed by the ATA. The guidelines are cited in Home Healthc Nurse. 2003 Oct;21(10):703-6 Britton BP.

American Telemedicine Association Guidelines