RAND pushes remote care to ease health system demand

Like so many others who follow healthcare, researchers at RAND believe home-based technology, such as remote monitoring devices and telemedicine, have great potential to rein in healthcare costs and lessen the strain on an overtaxed healthcare workforce. The problem is, there isn't enough evidence yet to prove that such technologies will have the intended effect.

"These new ideas are potentially very appealing. They move care out of costly institutions and into patients' homes," RAND senior scientist and managing director Soeren Mattke, told the Reuters. "But given that these are so new, they don't have a place in our traditional healthcare system."

RAND last week released a survey, commissioned by medical device manufacturer Royal Philips Electronics, of policymakers, healthcare providers, patient advocates and other stakeholders in six countries, discussing their needs and expectations for home health technology as the population ages and the incidence of chronic disease spreads. Of note, by 2014, China will have more people living with chronic diseases than the entire U.S. population.

"This is a global problem," Mattke said. "The world is literally running out of doctors and nurses." At a panel discussion in Washington, D.C., Mattke added, "Inaction is simply not an option," according to iHealthBeat.

RAND found that healthcare providers are concerned that home healthcare technologies don't integrate well with existing delivery structures, and see home-based as a threat to their livelihood if remote monitoring and consultation replace traditional office visits. Payers could help by reimbursing for remote services, but they haven't been shown a "clear business case" for doing so, Mattke said. "Removing these obstacles to the adoption of home healthcare tools is not a trivial task; it will require concerted efforts from many stakeholders."

To this end, the Home Care Technology Association of America, the National Association for Home Care and Hospice and the Visiting Nurses Association of America joined with Philips to send a letter to HHS Secretary Kathleen Sebelius and CMS Administrator Dr. Donald Berwick, calling on CMS to undertake a large-scale demonstration to determine if benefits the Department of Veterans Affairs has realized through home care can be replicated among Medicare and Medicaid populations.

"While the case is already compelling, further evidence is needed to show the powerful benefits of home healthcare when integrated with and supported by remote monitoring technologies. This is the missing link to propel adoption in Medicare and Medicaid, which provide the bulk of the nation's home care and serve the most vulnerable patients," the letter reads in part.

For more:
- have a look at this Reuters story
- see this iHealthBeat commentary
- download the complete RAND study
- read the letter to Sebelius and Berwick (.pdf)