Home hospital treatment: encouraging the development of telemedicine

Télémédecine | 21 Jun 2010
Although home hospital treatment institutions cannot deliver telemedicine services, they do have a major interest in encouraging the development of telemedicine, and of telemonitoring and teleconsultation in particular. 
As far as home hospital treatment is concerned, according to the white paper issued by the hospital-at-home organization (FNEHAD), telemedicine presents two major challenges. The first is "the deployment of telemonitoring in the homes of patients with chronic conditions (high blood pressure, post-transplant effects, diabetes, cardiac or respiratory insufficiency, etc), of women with high-risk pregnancies and of older people who are losing their independence". The second is to develop telemedicine services for certain specialties or in regions with low population densities, so that these services can be provided in the patient's home or in collective health institutions such as retirement homes".

Home hospital treatment and telemedicine: a productive relationship 

However, "telemedicine involves a doctor or midwife located some distance away, who is tasked with interpreting elements gathered remotely and provides diagnoses and therapies, generally within the framework of a teleconsultation. As such, home hospital treatment cannot deliver telemedicine services since its role is to provide care, and not to diagnose or prescribe". 
Nevertheless, the white paper states that the relationship between telemedicine and home hospital treatment could be extremely productive: “The development of telemedicine for certain pathologies and regions would allow patients to stay in their own homes or in residential care homes, by offering home hospital treatment and avoiding conventional hospitalization or a lack of any care at all". Furthermore, "some patients in receipt of home hospital treatment need a level of medical monitoring which, in the absence of telemedicine, requires them to travel or presents a risk of non-provision of treatment when the distance is too great". Finally, "home hospital treatment can be a component of telemedicine when the latter requires the assistance of paramedical personnel to install equipment safely or collect data to be interpreted by a doctor, or even to assist the patient during teleconsultations".

Two priority applications

The white paper emphasizes the advantages of this approach, encourages home hospital treatment stakeholders to get actively involved in its development, and advocates focusing on two types of application:
  • "Telemonitoring, which allows the monitoring of healthcare equipment (eg pumps), the gathering of data through sensors (telemetry) and the bringing together of measurements in a system capable of analyzing them and presenting them in such a way that they can be interpreted, particularly where pathology profiles and data history are concerned; this application should not be confused with tele-assistance or tele-alarm services, which are restricted to visual and telephone-based resources;
  • Teleconsultation, which allows a doctor to offer a diagnosis remotely by means of a high-quality sound and picture connection, telemetry equipment and access to the patient's file". 
Finally, the white paper highlights the need for vigilance on the part of home hospital treatment institutions with regard to some of the effects of telemedicine on patients. This is because it is necessary to support them to further the acceptance of technologies in the home, it also draws attention to home hospital treatment processes, and particularly the coordination of care.