The biggest care gap: the fear of going home after discharge

Roy Lilley’s NHS Managers.net newsletter is always interesting and worth subscribing to, but this week’s issue had a special resonance. Many of us have had to ‘manage’ a situation when you or a family member comes home after an illness, accident, or even minor injury. The actions you took for granted are now difficult, painful, or simply cannot be done. Climbing stairs, making a bed, lifting a full pot, even getting on a coat or jacket or tucking in a shirt are just a few. These have special resonance for those of us who have a few ‘cycles’ on us (as aviation terms a takeoff and landing), even if mentally we’re about 35 (!) Will we ever be quite right again? What happens when the home help goes home, or you’re by yourself?

Of interest to American readers is that the British Red Cross is pivoting to fill the care gap of discharge to home. The BRC has a long history of working with the NHS, which was a surprise to this Editor, as the American Red Cross’ emphasis is on disaster relief (of which we have aplenty). Home to the unknown: Getting hospital discharge right is their umbrella report with briefings for England, Scotland, and Northern Ireland. The BRC provides ambulance support, helps people get home from hospital, carries out home assessments and supports older and vulnerable people to live independently at home. As Mr. Lilley put it, referring to the traditional Red Cross mission:

Refugees? About 900,000 people used to get care and support from local council services. The eligibility criteria have been raised, now they get no help. They are refugees in our care system.

On a different note, this issue’s sidebar contains a link to a short article about the scientific pioneer Marie Curie and a few tidbits about anti-inflammatory drugs being used to treat depression, tick-borne diseases spreading in the UK, and medtech fighting breast cancer 10 ways. 

Deloitte’s consumer view of technology acceptance in home health

The Deloitte Center for Health Solutions (DCHS), the research division of Deloitte LLP’s Life Sciences and Health Care practice, conducted six focus groups late last year to gauge the acceptance of technology in home health. They tested two main home health scenarios among 42 younger (<44) and older (45-64) adults, both drawn from healthy and chronic condition patients and with a mix of demographics.

In this qualitative study, the two scenarios tested were: technology that would help manage chronic conditions and tech to promote healthy living. The first scenario gives a very advanced vision of chronic care management that involves telehealth, telemedicine and residential monitoring in the management of chronic conditions (diabetes and CHF). The second involves lifestyle factors including eating, activity and exercise management and managing travel.

Some findings in the report summarized and linked for download here, including implications for companies:

  • Overall they were open to and optimistic about using technology to enable better home care of older adults who require it–including embedded sensors.
  • ‘Smart home’ has appeal, but there is a preference for the less intrusive (stove burner/cooking range sensors, fall detectors) and resistance to perceived invasions of privacy (sleep, bathroom and activity monitoring).
  • They understood the balance of reward and risk in consideration of broad categories of nutrition, physical activity, prevention, and dealing with an acute episode (see quadrant below, click to enlarge)
[grow_thumb image=”http://telecareaware.com/wp-content/uploads/2016/03/us-lshc-hcc-march1-my-take-p1.png” thumb_width=”200″ /]

Center Director Harry Greenspun, MD’s in his Health Care Current blog notes that TECS has the capability of providing services formerly provided only in a doctor’s office or hospital in the home, but “One question remains, “How quickly will consumers adapt and accept new technologies that bring care into their home?”–then answers his own question.

All of these innovations have given us a level of insight and capability we could not have imagined even a few years ago. At the same time, each raises privacy concerns.

So why do we do it? Because we get something out of it.