How home telemedicine can improve communication with caregivers

Telehealth offers an ideal way to provide ongoing communication and care coordination for caregivers of patients with traumatic brain injury (TBI), a case study from the Department of Veterans Affairs illustrates, according to an article at Telemedicine and e-Health.

The article tells the story of a patient, Mr. S., who was seriously injured in a stateside motor vehicle accident in 2010. After months of hospitalization and rehabilitation, he was sent home to live with his parents, who served as his caregivers, with a home exercise plan.

It was difficult for Mr. S to travel back to the VA facility for follow-up appointments, so a care team made up of a physiatrist, a physical therapist and a licensed clinical social worker met regularly with him and his parents through video conferencing at their home.

The video visits helped the parents ensure that exercises were being done correctly, and allowed the care team to view the patient's home to address concerns about his transitions from bed to chair, to toilet, etc., by allowing them to see furniture placement, size of the doorway, availability of handrails and other factors.

The parents reported being satisfied with the telehealth arrangement and asked that it remain part of their son's treatment plan.

The article makes these recommendations for successful use of telehealth with TBI patients:

  • That a caregiver be present with the patient in the same room to provide any needed assistance
  • That an emergency plan be created including information about primary care physician and nearest hospital should there be any incident
  • The patient must have access to a secure and reliable Internet connection for a fluid and effective telehealth session to take place

The VA reported that it provided remote care to more than 690,000 veterans during fiscal year 2014, with about 55 percent of those veterans living in rural areas with limited access to VA facilities.

Researchers, led by John Fortney, Ph.D., of the University of Washington, found that telemedicine-based collaborative care is an effective means for providing psychotherapy to veterans in rural areas suffering from post-traumatic stress disorder.

An audit of the VA's Home Telehealth Program, however, found it had missed opportunities to expand enrollment, which could have delayed the need for long-term institutional care for approximately 59,000 additional veterans in FY2013.

To learn more:
- read the article