Chronic obstructive pulmonary disease
(COPD) and heart failure (HF) exert tremendous pressure on individuals and
community healthcare system throughout the world. In Canada, highest numbers of
deaths are caused by COPD and nearly half a million Canadians are affected by
HF. These chronic diseases are responsible for very high number of avoidable
hospitalizations and extended medical expenditure. Telehomecare is a highly
potent tool to reduce incidents of avoidable hospitalization, improve quality
of life, and enhance access of people with COPD and HF to health care. Chronic
diseases such as diabetes, cancer, COPD, and others, are these kind of diseases
that are accompanying a person throughout their life. When a person is
diagnosed with any kind of chronic disease, he/she is facing with a new
situation that challenges their coping methods, and therefore causing them to
constantly seek for medical support. In today’s world, specifically focusing in
Canada, inadequate chronic conditions management do not only impact the
chronically ill patient’s quality of care but also plays an important role in
the way health care is delivered for all Canadians. As stated in CIHI “Health
Care Cost Drivers: The Facts” report, “Survey data shows a stronger correlation
between the presence of multiple chronic diseases and higher utilization of
health services than between age and utilization.” (2011, pg.16).
To put it differently, chronic ill
patient will tend to utilize health care resources more frequently than others,
which in other words means increased cost in health care for both clients and
the government. This paper will emphasis on how a chronic disease such as
chronic obstructive pulmonary disease for example, can be more self-manageable,
reduce ER visits and be more cost effective for both patients and health care
providers. A program in Ontario called OTN Telehomecare may be the future
solution for improving chronic diseases management across Canada. The
telehomecare program, which uses technology methods to deliver the best care to
a client with a Chronic disease, at home rather than in health care facilities.
Giving the opportunity to patients to educate themselves about their chronic
illness, allow them to learn how to monitor their vital signs, and mostly give
them more independence can lead to greater health outcome in chronic disease
management.
The Ontario Telemedicine Network
(OTN) launched the largest Telehomecare program in Canada in 2007. The program
was launched with 800 COPD and HF patients. In 2012 the program was expanded to
three local health integration networks (LHIN) in North East, Toronto Central,
and Central West. Till July 2015, 6,334 patients with COPD and HF in these
LHINs have been referred to this program. The second phase of expansion
involving more LHINs is now taking place. Each LHIN is entrusted with
Telehomecare program planning and implementation and has one Community Care
Access Centre (CCAC) or hospital through which the Telehomecare program can be
accessed at the community level (Brown, 2013).
The twin goals of Telehomecare are to
impart self-monitoring skills of treatment to patients with COPD and HF, and to
improve treatment monitoring of such patients by remote health care
system. The different segments of
Telehomecare are; i) informal telephonic interaction between patient or
caregiver and a designated Telehomecare nurse, ii) daily updating of patient
data, e.g. blood pressure, sugar level, oxygen level, etc. along with
answers to questionnaire to a designated Telehomecare nurse, iii) individual
care if the data are on the wrong-side of the range, iv) communication
regarding patient’s health condition between Telehomecare nurse and other
member of the care.
Canada’s chronic health care system
is immensely pressurized due to wide prevalence of chronic obstructive
pulmonary disease (COPD) and heart failure (HF). This results in avoidable
hospitalization and unreasonable medical expenditure. Patients with such
chronic diseases also require to be monitored as a continuous process and
medicines administered accordingly.
Telehomecare has the potential to reduce number of avoidable
hospitalization and medical expenditure as well. It has been seen that patients
with COPD or HF can be more closely
monitored and the healthcare system can work more productively
when patients are brought under remote controlled health monitoring system.
However there are certain issues with
Telehomecare that need to be addressed. Studies show that there seem to be no
improvement in number of hospitalization, number of days confined in hospitals,
self-management skill, and risk of death. Some studies have shown increased
mortality rate in patients under Telehomecare program. It has also been found
that there have been instances of reluctance or refusal from patients, caregivers,
Telehomecare nurses, and even physicians. Another important issue is cost and
reimbursement. Telehomecare needs expensive equipment and also that telephonic
consultations by physicians are not reimbursed.
( To learn about more about this paper please contact us at info@writers24hr.com )
No comments:
Post a Comment