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In 2016, has the Future of Home Care Technology been achieved?

Imagine the coordinated care scenario that includes…home care.  In July of 2012, The Future of Home Care Technology was published, based on interviews with 21 industry executives and a survey of 315 home care managers (including non-medical care, home health care, geriatric care managers, organizations and franchises) who represented 34,509 workers across multiple states. And as market research reports tend to do, this one tries to predict the future use of technology.  It s worth a look back, both to re-read a much-downloaded report and place it in 2016 context of actions, announcements, and industry change.

A futuristic scenario was described – what system supports this? An 85-year-old woman living alone, Mrs. Smith, faints outside and is taken by ambulance to the hospital. The admission staffer scans a card she carries – it accesses a Home Care Information Network (HCIN). The card reveals her health status, plus contact information for her most recent home care agency and the visit history. Her in-hospital Care Coordinator, Ann, takes charge of Mrs. Smith, and a future home care plan is initiated. While in the hospital, Ann arranges for meal delivery, supplies, and a home care post-hospitalization visit. Using the information from the HCIN, long-distance family members are invited to participate in video meetings during her stay. Once Mrs. Smith is home, responsibility for her care is smoothly transferred to the Home Care Coordinator that will continue to oversee her care, ensuring that home health services are begun, visits are scheduled, and vital signs are taken. Mrs. Smith is eventually transitioned to non-medical home care visits.

The organization names and some rules were changed.  Many changes have happened in four years. In the context of 2012, the report noted that for home care, “there is no nationwide regulation or documented expectation about what care should be offered, its standard of care, or who will monitor its quality and delivery.” Four years later, what has changed besides the names of organizations? NPDA (private duty home care) became HCAOA, NAPGCM (geriatric care managers) became the Aging Life Care Association.  In 2015, the Department of Labor enacted the Home Care Final Rule, giving minimum wage and overtime protection to 2 million workers. And home health providers received approval to provide more types of care. What else?

Home care is beginning to be 'tech-enabled' – does it mean the future is here?  From last year's "Hometeam announcement: Hometeam provides an iPad for each home with an app that the caregiver uses to track care and communicate with the family via texts, pictures and medical updates." Most recently, GrandPad and ComfortKeepers announced plans to provide "tablets specifically designed for seniors allow elderly individuals to stay connected; it also offers access to games, video chat features, and the opportunity to take part in photo sharing." Next, will home care be connected to the health care system?  Will health care providers, faced with readmission penalties, quality metrics and a growing frail population, make the Future of Home Care Technology happen? Comments welcome!


Home care technology will change out of necessity.  The biggest factor is the population.  The number of Americans over 80 will double in the next 20 years and at the same time available care givers will decrease.  So, the future of home care tech will include managing caregivers who serve multiple clients in a "neighborhood group" and monitoring capabilities backed up by call centers that check in on people when their aide is not there.

In the short term, the biggest change will be driven by the CMS value based purchasing programs that relate to post-acute care.  A growing percentage of post-acute care will not be "reimbursed" but instead will be paid for by the hospital (as part of ACOs and bundled payments).  As such, non-medical home care will become a critical part of the continuum of care and this will pave the path for interoperability between home care tech and health care tech.

All in all, the 2012 report was quite good!  Keep up the good work Laurie!

Happy that people are discussing the important topic of technology (IT) in home health. We need more innovation, research and capital invested into home health IT. Our patients are depending on us. Major changes are happening like value-based payment and HHA rating (CMS’s 5 Star Rating) based on patient experience and clinical outcomes. I think that home health IT solutions can truly help facilitate improving every aspect of this vital industry.  I have a few HH IT solutions that I am working on now with the plan of bringing them to the market. Great post! Be well. 

The AIP technology implementation situation seems dire, yet we seem willing to accept evolution as the solution. Any strategy for broad rapid deployment of AIP technologies that doesn’t include AIP care consumers armed with powerful information and communication technology (ICT) tools that enable them to participate in organizing, controlling, and collaborating in their own in-home and other personal AIP care services probably needs forward looking revision.

Certainly some large healthcare organizations and in-home care firms are now able to vertically channel through the AIP care ecosystem. They don’t expect to survive long without better integration.  In general, complete cost effective AIP care solutions are very hard to come by.

We need simple ICT tools now to enable the AIP technology processes that depend upon having and using digital data in their work flows.  That is just about everything and most of that we now consider as AIP ‘technology’. ICT is lacking, lagging, and essential for AIP care ecosystem.

We must have: 1) Personal information control systems that have personal medical information control as a one core function, 2) Collaborative communication services configured to support all AIP work/process flows (see Technology for Aging in Place 2015 Market Overview, page 9, figure 4) and that are safe, secure and private, 3) Tools for integrating and organizing end-to-end solutions.

These basic AIP technology foundation blocks are missing now.  Some think this is not even possible, they must be wrong.  We need this basic ICT foothold so that AIP care consumers can pull technology into the AIP ecosystem.