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Telehealth and the Older Patient

Posted by James Baker, Chief Medical Officer | February 9, 2019 |
James Baker, Chief Medical Officer

One of the biggest strains today on our healthcare safety net is the influx of older patients. A policy article in Health Services Research called it healthcare’s “2030 problem,” pointing out that caring for seniors in the next few years will pose big challenges for healthcare providers. The number of Americans aged 65 and older will increase from 46 million in 2019 to more than 98 million by 2060. Advances in medicine will allow populations to live longer, but many with chronic diseases such as chronic obesity and diabetes will need to be managed.

While it’s true that the aging baby boomer population will place unprecedented burdens on healthcare, telehealth can help these elderly populations with complex care needs remain independent longer. This technology offers new ways to increase access to care while cutting costs and improving quality. Though in limited use today, these trends will elevate the use of telehealth across specialties, as policymakers work to eliminate barriers to telehealth and more organizations use the technology to improve care delivery.

Healthcare Costs for America’s Elderly

It’s clear that healthcare predictions show an increase in elderly populations as a burden on public finances and the care delivery network. We anticipate costs for long-term care will increase, along with social security payments, prescription drugs, and medical insurance costs. Long-term care for the disabled or frail will require a complex set of services from personal and in-home care assistance to assisted living, home health, and hospice. The Congressional Budget Office (CBO) reported expenditures for long-term care cost more than $120 billion in 2000. This rate is climbing at a rate of 2.6% annually to a predicted $270 billion in 2030. Added to this concerning mix is the fact that healthcare provider shortages are also looming in parallel to the aging baby boomer population.

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The American healthcare system is about to undergo the perfect storm of factors threatening the economy and our delivery networks. But the American Association of Retired Persons (AARP) has come out with a new position paper on telehealth as a tool to combat these trends and improve the quality of care for future elderly populations.

Telehealth and Community Networks of Care

“Through telehealth, providers can deliver a wide range of diagnostic, therapeutic, and care management services, as well as services to support family caregivers, such as communication tools with clinicians – services that otherwise would be delivered in a health care setting or through in-person home visits. Telehealth has the potential to be an effective tool for improving access and continuity, improving outcomes, and lowering cost.”
AARP Public Policy Institute

The AARP suggests that elderly patients could benefit greatly from extending home-based telehealth care by offering:

Telehealth has a track record of improving outcomes for the elderly in a variety of settings. Remote monitoring tools can be used to help manage chronic healthcare issues in elderly patients. Monitoring weight, heart rate, blood pressure, or other important metrics can help detect problems before they become a crisis in an elderly patient. Geriatric patients can receive reminders and alerts or receive feedback from a remote healthcare provider from the comfort of their homes, without adding the discomfort and risk associated with travel for a frail patient.

Using the virtual visit in place of a home-based visit can reduce the cost of care for healthcare providers while easing the burdens of travel for patients with mobility issues. The virtual visit can help with self-monitoring and management skills allowing these patients more autonomy over their own lives; something AARP assures us is still important to their constituents.

Telehealth can also be extended to family caregivers to help educate them on how to manage their elderly loved one’s treatment. The AARP says that telehealth can extend a community network of care and caring that extends from clinical providers to caregivers and patients. They say, “By improving the continuity of care, home telehealth care reduce crises that may lead to hospitalization and lower the health care spending associated with unmet needs of care.”

AARP’s white paper lists several case studies of how telehealth is being used today to help elderly patients improve. Here are some examples:

  • Smart home remote monitoring tools can connect remote family caregivers with the elderly. Wearable devices can track everything from vital signs to physical mobility. Home monitoring tools could flag when an elderly person leaves the home, or use smoke and water leak sensors to detect if a stove or faucet have been forgotten. In-home cameras can alert caregivers to any unusual activity and lessen the number of trips necessary to provide care.
  • Palliative care can be provided via telehealth using video conferencing that links the patent with providers and their family members. It is in this way that telehealth can improve the continuity of care between primary and palliative care providers as well as caregivers.
  • Chronic disease management is currently positively impacted by telehealth. Acute-chronic diseases like diabetes can be positively impacted via remote conversations regarding their physical and psychological health. Remote monitor tools can share weight, glucose, and blood pressure, transmitting these details securely to clinicians for better long-term care management. Heart failure patients can conduct and transmit their daily weigh-ins while receiving counseling on nutrition and physical activity. Telehealth can be used to not only electronically submit health data, but ongoing patient education can occur. For example, virtual house calls can be conducted to discuss better and more proactive care of these ongoing health issues.
  • The mental and behavioral health of the elderly patient can be positively impacted with telehealth. Connecting with a virtual provider can keep the shut-in patient more connected with the world outside their door. Geriatric patients with mobility challenges can speak more regularly with a care provider without traveling to an office.

While these are some examples that the AARP suggests will improve the safety net for elderly patients in the coming years, it’s clear that there is an unprecedented opportunity to leverage telehealth technology to improve access to care for all patients – including the elderly.

OrthoLive offers a telehealth virtual service for orthopedic physicians. Our tool can help you manage the post-operative elderly hip or knee patient, providing ongoing wound care, patient counseling, and monitoring of patient recovery.

Contact us today to find out more.

Topics: "telehealth", "telemedicine", patient engagement, technology, elderly, doctor-patient relationship, AARP

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