Long-Term Care Goes Virtual

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ShutterstockSome systems allow seniors to record health information in an app then share it with family members and health care providers.
By Maryalene LaPonsie

Every morning, Marion Berg measures her blood pressure and heart rate and then uses a tablet to relay the results to her health care team. At 101 years old, the Sun City, Arizona, resident says the system is a change for her, but one she likes.

"Using a tablet is new to me, but my health care coach is helping me learn every week when she visits my home," Berg says.

Berg participates in the Banner iCare program, and her experience is one example of how long-term care plans are integrating technology as a way to reduce costs and improve quality of life.

How Long-Term Care Is Using Technology

Virtual long-term care services can vary significantly, and almost all programs can be used in combination with a home health aide or other home care.

%VIRTUAL-pullquote-We see this as an affordable way to extend [a caregiver's] budget.%"We see this as an affordable way to extend [a caregiver's] budget," says Danna Gomez, founder and co-owner of Managed Senior Care in Grand Rapids, Michigan. She notes that home health aides can cost an average of $21 an hour in her area. By using a remote monitoring system, a caregiver may be able to reduce the number of hours an aide needs to be in the house without sacrificing a senior's safety.

While technology-based care systems can be set up in many ways, they usually fall into one of three categories:

1. Independent-Use Systems. Some systems are used independently by families to record information that can then be shared with health care providers or used to keep other family members informed of a loved one's condition.

For example, eCaring is software that can be downloaded as an app and set up for independent use. Family caregivers or seniors themselves can enter information such as what they ate, what medications they took and how they are feeling.

"We needed to create something simple," says Robert Herzog, founder and CEO of eCaring, "so we invented language that uses symbols for caregivers to enter information about a patient."

Authorized family members or health care professionals can access the information, and customized alerts can be sent to notify a caregiver of potential safety concerns, such as when meals are skipped or a blood glucose reading is too high.

2. Virtual Reporting Systems to Complement Home Health Care. This category of care combines some level of virtual monitoring with traditional home health care visits. Deborah Dahl, vice president of patient care innovation for the health care nonprofit Banner Health, says Banner iCare uses this type of delivery system to keep seniors at-home and healthy.

"We are focused on the chronic, complex patient population who have five or more conditions," Dahl says. "Our objective is to keep them living at home."

To do that, Banner iCare uses a number of tools. The program may set patients up with a Philips Lifeline system, so they can easily call for help, and Samsung tablets are typically installed in each patient's home. Through the tablet, vital statistics such as blood pressure, heart rate, weight and other data can be transmitted to health providers. Two-way video conversations may be also be used to gauge how a person is doing that particular day. While the technology does the daily monitoring, a home health aide may visit once a week to provide personal follow-ups as needed.

3. Twenty-Four Hour Remote Monitoring. For those who want to maximize their peace of mind, Gomez says the Cadillac of virtual long-term care is a remote-monitoring system like that offered by grandCARE.

With this system, activity sensors are placed in a senior's home. To use grandCARE, Managed Senior Care first evaluates what a typical "good day" looks like for a senior and sets alerts accordingly. For example, if a senior typically has breakfast by 9 a.m. and the refrigerator hasn't been opened by that time, an alert may go out to a caregiver.

As with Banner iCare, seniors using the grandCARE system are set up with a tablet. In this case, it's an oversized tablet that can be remotely activated. If a caregiver needs to check on a senior, he or she can open Skype which will activate the camera and microphone on the tablet. At that point, the caregiver can look for the senior and call out to him or her to determine whether help is needed.

"One of the reasons we like this product is because it's respectful of the senior," Gomez says. "You know when people are watching. There is no secret monitoring."

Benefits of Virtual Care Services

Both Herzog and Dahl say data show virtual care services are having an impact, both in terms of cost savings and patient outcomes.

"We save over $4,000 per patient per year and avoid hospital visits and readmissions," Herzog says. From 2013 to 2014, Banner Health tracked the outcomes of newly enrolled iBanner members and compared that to claims data from the year before their enrollment. They found the program resulted in an overall 27 percent cost savings of $788 a month for each patient. Hospitalizations also dropped to 6.3 per 100 patients per month six months after enrollment from 11.5 per 100 patients per month in the year prior to enrollment.

While virtual care and remote monitoring systems may never be appropriate for people who require intensive hands-on help, health care professionals say these systems are making a significant impact on the lives of many seniors.

"We feel really good that we're keeping people out of the hospital every week," Herzog says.
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