Home health technologies will have an increasingly larger role to play in healthcare delivery as the silver tsunami of the aging population strain the system. And if more consumers embrace preventative care that can easily be done in the home.

It's important to understand that home health technologies are leveraged in home health settings by clinicians for home health patients, and at-home or home-based health technologies are diagnostic and/or screening tools that can be used in non-clinical settings for the purpose of understanding overall health conditions.

Home-based health technologies are any preventive care technology tool that elevates health. This includes tools like blood pressure cuffs, weight scales, thermometers and other screening tools that can be used to gauge a biometric value.

It also includes tools such as telehealth platforms that facilitate communication between physicians and patients, smartwatches that track heart rate, and other technologies used to manage chronic disease such as respirators and CPAP devices or other remote monitoring devices. In the past, many of these innovations were limited in coverage and use to Medicare seniors.

Today they’re used much more broadly. One big reason for this is the availability of smart capabilities such as Bluetooth enablement (for example, Bluetooth-enabled digital scales or a digital glucometer that can measure total cholesterol, glucose and triglycerides, and transmit this information into a personal health record).

"The greater value in smarter tools is that they can alert the individual or their physician to potential health issues," said Travis Rush, CEO of Reperio, a vendor of at-home biometric screening technologies. "One of the most obvious and tangible examples of this is technology that detects elevated blood-glucose levels, a red flag for prediabetes or diabetes.

"Since one in four young adults have diabetes but don’t know it until they end up in the hospital in an emergency, having this kind of capability within a tool is amazing," he continued. "Also, because hospitals are often so short-staffed, they sometimes can’t accept patients right away."

Healthcare IT News sat down with Rush for a discussion of these home health issues and technologies.

Q. You suggest healthcare provider organization leaders need to rethink healthcare delivery for 2023 by looking at home health technology advancements. Why?

A. The de-facto healthcare delivery system that we rely on today is predicated on outdated norms and assumptions. For example, just because every individual with insurance is offered an annual wellness exam as part of their benefits does not mean that every individual takes advantage of that offering.

In fact, fewer individuals than ever visit their primary care doctor on a regular basis – even if they have insurance.

That might not seem like a big deal, but the reality is that many Americans are struggling with chronic health conditions that go unmanaged or undetected. Current studies suggest 60% of Americans live with at least one chronic condition such as hypertension, which raises their risk for illness and preventable events like heart attacks.

But even more troubling, many Americans are unaware of their health status. For example, 96 million Americans are prediabetic, but 80% do not know they have the condition.

Compounding this issue is the physician shortage – Americans are having a harder time securing an appointment with a doctor than 10 years ago. To no fault of our existing and overworked healthcare workforce, many patients are left in limbo while waiting weeks for an appointment.

The resulting inconvenience is leading many seemingly healthy patients to skip an in-person visit unless they’re experiencing physical pain or obvious symptoms.

The confluence of all these trends is a call to action for all stakeholders. We need to reframe our collective mindset around preventive care. We need to embrace hybrid approaches to healthcare that benefit both patients and providers, such as a shift to telehealth for pre-operative consultations, or by using home-based health screening technologies as an alternative to traditional, in-person care.

Health metrics derived from at-home health screenings allow stakeholders to gain comprehensive insight into the overall health and well-being of their population and proactively mitigate costly chronic diseases.

In general, focusing on preventive care, rather than reactive care, is central to our physical and economic survival. Chronic diseases cost the U.S. an estimated $3.7 trillion per year, including lost economic productivity.

Q. What are a few of the most important advancements, and why are they important?

Several examples come to mind here.

One of the biggest advances in home-based technologies is the array of accessible mobile apps that anyone can download. The best ones, such as weight loss apps that enable users to “chat” with a health coach, are engaging and effective – and can be a critical tool for high-risk individuals to take the steps they need to prevent disease.

In terms of home-based screenings, the ability to measure blood glucose and cholesterol in the home, and then process those blood samples on the spot with a glucometer, is remarkable. While a doctor’s office can oversee a screening, results often take days or weeks to process.

The most advanced at-home screenings can produce results and recommendations in less than an hour. Having actionable insights is critical to engage individuals that may otherwise be in the dark about their health status.

Health problems such as high cholesterol or high blood-glucose – two risk factors for more serious conditions like heart disease or diabetes – aren’t always obvious. Patients may skip their annual wellness visit if they feel fine, because going to an appointment or blood-draw lab is inconvenient. By empowering patients to do a test when it’s convenient for them, they’re more likely to engage.

Bluetooth capabilities also are a key advancement for home-based screening tools: Measuring data is great but measuring data that can be remotely transmitted to a hub where it can be processed and synthesized with other metrics (for example, baseline averages for height, weight, blood sugar) and deliver assessments and recommendations in real time is a next-level capability.

Q. How can home health technology advancements help ease the strain on EMS services?

A. Home-based screening tools can ease the strain on emergency services by raising awareness of health problems, such as elevated blood sugar, high blood pressure and obesity. These all are controllable risk factors for emergent care that an individual may not be aware of without a screening.

When individuals become aware of their real health risks, or burgeoning health issues, it’s often the wakeup call they need to get serious about improving their health. Maybe they need to take a closer look at their diet or exercise routine or maybe their problem is serious enough to warrant a discussion with their primary care physician about other interventions.

We only need to look into our recent past, in the first half of 2020, when emergency rooms were flooded, but more than one in four patients missed their preventive care appointments, largely because they didn’t want to risk exposure and sickness.

While that’s understandable, the drop in preventive care likely may have led to the spike in serious, but preventable, illnesses. For example, according to the American Association for Cancer Research, between March and December 2020, the U.S. saw an 11 percent increase in patients diagnosed with inoperable or metastatic cancer compared with the same period in 2019.

With that in mind, let’s reconsider a condition like diabetes. Studies suggest one in four individuals don’t know they have it. But if an individual undergoes a simple blood-glucose screening and is told that their elevated blood sugar levels mean they need further testing, that person is empowered with information: They can make the choice to see their doctor for further guidance or ignore the information.

Chances are they’ll choose to act on it. This small piece of information can save that individual from one or more emergent care encounters and ease the strain on overworked healthcare staff.

Q. How can home health technology advancements help organizations focus on proactive prevention?

A. This is an important question, as healthcare costs are rising fast, and seemingly uncontrollably, in many parts of the country.

One thing we should consider is how to leverage high tech when we’re not undergoing a health emergency. Innovative solutions we relied on during the height of the pandemic – like home-based medical equipment and telehealth.

In 2020, the pandemic forced healthcare leaders and organizations to implement multiple home-based innovations or tools. Not all of them were winners, but we can’t lose that mindset of embracing technologies to enhance healthcare and remove inequities that exist.

Ultimately, home-based health technologies can help organizations empower their workers to engage in preventive care, which can help them to avoid the higher costs of treatment down the line. It’s no secret that chronic health problems, including preventable conditions such as Type 2 diabetes, cost organizations a fortune, between productivity losses and absenteeism.

Encouraging patients to engage in, and improve, their own health starts with meeting them at their level. Most people want to improve their health, but they don’t want to use their paid time off for preventive care.

There’s no obvious immediate benefit to them for taking that action if they feel fine. We can nudge patients in the right direction by offering tools that are convenient and simple to engage with.

By arming our workers with the tools they need and want to prevent disease, we’re also demonstrating that we care about their health, and want to prevent disease.

Follow Bill's HIT coverage on LinkedIn: Bill Siwicki
Email the writer: bsiwicki@himss.org
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