Page 12 Telehealth and Remote Patient Monitoring RPM for Long Termand Post Acute Care A Primer and Provider Selection Guide 2013

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(e.g., diet, exercise), or self-management of chronic “snapshot” assessment obtained during an annual
conditions (e.g., biometric readings, medication physical examination. They may be able to detect
management). Informal caregivers will get objec- the early onset of disease and prescribe appropriate
tive assessment of their loved one’s ability to remain interventions (including preventive interventions),
independent and peace of mind when everything is and can monitor the efficacy of these interventions
fine. This reassurance will eliminate interrogation, objectively and longitudinally.
questioning and role reversal between the older
adult and their adult children and would increase Finally, access to the analysis of the same objec-
the social content of their communications. This tive data by all authorized stakeholders is expected
will improve the quality of life for both parties, as to improve the communication between them,
well as reduce unnecessary early institutionaliza- including the monitored individual (e.g., the aging
tion of older adults driven by the anxiety of their services provider and the adult child, when decid-
children. ing on the most appropriate care package for the
older adult) and enhance coordination.
When the older adult needs assistance in some of
his or her activities of daily living (ADLs) or instru- This paradigm exploits the technical capabilities of
i
iii
mental activities of daily living (IADLs) , profes- embedded sensing, ambient intelligence , interop-
ii
iv
sional caregivers accessing the reports will have an erability and interconnectivity between different
objective assessment of their actual needs and can devices in the home, as well as other information
determine the appropriate care package. They can and communication technologies, in automating
coordinate, dispatch and track the delivery of care continuous assessment, documentation and com-
and services to the monitored older adults via home munication. It enables a network of professional
care agencies (e.g., Meals on Wheels, bathing) if and informal caregivers to coordinate and deliver
they live in the community, or on-site direct care high-touch care when needed. The paradigm is
workers if they live in a continuum of care facility. expected to prolong and enhance the independence
of seniors, delay their transition to nursing facilities
Primary health care providers can perform an and thereby reduce the overall cost of care. 15
educated evaluation of the monitored older adult’s
health that is more objective based on trending Table 1 summarizes the technical capabilities of the
health data, and more comprehensive than the technology and the resulting value utility of this
paradigm for seniors, caregivers in their network
and payers.
i ADLs (Activities of Daily Living) include the ability to move from
one place to another, eat, bathe, toilet, and dress in addition to
the ability to control the bladder and bowels (Katz S, Ford AB,
Moskowitz RW. Studies of illness in the aged. The index of A.D.L.,
a standardized measure of biological and psychological function.
JAMA; 185:914-919).

ii IADLs (Instrumental Activities of Daily Living) include the ability iii A vision of the future where we are surrounded by electronic
to use transportation, shop for necessities, prepare meals, and environments that are sensitive and responsive to people.
perform house work (Fillenbaum GG. Screening the elderly: A brief
instrumental activities of daily living measure. Journal of American iv The ability of two or more systems or components to exchange
Geriatric Society. 33:698-706.). information and to use the information that has been exchanged.

Telehealth and Remote Patient Monitoring for Long-Term and Post-Acute Care:
A Primer and Provider Selection Guide 2013