A LeadingAge CAST Report
TELEHEALTH AND REMOTE
PATIENT MONITORING
FOR LONG-TERM AND
POST-ACUTE CARE
A Primer and Provider Selection Guide
2013
TELEHEALTH AND REMOTE PATIENT MONITORING
FOR LONG-TERM AND POST-ACUTE CARE:
A Primer and Provider Selection Guide
2013
A program of LeadingAge
2519 Connecticut Ave., NW
Washington, DC 20008-1520
Phone 202-508-9438
Fax 202-783-2255
© Copyright 2013 LeadingAge
LeadingAge Center for Aging Services Technologies:
The LeadingAge Center for Aging Services Technologies (CAST) is focused on development, evaluation and
adoption of emerging technologies that will transform the aging experience. As an international coalition of more
than 400 technology companies, aging-services organizations, businesses, research universities and government
representatives, CAST works under the auspices of LeadingAge, an association of 6,000 not-for-profit organizations
dedicated to expanding the world of possibilities for aging.
Table of Contents
1
Purpose of Whitepaper and Executive Summary
1
1.1
Purpose of Whitepaper
1
1.2
Executive Summary
1
1.3
Disclaimer
2
2
Definitions
2
2.1
Information and Communication Technology (ICT) Infrastructure
2
2.2
Electronic Documentation Technologies
2
2.2.1 Electronic Health Record (EHR)
2
2.2.2 Electronic Medical Record (EMR)
2
2.2.3 Personal Health Records (PHR)
2
2.2.4 Health Information Technology (HIT)
3
2.2.5 Electronic Point of Care (POC)/Point of Service (POS) Documentation Systems
3
2.3
Safety Technologies
3
2.4
Health and Wellness Technologies
4
2.4.1 Telehealth, Remote Patient Monitoring (RPM) and Telemedicine
4
2.4.2 Telecare/Telemonitoring/Behavioral Monitoring capabilities
5
2.5
Clinical Decision Support Systems
5
2.6
Social Connectedness Technologies
6
3
Vision of Technology-Enabled Care and Continuum of Monitoring
6
3.1
Vision for Technology-Enabled Care
6
3.2
Continuum of Monitoring Technologies and their Value
9
3.2.1 Safety Monitoring Technologies
9
3.2.2 Health and Wellness Monitoring Technologies
9
3.2.3 Scope and Focus
9
4
Potential Uses of Telehealth and RPM
10
4.1
Patient Education and Self-Management
10
4.2
Pre- and Post-Acute Management of Chronic Conditions
10
4.3
Post-Acute Patient Stabilization
11
4.4
Long-Distance Routine Check-Ups/Treatment
11
4.5
Specific Teleconsult
11
5
Benefits of Telehealth and RPM
12
5.1
Health Outcomes/Improved Management
12
5.2
Reduction in Hospitalizations and Hospital Readmissions
12
5.3
Patient Self-Efficacy, Quality of Life and Satisfaction
13
5.4
Physician Engagement Key to Success
14
5.5
Caregivers’ Workload and Efficiencies
15
5.6
Reduced Risk and Liability
15
6
Potential LTPAC Provider Business Models
16
6.1
Medicare Coverage
16
6.1.1 Medicare Reimbursement of Home Telehealth
16
6.2
Medicaid Coverage
17
6.3
Private Health Insurance Coverage
18
6.4
Medicaid Waiver Coverage
19
6.5
Potential Affordable Care Act (ACA) Related Opportunities
19
6.6
Private Pay
20
6.7
Standard of Care and Other Payment Sources
20
6.8
Return on Investment (ROI) of Telehealth and RPM
21
6.8.1 ROI to Patients and/or their Families
21
6.8.2 ROI to Payers
21
6.8.3 ROI to Care Provider
22
6.8.4 Online ROI Calculator for RPM
23
7
Planning for Telehealth and RPM Solutions
24
7.1
Visioning and Strategic Planning
24
7.2
Organizational Readiness Assessment
27
7.2.1 Staff Competencies
28
7.2.2 IT Infrastructure
29
7.2.3 Operating Environment
30
7.3
Operational Planning
30
7.3.1 Project Team
30
7.3.2 Goal Setting
30
7.3.3 Program Design
31
7.4
Technology Review and Selection
32
8
Telehealth and RPM Selection Matrix Components
32
9
Acknowledgement of Contributors
36
9.1
Contributing Writers
36
9.2
Workgroup Members
36
9.3
Participating Telehealth and RPM Vendors
37
10
References and Resources
38
11
The Telehealth and RPM Selection Matrix
42
1
delivery models, position them well for strategic
1
Purpose of Whitepaper
partnerships, meet the needs of older adults and
and Executive Summary
prepare them for the future.
1.1
Purpose of Whitepaper
Te purpose of this paper is to aid LeadingAge and
1.2
Executive Summary
CAST members, long-term and post-acute care
Tis paper begins with definitions to help the
(LTPAC) providers, and other aging services orga-
reader understand the terms used throughout
nizations in understanding telehealth and remote
the whitepaper and then delves into the vision
patient monitoring (RPM) technologies, their uses
of technology-enabled care and the continuum
and their benefits. Te paper also includes a Selec-
of monitoring. Te whitepaper then provides an
tion Matrix of a number of telehealth and RPM
explanation of the potential uses of telehealth and
solutions that will help providers select solutions
RPM including patient education and self-manage-
that best fit their requirements.
ment, pre- and post-acute management of chronic
Case studies were collected highlighting provid-
conditions, post-acute patient stabilization, long-
ers’ impacts and benefits of telehealth and RPM on
distance routine check-ups/treatment and specific
health outcomes (blood pressure, blood glucose,
teleconsults.
etc.), staff efficiencies, quality of life/satisfaction with
A review of evidence of the benefits of telehealth
care, hospitalizations and hospital readmissions,
and RPM, including improved health outcomes and
and/or cost of care and return on investment (ROI)
reduction in hospitalizations and hospital readmis-
to providers, payers, and/or consumers. Tese case
sions, is provided in section 5. Potential LTPAC
studies will be published separately approximately
provider business models including Medicare,
one month afer the release of this paper.
Medicaid, Medicaid Waiver, and private insurance
Tis whitepaper is available in a PDF format as a
coverage are explained in section 6. In addition, this
living document with links. CAST plans to update
section provides an overview of potential Afford-
the Telehealth and RPM Selection Matrix annually.
able Care Act (ACA)-related opportunities. Finally,
Finally, the Telehealth and RPM Selection Matrix
this section concludes with a discussion about
will be used to create CAST’s online Selection Tool
return on investment (ROI) for telehealth and RPM
to simplify and facilitate the process of selecting a
and provides a link to an online ROI calculator.
telehealth and RPM solution for LTPAC providers;
Section 7 reviews the planning process for tele-
the online tool will be updated as needed.
health and RPM solutions to help organizations
Tis whitepaper and the companion Telehealth and
prepare through visioning and strategic planning,
RPM Selection Matrix, online Selection Tool and
looking at organizational readiness, operational
case studies, represent a continuation of CAST’s
planning, and technology review and selection.
efforts to produce hands-on tools that help LTPAC
Te whitepaper concludes with a description of the
providers adopt appropriate aging services tech-
components of the Telehealth and RPM Selection
nologies that enable them to deliver innovative care
Telehealth and Remote Patient Monitoring for Long-Term and Post-Acute Care:
A Primer and Provider Selection Guide 2013
2
Matrix, which is included in section 8. Informa-
2
Definitions
tion from the Telehealth and RPM Selection Matrix
will be available as an online Telehealth and RPM
2.1
Information and Communication
Selection Tool to help LTPAC organizations narrow
Technology (ICT) Infrastructure
their selections to a manageable list of products that
meet their business line, care applicability needs
Information and Communication Technology
and essential requirements, based on their answers
(ICT) Infrastructure includes high-speed Internet
to key questions.
connectivity, wired/wireless networks (switches,
routers, repeaters), servers, laptop/desktop comput-
ers, cloud-based information systems, mobile com-
1.3
Disclaimer
munications device, etc.
Te information included in this paper is meant
to assist care providers in the understanding and
2.2
Electronic Documentation
selection of telehealth and remote patient monitor-
Technologies
ing (RPM) solutions, but cannot possibly include all
systems that may be available. Products mentioned
Electronic documentation technologies are mainly
in this paper serve as illustrative examples. Infor-
aimed at health care professionals and professional
mation about the functionalities and capabilities for
caregivers such as electronic health records (EHR),
this effort were provided by participating vendors
point of care (POC), point of services (POS) sys-
of telehealth and RPM solutions. A few telehealth
tems, electronic prescribing (ePrescribing), elec-
and RPM vendors chose not to participate. Func-
tronic medication administration records (eMAR),
tionalities and capabilities of listed telehealth and
electronic charting and electronic workflow and
RPM products have not been verified, tested, in-
documentation systems. Some EHR systems offer
dependently evaluated or endorsed by LeadingAge
the individual and/or an authorized family member
or LeadingAge CAST. Please use this as general
access to health information on a patient portal or a
guidelines in understanding functionalities and
personal health record (PHR).
examples of current telehealth and RPM systems.
Te Telehealth and RPM Selection Matrix may help
2.2.1
Electronic Health Record (EHR)
providers identify potential telehealth and RPM
solutions that may meet their requirements, and
An EHR is a longitudinal electronic record of pa-
is intended to help them target vendors to submit
tient health information generated by one or more
a Request for Proposal (RFP). Where appropriate,
encounters in any care delivery setting. Included
provider case studies were identified and published
in this information are patient demographics,
separately. However, providers are strongly advised
progress notes, problems, medications, vital signs,
to verify functionalities of the telehealth and RPM
past medical history, immunizations, laboratory
solutions prior to final selection through demon-
data and radiology reports. Te EHR automates
strations, site visits, reference checking and other
and streamlines the clinician’s workflow. Te EHR
due diligence steps.
has the ability to generate a complete record of a
LeadingAge Center for Aging Services Technologies (CAST)
3
clinical patient encounter - as well as supporting
it contains. It is not a legal record unless so defined
other care-related activities directly or indirectly via
and is subject to various legal limitations.4 Some
interface - including evidence-based decision sup-
EHRs offer patients/consumers the ability to view
port, quality management, and outcomes report-
their records through web portals or the ability to
ing.1
export data to a PHR.
2.2.2
Electronic Medical Record (EMR)
2.2.4
Health Information Technology (HIT)
An EMR is an electronic record of health-related
HIT encompasses a broad array of technologies
information on an individual that can be created,
involved in managing and sharing patient informa-
gathered, managed and consulted by authorized
tion electronically, rather than through paper re-
clinicians and staff within a single health care orga-
cords. HIT performs information processing using
nization.2
both computer hardware and sofware for the entry,
storage, retrieval, sharing, and use of health care
An EMR is an application environment composed
information.5 EHR, EMR and PHR are examples of
of the clinical data repository, clinical decision sup-
HIT.
port, controlled medical vocabulary, order entry,
computerized provider order entry (CPOE), phar-
2.2.5
Electronic Point of Care (POC)/Point of
macy, and clinical documentation applications. Tis
Service (POS) Documentation Systems
environment supports the patient’s EMR across
inpatient and outpatient environments, and is used
Electronic point of care (POC)/point of service
by health care practitioners to document, moni-
(POS) documentation systems allow the nurse, phy-
tor, and manage health care delivery within a care
sician, aide, or other provider to enter information
delivery organization (CDO). Te data in the EMR
into an electronic record during or immediately
is the legal record of what happened to the patient
afer visits with clients/residents (e.g., kiosks, tablet
during their encounter at the CDO and is owned by
computers, hand-held devices, etc.).
the CDO.3
2.2.3
Personal Health Records (PHR)
2.3
Safety Technologies
A PHR is a universally accessible, layperson-com-
Safety technologies include technologies for
prehensible, lifelong tool for managing relevant
emergency call and personal emergency response
health information, promoting health maintenance
systems (PERS), fall detection and prevention
and assisting with chronic disease management via
technologies (bed and chair alarms), environmental
an interactive, common data set of electronic health
monitoring (temperature, carbon monoxide, flood,
information and e-health tools. Te PHR is owned,
smoke and fire alarms), access control, wander
managed, and shared by the individual or his or her
management, unattended stove shut-off systems
legal proxy(s) and must be secure to protect the pri-
and the like.
vacy and confidentiality of the health information
Telehealth and Remote Patient Monitoring for Long-Term and Post-Acute Care:
A Primer and Provider Selection Guide 2013
4
include both clinical services (e.g., teleradiology in
2.4
Health and Wellness Technologies
which test results are forwarded to another facil-
Health and wellness technologies include health
ity for diagnosis; home monitoring to supplement
promotion technologies, behavioral and health sta-
home visits from nursing professionals) as well as
tus monitoring systems, telehealth and telemedicine
non-clinical services (e.g., continuing professional
systems, and medication management technologies,
education, including presentations by specialists to
which focus on the physical health and wellness of
general practitioners).8
seniors. In addition, cognitive assessment technolo-
Tere are two primary modes of delivering tele-
gies, reminder systems and cognitive monitoring,
health:
and stimulation technologies, which focus on the
mental health and wellness of seniors, are also clas-
2.4.1.1.1 Store-and-Forward (Asynchronous):
sified under this category. Finally, these technolo-
gies include physical exercise and rehabilitation
In store-and-forward telehealth, clinical informa-
technologies.
tion (e.g., data, images, sound, video) is captured
locally, then temporarily stored for transfer at a
2.4.1
Telehealth, Remote Patient Monitoring
later time as encrypted e-mail or messages using
(RPM) and Telemedicine
specially-designed store-and-forward communica-
tions modems and sofware, to a secure web server
Telehealth, remote patient monitoring (RPM) and
or EHR, either via phone lines or high-speed inter-
telemedicine capabilities are defined as the use of
net connection (including DSL, ADSL, cable, fiber-
electronic communication and information tech-
optic or cellular modems). Te consulting provider
nologies to allow interaction between providers and
then reviews the stored data and makes diagnosis,
patients in different locations (e.g., wound consul-
treatment, and planning recommendations.9
tation by a physician at an offsite location using
audiovisual equipment, monitoring blood pressure,
2.4.1.1.2 Real-Time Interactive Systems
etc.).
(Synchronous):
2.4.1.1 Telehealth
Real-time telehealth sessions are live and interac-
tive, and frequently use videoconferencing tech-
Telehealth can be defined broadly as the use of
nologies. Ofen, special instruments such as a video
electronic information and telecommunications
otoscope (to examine the ear) or an electronic
technologies to provide access to health assessment,
stethoscope are operated by a nurse or technician
diagnosis, intervention, consultation, supervision
at the consulting provider’s direction to remotely
information and education across a distance.6, 7
perform a physical examination.9 Or, real-time
Telehealth technologies include telephones, fac-
communication may be a patient and a nurse prac-
simile machines, electronic mail systems, video-
titioner consulting with a specialist via a live audio/
conferencing, and RPM devices, which are used
video link, or a physician and a patient in an exam
to collect and transmit data for monitoring and
room communicating through an interpreter who
interpretation. Common applications of telehealth
is connected by phone or webcam.
LeadingAge Center for Aging Services Technologies (CAST)
5
2.4.1.2 Remote Patient Monitoring
another via electronic communications to improve
a patient’s clinical health status.” Two-way video,
Remote patient monitoring (RPM) is a type of
email, smartphones, and wireless tools are examples
home telehealth that enables patient monitoring
of a growing variety of telemedicine applications
as well as transfer of patient health data to a health
and services.12 While the terms “telehealth” and
care provider. To capture data, these technolo-
“telemedicine” are ofen used interchangeably,
gies use a variety of wired or wireless peripheral
telemedicine can be more narrowly defined to
measurement devices such as blood pressure cuffs,
mean the delivery of remote clinical services using
scales, and pulse oximetry, and they are most ofen
technology. Examples of telemedicine include a
used afer a hospital discharge or between routine
physician’s review of a patient’s digital images (i.e.
office visits. Some technologies also permit video
x-rays, CT scans, MRI) via a computer, a physician
interaction/chat between the patient and health
consult done via a web conference, or telephar-
care professional in real-time. Tese systems can
macy whereby pharmacy technicians can prepare
prompt users to enter answers to targeted questions,
prescriptions under the supervision of a qualified
and then use this information for data interpreta-
pharmacist remotely.
tion, provision of educational materials, as well as
instructions such as scheduling an office visit or
2.4.2
Telecare/Telemonitoring/Behavioral
going to the nearest emergency room. Similarly,
Monitoring capabilities
these systems can transmit user-entered data, store
the data in secure records systems accessible to
Telecare/telemonitoring/behavioral monitoring
clinicians, flag abnormal readings or responses,
capabilities technologies include sensors to monitor
and alert clinicians to abnormalities via e-mail or
functional abilities, activities of daily living, behav-
text messages. In response to these alerts, clinicians
iors, sleep patterns etc.
can log into the system, review data, follow up with
patients, or take other appropriate actions. Some
2.5
Clinical Decision Support Systems
systems have the capacity to connect patients with
additional resources such as PHR or EMR, targeted
Clinical decision support (CDS) systems provide
educational materials, interactive self-care tools,
clinicians, staff, patients or other individuals with
medication optimization technologies, and health
knowledge and person-specific information, intel-
care providers.10 Although applications of RPM
ligently filtered or presented at appropriate times, to
technologies are ofen used in the home setting,
enhance health and health care. CDS encompasses
these technologies have been pilot-tested in con-
a variety of tools to enhance decision-making in
gregate settings such as community-based senior
the clinical workflow. Tese tools include com-
centers.11
puterized alerts and reminders to care providers
and patients; clinical guidelines; condition-specific
2.4.1.3 Telemedicine
order sets; focused patient data reports and summa-
ries; documentation templates; diagnostic support,
Formally defined, telemedicine is the “use of
and contextually relevant reference information,
medical information exchanged from one site to
among other tools.13 CDS systems offer sophisti-
Telehealth and Remote Patient Monitoring for Long-Term and Post-Acute Care:
A Primer and Provider Selection Guide 2013
6
cated functions that provide decision support to as
of an older adult can be monitored in his or her
a functionality of broader HIT systems including
own living setting through sensors embedded in the
EMRs, EHRs, health information exchange (HIE),
environment or other objects, wearable monitoring
and telehealth.
technologies, telehealth devices, and other tech-
nologies. Te environment is the place the older
adult calls home and it may be the person’s house or
2.6
Social Connectedness Technologies
apartment in the community, or a residence pro-
vided by an aging services provider—a continuing
Social connectedness technologies include spe-
care retirement community, an independent living
cial phones (amplified, large-button, and memory
apartment, assisted living or even a skilled nursing
phones) and easy to use/simplified cell phones,
facility. Safety, activity, physiological, health and
which may offer, in addition to basic communica-
socialization data can be analyzed, archived and
tion functionality, different communication mo-
mined to detect indicators of early disease onset,
dalities such as video reminders and multimedia
deterioration or improvement in health conditions
messaging to keep seniors connected with family
at various levels. Te care delivery diagram in Fig-
and friends. Senior-friendly social networking
ure 1 illustrates the process.
websites, easy to use email systems, e-mail-to-paper
communications systems, easy to use video phones
Figure 1. Model for the Technology-Enabled
Geriatric Care Paradigm.
and video conferencing systems also fall into this
category. Some of the computer-based cognitive
and/or physical stimulation technologies may also
provide an opportunity to connect with peers par-
ticularly in congregate living settings.
3
Vision of Technology-
Enabled Care and Continuum
of Monitoring
Data analysis results, at various levels, can be made
3.1
Vision for Technology-Enabled Care
available to all stakeholders in the care process,
including the monitored older adults, their profes-
Te use of information technologies in the care
sional caregivers, informal caregivers and primary
environment is perceived by care professionals to
health care providers, and integrated into an EMR
have added value on the levels of administration,
or PHR accessible to authorized caregivers when-
integration of services, care quality, and profes-
ever they need them.
sionalism.14 It can be argued that a new paradigm
for technology-enabled geriatric care can emerge
Te monitored individual can use the analysis
with more integrative technologies. For example,
results in personal wellness and health maintenance
the activities and selected physiological parameters
LeadingAge Center for Aging Services Technologies (CAST)
7
(e.g., diet, exercise), or self-management of chronic
“snapshot” assessment obtained during an annual
conditions (e.g., biometric readings, medication
physical examination. Tey 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. Tis reassurance will eliminate interrogation,
objectively and longitudinally.
questioning and role reversal between the older
Finally, access to the analysis of the same objec-
adult and their adult children and would increase
tive data by all authorized stakeholders is expected
the social content of their communications. Tis
to improve the communication between them,
will improve the quality of life for both parties, as
including the monitored individual (e.g., the aging
well as reduce unnecessary early institutionaliza-
services provider and the adult child, when decid-
tion of older adults driven by the anxiety of their
ing on the most appropriate care package for the
children.
older adult) and enhance coordination.
When the older adult needs assistance in some of
Tis paradigm exploits the technical capabilities of
his or her activities of daily living (ADLs)i or instru-
embedded sensing, ambient intelligenceiii, interop-
mental activities of daily living (IADLs)ii, profes-
erabilityiv and interconnectivity between different
sional caregivers accessing the reports will have an
devices in the home, as well as other information
objective assessment of their actual needs and can
and communication technologies, in automating
determine the appropriate care package. Tey can
continuous assessment, documentation and com-
coordinate, dispatch and track the delivery of care
munication. It enables a network of professional
and services to the monitored older adults via home
and informal caregivers to coordinate and deliver
care agencies (e.g., Meals on Wheels, bathing) if
high-touch care when needed. Te paradigm is
they live in the community, or on-site direct care
expected to prolong and enhance the independence
workers if they live in a continuum of care facility.
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
Table 1 summarizes the technical capabilities of the
health that is more objective based on trending
technology and the resulting value utility of this
health data, and more comprehensive than the
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).
iii A vision of the future where we are surrounded by electronic
ii IADLs (Instrumental Activities of Daily Living) include the ability
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
8
Table 1. Technical capabilities and potential value for the technology-enabled care paradigm for seniors
and caregivers in their network
Seniors
Informal
Professional Caregivers
Payers
Caregivers
Service Providers
Health Care
Professionals
Capability
Objective, up-to-
Objective, up-to-
Objective, up-to-
Objective, up-to-
Objective, up-to-
date assessment
date assessment
date assessment
date assessment
date assessment
of health,
of health,
of health,
of health,
of health,
functional abilities,
functional abilities,
functional abilities,
functional abilities,
functional abilities,
and care needs
and care needs of
and care needs of
and care needs of
and care needs of
their loved ones
seniors
seniors
seniors
Values
Health self-
Opportunity to
Identification of
Chronic disease
Enhanced quality
management
participate in the
services needed
management
of care
management of
Sense of security
the health and
Coordination of
Detection of early
Reduced care
care needs of their
services
disease onset
costs
Prolonged/
loved ones
enhanced
Dispatching
Early and
Improved
independence
Peace of mind
appropriate
preventive
customer
timely services as
interventions
satisfaction
Improved quality
Reduced care
needed
of life
burdens and
Monitoring efficacy
strains
Improved
of interventions
caregiver
Improved quality
efficiency
Improved
of life
efficiency
Reduced caregiver
workloads
Potential revenue
opportunities
Improved
customer
Improved
satisfaction
customer
satisfaction
Revenue
opportunity
LeadingAge Center for Aging Services Technologies (CAST)
9
creased caregiver efficiency, longitudinal data, peace
3.2
Continuum of Monitoring
of mind for informal/family caregivers and reduced
Technologies and their Value
informal caregiver burdens and strains.
Te continuum of technologies that enable this
vision of care includes safety monitoring, as well as
3.2.3
Scope and Focus
health and wellness monitoring technologies. Te
Tis CAST whitepaper focuses on telehealth and
latter covers telehealth, biometric RPM, medication
management/monitoring, and telecare/telemonitor-
biometric RPM only and does not cover safety
ing/behavioral monitoring.
monitoring, telecare/telemonitoring of activities/
behavioral telemonitoring, or medication manage-
ment/monitoring. CAST recognizes the importance
3.2.1
Safety Monitoring Technologies
of all these technologies and acknowledges that the
Safety monitoring technologies provide an en-
lines separating these categories of technology are
hanced sense of security, prolonged independence,
sometimes blurred because some telehealth and
improved quality of life and have the potential
RPM technology platforms may integrate with, or
for improved health outcomes for seniors. Tey
offer applications/functionalities, for safety, be-
provide peace of mind and reduce the strains of
havioral monitoring or medication management.
informal/family caregivers. Tese technologies also
CAST will consider dedicating whitepapers, selec-
have the potential to improve the quality of care
tion matrices and online selection tools to these
and reduce liability for care providers.
other categories of technology based on providers’
interest and demand for such tools. However, the
Finally, safety technologies have the potential to
selection matrix of telehealth and RPM products
improve care quality and reduce health care costs
will include information about these products’ abil-
for payers and society in general.
ity to interface to or integrate with safety moni-
toring, telecare and medication monitoring tech-
3.2.2
Health and Wellness Monitoring
nologies, as well as EHRs. Finally, the whitepaper
Technologies
and Telehealth and RPM Selection Matrix will be
followed with an online Selection Tool that facili-
Health and wellness technologies include health
tates and expedites the process of narrowing down
monitoring and promotion technologies, behavioral
potential solutions and identifying vendors to invite
and health status monitoring systems, telehealth,
to participate in a Request for Proposal (RFP), as
RPM and telemedicine systems, and medication
well as a set of provider case studies delineating the
management technologies, which focus on the physi-
benefits they experienced and the lessons learned
cal health and wellness of seniors, among others.
during the implementation of telehealth and RPM
Te anticipated value propositions these technolo-
solutions.
gies offer may include better health outcomes for
Tis whitepaper and the companion Telehealth and
seniors and reduced health care bills for payers.
RPM Selection Matrix, online Selection Tool and
Tese technologies may provide coordination of
case studies, represent a continuation of CAST’s
care, reduced professional caregiver workloads, in-
Telehealth and Remote Patient Monitoring for Long-Term and Post-Acute Care:
A Primer and Provider Selection Guide 2013
10
efforts to produce hands-on tools that help LTPAC
to it, so that they can make the appropriate inter-
providers adopt appropriate aging services tech-
ventions in a timely manner. With regular use of
nologies that enable them to deliver innovative care
telehealth and RPM solutions and the use of data,
delivery models, position them well for strategic
benchmarks can be established, and individuals can
partnerships and the future. Telehealth and RPM
trend and track their readings themselves, noting
technologies were the second enabling technology
when they are outside acceptable ranges.
identified in the CAST Strategic Scenario Plan-
When evaluating technology it is important to keep
in mind that what helps people learn most effective-
ly differs from one person to another. Some tech-
nologies offer visual, audible and video education to
help support different learning needs and abilities.
4
Potential Uses of
Telehealth and RPM
4.2
Pre- and Post-Acute Management
of Chronic Conditions
4.1
Patient Education and Self-
Management
Telehealth and RPM can provide a means for clini-
cians to collect vital signs and other data to fol-
Telehealth and RPM can be used as a tool to not
low patients between formal interactions with the
only reinforce disease specific education but also
health care system (physician office and hospital
help to instill some of the concepts required for
visits). Tis regular tracking of vitals and daily dis-
self-management, like the importance of taking
ease condition monitoring provides clinicians with
medications regularly as prescribed and implica-
an opportunity to perform early intervention, such
tions of lifestyle choices, such as smoking, diet and
as medication titration, that aim to improve chronic
exercise, on the individual’s vital signs and condi-
disease management by attending to exacerba-
tion in general. Te variety of educational materials
tions, avoiding the worsening of the condition and
and delivery options available differ with telehealth
preventing the disease from progressing, thereby
solutions. All patient education should consist
reducing unnecessary emergency department visits,
of evidence-based care materials, recommended
hospitalizations and associated costs. Similarly,
self-management best practices, and incorporate
telehealth and RPM can be effective in stabilizing,
chronic care management principles to assist in
following and managing individuals with chronic
providing consistent disease- or condition-specific
conditions afer an acute episode, e.g., emergency
education that promotes health, wellness, indepen-
department, hospital or physician visit, and can
dence and safety in the home.
help shorten hospital stays. Telehealth and RPM
can be used afer hospital discharge to reinforce the
In addition, self-management helps individuals
discharge plan instructions with daily monitoring,
with chronic conditions recognize symptoms of
and provide individuals and their clinicians with op-
exacerbation of their condition and identify what to
portunities to take steps to prevent a second exacer-
report to a provider/clinician, and when to report
bation and avoid unnecessary hospital readmissions.
LeadingAge Center for Aging Services Technologies (CAST)
11
receive routine check-ups and treatment services
4.3
Post-Acute Patient Stabilization
remotely.17
To help with post-acute patient stabilization,
In addition to improved access, telemedicine, tele-
telehealth and RPM is used for daily monitoring
health and RPM offer potential cost reductions for
of disease conditions to detect exacerbation. In
patients, as well as health care professionals (e.g.,
theory, telehealth and RPM can keep eyes and ears
mileage for home health nurses) because of the
on patients every day to track conditions; this can
ability to target visits as needed; this is especially
be done through biometric data, specific check-in
helpful in rural areas, for home bound patients, or
data, and environmental sensors (if/when avail-
those who don’t have easy access to transportation.
able).
Telehealth and RPM allow for recognition of key
indicators that put the individual at risk for read-
4.5
Specific Teleconsult
mission, including medication non-adherence,
Te standard face-to-face method for the delivery
and provides a means for communication with and
of medical care is the preferred means of evaluation
between multiple care providers (e.g., primary care
and treatment for most health care professionals.
physician, hospitalist, home and community-based
Nevertheless, there are times when this type of in-
care provider) for follow-up. Care providers can
teraction may not be necessary or possible. In these
also use telehealth and RPM to provide remind-
circumstances, “remote consultation” has served as
ers for treatment and coordinate care with other
an alternative in recent years.
providers who may provide supportive services to
the individual.
For the scope of this discussion, the use of the
term remote consultation will refer to all methods
Telehealth and RPM have a much larger penetra-
(not restricted to the use of the Internet, but also
tion in post-acute care as compared to ambulatory
to include traditional technologies of information
care patients as the majority of patients are only
transfer such as mail or facsimile) where:
considered for home monitoring following hospital
discharge to prevent readmission. In the U.S., for
1. There is an exchange of medical information.
example, 140,000 post-acute patients were estimat-
ed to have been monitored by telehealth in 2012, as
2. A formal report is issued.
compared to 80,000 ambulatory patients.16
3. A fee is charged for the consultative service.
Tere are several reasons that a remote consultation
4.4
Long-Distance Routine Check-Ups/
may be requested. It may be initiated by the patient
Treatment
(or patient’s family), a clinician in an LTPAC set-
Telemedicine, telehealth and RPM improve access
ting, a primary care doctor seeking another opinion
to health care and benefits individuals who live in
for their patient, or by a specialist requesting ad-
rural areas, are home-bound or have obstacles to
ditional expert assistance. In these select instances,
accessing traditional delivery of health services to
the use of remote consultation is a “win-win-win-
Telehealth and Remote Patient Monitoring for Long-Term and Post-Acute Care:
A Primer and Provider Selection Guide 2013
12
win” concept for the patient, their primary doctor,
pulmonary disease (COPD), asthma and hyperten-
the specialist, and the remote consultant. In the
sion involve frequent monitoring, coordination
setting in which a treating physician is willing to
among care providers and effective and sustained
take responsibility to assist in the process, appropri-
self-care, all of which can be addressed using tele-
ate reasons for remote consultation could include:
health and RPM technologies. Chronic disease is
also quite prevalent and very costly in the United
• The patient lives in a remote region where
States, especially among older adults; they are the
travel would be difficult.
primary cause of death in 7 out of 10 deaths and, in
2009, cost an estimated $262 billion in direct health
• The patient is hospitalized, institutionalized or
care expenditures. Nearly 92% of older adults have
otherwise too ill to travel.
at least one chronic condition, and 77% have at least
• The history and examination are well-
two.19
established: there is simply a need for more
diagnostic or therapeutic suggestions.
5.1
Health Outcomes/Improved
• The diagnosis is known and specific treatment
Management
options are requested.
Effectively managing weight, blood pressure, and
Te use of telemedicine technologies like imaging
cholesterol is critical for individuals with diabe-
devices for example, can increase the efficacy of
tes, hypertension and heart disease. Telehealth
the consult. In addition, it can save lives in critical
and RPM can play an important role in assisting
care and emergency situations allowing clinicians to
patients and care providers in monitoring and
consult with specialists and more experienced care
tracking these types of vital signs. In fact, several
teams that they would not have access to other-
studies have demonstrated that, compared to usual
wise.18
care, diabetic patients receiving RPM and telehealth
had greater improvements in glucose control, blood
pressure, and cholesterol.20, 21 A review of studies
5
Benefits of Telehealth and
on the effectiveness of blood pressure monitoring
RPM
among patients with hypertension found that a ma-
jority of the studies showed improvement in both
Improved health outcomes, reduced hospitaliza-
systolic and diastolic blood pressures.22
tions and readmissions, better quality of life, and
reduced costs for both the payer and care provider
are all potential benefits of telehealth and RPM. A
5.2
Reduction in Hospitalizations and
review of the research conducted thus far, including
Hospital Readmissions
several meta-analyses on telehealth and RPM show
Perhaps some of the most promising research con-
that its direct benefit may be greatest on chronic
ducted thus far has focused on the benefits of tele-
disease management. Tese types of conditions in-
health and RPM in reducing hospitalizations and
cluding diabetes, heart disease, chronic obstructive
LeadingAge Center for Aging Services Technologies (CAST)
13
hospital readmissions, especially among patients
results. Te first study looked at patients with mod-
with heart disease and COPD. For example, one
erate to severe COPD and found that, compared to
meta-analysis of telehealth studies conducted in
usual care, case managers’ use of RPM for daily
2011 found that, compared to standard care, those
symptom surveillance resulted in a significant
patients with heart failure receiving telehealth had a
decrease in hospital readmission rates as well as a
42% reduction in hospitalizations.23 Another study
tendency toward fewer hospital days and outpa-
that focused on the impact of telehealth on hospital
tient visits.26 Te second study was a retrospective
readmissions found there was a 60% reduction in
cohort study using the Veterans Health Admin-
hospital readmissions using RPM compared with
istration database of COPD patients enrolled in
standard care, and a 50% reduction compared with
the CCHT program. Results indicated that 71.5%
other disease management programs that did not
of the CCHT patients had a reduction in the
use RPM. Tis study concluded that RPM has the
number of ED visits and exacerbations related to
potential to prevent between 460,000 and 627,000
COPD requiring hospitalizations afer enrollment
heart failure-related hospital readmissions each
in the program.27
year.24
Te Department of Veterans Affairs (VA) has
5.3
Patient Self-Efficacy, Quality of Life
made a strong commitment to telehealth among
and Satisfaction
its large cohort of veterans by developing a
Te use of educational materials and the delivery
national program called the Care Coordination/
of disease-specific self-management tips at the
Home Telehealth (CCHT) program. Te pur-
appropriate times through telehealth and RPM,
pose of CCHT is “to coordinate the care of veteran
can increase the patient’s knowledge, engagement
patients with chronic conditions and avoid the
and self-efficacy. In one study, LaFramboise ran-
unnecessary admission to long-term institutional
domized 103 patients with heart failure to receive
care.” To that end, the VA has broadly deployed a
(a) a telehealth intervention that included RPM,
range of RPM technologies in 50 different health
clinician assessment, and feedback with advice or
management programs across 18 Veterans Integrat-
encouragement; (b) the telehealth intervention plus
ed Service Networks and conducted various studies
home care; (c) home care alone; or (d) telephone
showing improved chronic disease management,
care. Patients using the telehealth intervention had
cost savings, and reduced hospital admissions and
increased self-efficacy, while all groups had equal
emergency department (ED) visits. Findings from
improvement in health related quality of life, the
comparative studies conducted on 17,025 patients
6-minute walk test, and depression scores.28 In
enrolled in the VA CCHT program in 2006 and
addition, telehealth and RPM has the potential
2007 show a 25% reduction in bed days of care, 20%
to positively impact the patient’s quality of life. A
reduction in numbers of admissions, and a mean
review of home telehealth found that, compared
satisfaction score rating of 86%.25
to conventional home care or usual care, home
In addition, two studies focusing on the impact of
telehealth improved access to care, patients’ medical
telehealth and RPM on COPD found promising
conditions, and quality of life.29
Telehealth and Remote Patient Monitoring for Long-Term and Post-Acute Care:
A Primer and Provider Selection Guide 2013
14
Finally, active and timely response on the part of
advice; and (e) repetition of this cycle at appropriate
health care professionals are important and an
intervals. Tese “complete loop” interventions were
expected component of the telehealth intervention.
effective across a wide range of medical conditions,
Such active/proactive interventions and timely re-
monitoring and communication technologies,
sponses, in turn, lead to higher patient satisfaction
geographical areas, and patients’ socioeconomic
rates. For example, one study reported that rapid
status.31
electronic messaging turnaround and replies by
Financial incentives for physicians to review data
physicians increased patient satisfaction (the aver-
and engage in telehealth interventions may be key
age turnaround time was 48 hours in this study).30
to delivering the expected benefits of telehealth
In fact, the VA’s telehealth program demonstrated a
and RPM.11 As discussed above, physician’s respon-
high, 86%, patient satisfaction score.25
siveness and proactive interventions can lead to
higher patient satisfaction, and tying physicians’
financial incentives to patient satisfaction through
5.4
Physician Engagement Key to
the Consumer Assessment of Healthcare Providers
Success
and Systems (CAHPS)32 and similar measures is
Engaging physicians and health care providers as
one way to ensure physician engagement. Te abil-
partners in care beyond the formal interactions
ity of group practice physicians to negotiate with
with the health care system (office and hospital
hospitals and insurance companies are becoming
visits) is vital to improving health outcomes for
intimately tied with CAHPS outcomes. Initial stud-
patients. Telehealth and RPM technology can play a
ies seem to suggest that physicians who spend more
significant role in increasing such engagement, and
time with their patients and are able to effectively
consequently, the patient’s and family’s satisfaction
communicate and answer all patient questions tend
with care. However, telehealth and RPM may not
to have better CAHPS scores. 33 Tere may be an
deliver the anticipated benefits unless physicians
opportunity to study how certain technologies can
and health care providers are involved. In fact, the
affect physicians’ and health care providers’ CAHPS
most important and consistent finding of a review
outcomes.
of 74 studies that reported the effect of interactive
Additionally, the accountable, person-centered, and
consumer health IT on health outcomes or health
quality-driven managed care era is driving health
care process measures, was that systems were ef-
care providers to focus more on patient outcomes
fective when they provided a complete feedback
and satisfaction. Physician-led Accountable Care
loop. Te review revealed that such a feedback
Organizations (ACOs) tend to focus their cost-sav-
loop included (a) monitoring and transmission
ing efforts on keeping patients out of the hospital
of patient status; (b) interpretation of this data by
as much as possible. Conversely, hospital-led ACOs
comparison with previously established individual
ofen attempt to reduce the costs involved with
treatment goals or published guidelines; (c) adjust-
hospitalizations and hospital readmissions. In both
ment of medications, diet, or information according
scenarios, telehealth and RPM can play a role in the
to patient status; (d) timely communication back
ACO model. CAHPS is one of the quality measures
to the patient with tailored recommendations or
LeadingAge Center for Aging Services Technologies (CAST)
15
that will be used to evaluate the performance of the
ing home services, and limit the need for patients
Centers for Medicare & Medicaid Services (CMS)
to be transported.38 Another study by researchers at
Shared Savings ACO program.34
the University of Virginia Health System found that
telehealth interventions in a long-term care com-
munity setting replaced patient transport to a local
5.5
Caregivers’ Workload and
wound care clinic.39 Furthermore, some research in-
Efficiencies
dicates there may also be a decreased need or desire
to travel outside the local community for health
Increasing access to health care through telehealth
care services in communities where telehealth ser-
and RPM, especially to patients living in rural areas,
vices are offered.40
has the potential to reduce health care costs and
Operational efficiency is another important con-
improve efficiencies in a variety of ways includ-
ing decreasing the number of nurse home care
sideration. Many telehealth and RPM solutions
visits, reducing the number of patient transports
operate at very low levels of efficiency because of
to hospitals and physician offices, and increasing
time consuming set-up and inefficient sofware
access to specialists such as wound care experts or
solutions. A low level of efficiency is very difficult
pulmonologists. One study, for example, found that
and costly to scale to large populations. Staffing is
a telehealth intervention utilized by a home health
ofen times one of the greatest expenses to an orga-
agency reduced the number of home visits by
nization and ensuring that the telehealth and RPM
nurses from 8.2 to 5.8 per month.35 Another study
solution maximizes operational efficiency while
found that one out of every four in-person visits
maintaining efficacy is a key area to consider.
can be avoided with telehealth store-and-forward
technology. And, one out of every two clinic visits
can be avoided with real-time consults.36 Finally, a
5.6
Reduced Risk and Liability
recent study published in Health Affairs found that
Telehealth and RPM, as well as other monitoring
telehealth and RPM can increase care provider’s
technologies, provide a means for detecting aris-
productivity by decreasing home visit travel time
ing health issues that would go undetected without
and utilizing automated documentation systems.37
the technology. Hence, they have the potential to
Efficiencies can also be found in reducing patient
reduce risks and providers’ liability as they gener-
transportation costs and increasing access to spe-
ate documentation of events, signs, symptoms and
cialists via telehealth technologies. Remote visits
interventions. Tis is especially true when the use
to patients in skilled nursing facilities for wound
of these technologies is coupled with policies and
care, for example, can result in avoided transporta-
procedures about response protocols and respon-
tion costs. In a review of 53 geriatric applications
sibilities, clear delineations of responsibilities in
of telehealth, Jennett and colleagues found that
contractual and service agreements, and documen-
telephone consultations to geriatric patients and
tation of interventions/actions taken, by whom and
video consultations related to chronic wounds can
when.41
be cost-saving because they reduce the use of nurs-
Telehealth and Remote Patient Monitoring for Long-Term and Post-Acute Care:
A Primer and Provider Selection Guide 2013
16
related to the location or geographic areas. Prac-
6
Potential LTPAC Provider
titioners at the distant site who may furnish and
Business Models
receive payment for covered telehealth services
(subject to state law, including inter-state licensure
6.1
Medicare Coverage
laws) are: physicians; nurse practitioners (NP);
Under its fee-for-service model, Medicare pays a
physician assistants (PA); nurse midwives; clinical
distant practitioner for a limited number of Part B
nurse specialists (CNS); clinical psychologists (CP)
services that are furnished by a physician or practi-
and clinical social workers (CSW)vi; and registered
tioner to an eligible beneficiary via a telecommuni-
dietitians or nutrition professionals.
cations system. For eligible telehealth services, the
As a condition of payment, an interactive audio
use of a telecommunications system substitutes for
and video telecommunications system that permits
an in-person encounter. An originating site is the
real-time communication between the physician or
location of an eligible Medicare beneficiary (pa-
practitioner at the distant site and the beneficiary,
tient) at the time the service being furnished via a
at the originating site, must be used. Asynchronous
telecommunications system occurs. Medicare ben-
store-and-forward technology is permitted only in
eficiaries are eligible for telehealth services only if
federal telemedicine demonstration programs con-
they are presented from an originating site located
ducted in Alaska or Hawaii.42 For a list of Medicare
in a rural Health Professional Shortage Area or in
telehealth services, please see the following fact
a county outside of a Metropolitan Statistical Area.
Entities that participate in a Federal telemedicine
demonstration project approved by (or receiving
funding from) the Secretary of the Department of
Health and Human Services as of December 31,
It is important to note that when telehealth is used
2000, qualify as originating sites regardless of geo-
with patients in nursing homes, one of the eligible
graphic location.
originating sites, the payment goes to the distant
physician, clinician or practitioner.
Te originating sites authorized by law are all medi-
cal facilities; these sites include: offices of physicians
6.1.1
Medicare Reimbursement of Home
or practitioners; hospitals; Critical Access Hospi-
Telehealth
tals (CAH); Rural Health Clinics (RHC); Federally
Qualified Health Centers (FQHC); hospital-based
Section 1895(e) of the Social Security Act43 states
or CAH-based Renal Dialysis Centers (including
that telehealth services are outside the scope of the
satellites)v; skilled nursing facilities (SNF); and
Medicare home health benefit and home health
Community Mental Health Centers (CMHC). Te
Prospective Payment System (PPS). Tis provision
patient’s home is not an eligible originating site.
Distant sites from which practitioners furnish
vi CPs and CSWs cannot bill for psychiatric diagnostic interview
examinations with medical services or medical evaluation and management
telehealth services are not subject to restrictions
services under Medicare. These practitioners may not bill or receive
payment for Current Procedural Terminology (CPT) codes 90792, 90833,
v Note: Independent Renal Dialysis Facilities are not eligible originating sites.
90836, and 90838.
LeadingAge Center for Aging Services Technologies (CAST)
17
does not provide coverage or payment for Medicare
be determined based on the patient’s characteristics
home health services provided via a telecommuni-
and the need for and receipt of the Medicare cov-
cations system (i.e. home telehealth, or RPM are not
ered services ordered by the physician. If a physi-
covered under PPS). Te law does not permit the
cian intends that telehealth services be furnished
substitution or use of a telecommunications system
while a patient is under a home health plan of care,
to provide any covered home health services paid
the services should be recorded in the plan of care
under the home health PPS, or any covered home
along with the Medicare covered home health ser-
health service paid outside of the home health PPS.
vices to be furnished.”46
As stated in 42 CFR 409.48(c), a visit is an episode
of personal contact with the beneficiary by staff of
the home health agency (HHA), or others under
6.2
Medicaid Coverage
arrangements with the HHA for the purposes of
Medicaid and the Children’s Health Insurance
providing a covered service.44
Program (CHIP) provide health coverage to nearly
However, this provision clarifies that there is noth-
60 million Americans, including children, preg-
ing to preclude a home health agency from adopt-
nant women, parents, seniors and individuals with
ing telemedicine or other technologies they believe
disabilities. In order to participate in Medicaid,
promote efficiencies, but those technologies will not
federal law requires states to cover certain popula-
be specifically recognized or reimbursed by Medi-
tion groups (mandatory eligibility groups) and
care under the home health benefit. Tis provision
gives them the flexibility to cover other population
does not waive the current statutory requirement
groups (optional eligibility groups). States set indi-
for a physician certification of a home health plan
vidual eligibility criteria within federal minimum
of care under current §§1814(a)(2)(C) or 1835(a)
standards. Medicaid coverage is based on financial
(2)(A) of the Act.45 Within its home health agency
and other non-financial eligibility criteria that are
manual, CMS states that “an HHA may adopt
used in determining Medicaid eligibility. In order to
telehealth technologies that it believes promote ef-
be eligible for Medicaid, individuals need to satisfy
ficiencies or improve quality of care. Telehomecare
federal and state requirements regarding residency,
encounters do not meet the definition of a visit set
immigration status, and documentation of U.S.
forth in regulations at 42 CFR 409.48(c) and the
citizenship; these criteria vary by state.47
telehealth services may not be counted as Medicare
Te Center for Telehealth and e-Health Law
covered home health visits or used as qualifying
(CTeL) completed a 50 state survey which reviewed
services for home health eligibility. An HHA may
each state’s telehealth reimbursement policies.
not substitute telehealth services for Medicare cov-
CTeL’s research found that 45 states have some
ered services ordered by a physician. However, if an
type of reimbursement for services provided via
HHA has telehealth services available to its clients,
telehealth. Tere are many factors that states use
a doctor may take their availability into account
to determine the scope of coverage for telehealth
when he or she prepares a plan of treatment (i.e.
applications, such as the quality of equipment, type
may write requirements for telehealth services into
of services to be provided, and location of providers
the POT). Medicare eligibility and payment would
Telehealth and Remote Patient Monitoring for Long-Term and Post-Acute Care:
A Primer and Provider Selection Guide 2013
18
(e.g., remote rural sites).
bursement policies, so payment for telehealth may
require prior approval. Likewise, different states
CMS requires that reimbursement for Medicaid-
have various standards by which their Medicaid
covered services, including those with telehealth
programs will reimburse for telehealth expenses.
applications, must also satisfy federal requirements
As with Medicaid, regulations for telehealth reim-
of efficiency, economy, and quality of care. With
bursement by private insurers are set by the states.49
this in mind, states are encouraged to use the flex-
Nineteen states have enacted parity laws requiring
ibility inherent in federal law to create innovative
that services provided via telehealth must be re-
payment methodologies for services that incorpo-
imbursed if the same service would be reimbursed
rate telehealth technology.
when provided in person. Tese states include:
Arizona, California, Colorado, Georgia, Hawaii,
For example, states covering medical services utiliz-
Kentucky, Louisiana, Maine, Maryland, Michigan,
ing telehealth may reimburse both the provider at
Mississippi, Missouri, Montana, New Hampshire,
the distant site from which the services are pro-
Oklahoma, Oregon, Texas, Vermont and Virginia.50
vided for the consultation as well as the provider at
the originating site where the patient received the
Some insurance programs cover specific telehealth
telehealth services for the office visit. States also
services, e.g., behavioral health. Even in the absence
have the flexibility to reimburse any additional cost
of a definitive policy, some insurers and Medicaid
(i.e. technical support, line-charges, depreciation
agencies will reimburse for telehealth services as
on equipment, etc.) associated with the delivery of
long as the rationale for using telehealth is justified
a covered service by electronic means as long as the
to the agency’s satisfaction. State waivers or spe-
payment is consistent with the requirements of ef-
cial programs offering remote diagnostics, remote
ficiency, economy, and quality of care. Tese add-on
monitoring for specific disease entities or for
costs can be incorporated into the fee-for-service
particular populations, allow for additional cover-
rates or separately reimbursed as an administrative
age of telehealth services. A few states simply pay
cost by the state. If they are separately billed and
claims regardless of whether the encounter was in
reimbursed, the costs must be linked to a covered
person or via telehealth. Te introduction of man-
Medicaid service.48 For specific information about
aged care, within Medicaid and the private sector,
Medicaid coverage of telehealth in each state, please
has complicated telehealth reimbursement policies
since a number of state programs acknowledge us-
ing telehealth within managed care but do not keep
specific telehealth utilization data. In many cases,
state Medicaid managed care and fee-for-service are
6.3
Private Health Insurance Coverage
separate programs with separate guidelines.
Tere is no single widely-accepted standard for pri-
vate insurance coverage of telehealth services. Some
insurance companies value the benefits of tele-
health and will reimburse a wide variety of services.
Others have yet to develop comprehensive reim-
LeadingAge Center for Aging Services Technologies (CAST)
19
ing and personal emergency response systems
6.4
Medicaid Waiver Coverage
(PERS). New York, South Carolina, and South
Medicaid waivers are vehicles states can use to test
Dakota also have exemplary telehealth and RPM
new or existing ways to deliver and pay for health
reimbursement programs.52 Rates and requirements
care services in Medicaid and CHIP. Tere are
vary. For more details about the coverage of tele-
four primary types of waivers and demonstration
health and other aging services technology services
projects:
•
flexibility to test new or existing approaches to
financing and delivering Medicaid and CHIP.
6.5
Potential Affordable Care Act (ACA)
Related Opportunities
•
can apply for waivers to provide services
Te Affordable Care Act (ACA) is shifing the
through managed care delivery systems or
health care system in the U.S. away from the tra-
otherwise limit people’s choice of providers.
ditional fee-for-services to a pay-for-performance
system. Moreover, CMS is moving to reimburse
•
Medicare Certified Home Health based on a value-
based purchasing model instead of a Prospective
to provide long-term care services in home and
Payment Model. Tis is starting to eliminate the
community settings rather than institutional
misalignment of incentives inherent in traditional
settings.
Medicare, Medicaid and private insurance pro-
grams. Tere are many provisions and models in
•
the ACA that would benefit from, provide oppor-
Waivers: States can apply to simultaneously
tunities to cover, and consequently encourage the
implement two types of waivers to provide
adoption of telehealth and RPM technologies and
a continuum of services to the elderly and
services.53 Te act created the Center for Medicare
people with disabilities, as long as all federal
and Medicaid Innovations (CMMI), which is tasked
requirements for both programs are met.51
with exploring new care delivery and payment
models and initiatives54 that:
According to a CAST Analysis of Medicaid Waiver
Programs, seven states, including Kansas, New
• Use more holistic, patient-centered and
York, Pennsylvania, South Carolina, South Dakota
team-based approaches to chronic disease
and Texas reimburses for home telehealth under
management and transitional care.
sections 1915(b) and/or 1915(c). Te analysis
showed that Pennsylvania has the most comprehen-
• Improve communication and care
sive coverage for aging services technologies in its
coordination between/among care providers.
telecare program, which includes home telehealth,
activity/wellness monitoring, medication dispens-
Telehealth and Remote Patient Monitoring for Long-Term and Post-Acute Care:
A Primer and Provider Selection Guide 2013
20
• Improve care quality and population health
• LTPAC provides holistic person-centered care,
while reducing growth in expenditures.
including support services.
Te act puts explicit emphasis on the use of health
• LTPAC offers lower cost care settings than
information technology (HIT), including telehealth
hospitals.
and RPM, in Health Homes for Enrollees with
Tese new care delivery and payment models will
Chronic Conditions, the Independence at Home
provide LTPAC providers utilizing technologies,
Demonstration and the Use of Technology in New
like telehealth and RPM technologies, with oppor-
State Options for Long-Term Services and Sup-
tunities to derive revenue sources from strategic
ports.55
partners. Te following whitepaper offers some key
Tese initiatives include:
questions LTPAC providers should discuss with
• Hospital Readmission Reduction Program
(HRRP)56
• ACOs57
• Bundling of Payments models, of which
6.6
Private Pay
the following two are relevant to LTPAC
providers:
Another payment source for telehealth and RPM
services may be private payers or out of pocket. As
•
Retrospective Acute Hospital Stay plus
mentioned above, home health services under the
Post-Acute Services58
prospective payment system may use telehealth to
•
Retrospective Post-Acute Care Only59
enhance the efficiency and effectiveness of home
visits during the 30-60 days of post-acute services.
LTPAC providers bring a significant value for hos-
When the Medicare coverage period expires, these
pitals, physician groups, payers and ACO partners,
agencies usually offer an extension of telehealth
by providing the following services:
and RPM services, with home visits as needed, to
clients if they would benefit from such a program as
• Rehabilitation and skilled nursing facilities
private duty services covered out of the patient’s or
provide post-discharge/post-acute patient
family’s pocket.
rehabilitation.
• Skilled nursing facilities, assisted living
6.7
Standard of Care and Other
facilities, continuing care retirement
Payment Sources
communities, housing with services, and home
health agencies provide post-acute patient
LTPAC and community health providers, special
stabilization and sub-acute chronic disease
population agencies, self-pay and self-insured orga-
management.
nizations and others, especially not-for-profits, may
offer/cover an array of telehealth and RPM services.
LeadingAge Center for Aging Services Technologies (CAST)
21
Tese services may be covered by grants, or offered
6.8.1
ROI to Patients and/or their Families
as standard of care with the cost absorbed by the
ROI to patients and/or their families can be calcu-
organization and covered from different revenue
lated as:
sources, including charitable contributions.
ROI
Patient or Family = Net Gains Patient or
⁄ Investment
Family
Patient or Family
6.8
Return on Investment (ROI) of
For private pay patients and their families, for
Telehealth and RPM
example, the financial gains of home telehealth and
Return on investment (ROI) represents the ratio of
RPM lie in prolonging independence by avoiding
the net gains relative to the initial investment over
deterioration in health that may lead to disability
a certain period of time. Subsequently, ROI can be
and avoiding the need to move into assisted living
expressed in the following equation:
or skilled nursing facilities, which is significant. Te
gains may also include savings in co-pays for recur-
ROI = Net Gains ⁄ Investment
ring hospital visits, and of course a higher quality
As discussed above, telehealth and RPM delivers
of life, which is difficult to quantify. Te patient’s/
various benefits, including potential financial sav-
family’s expenses/investment are the monthly out of
ings to different stakeholders, including patients
pocket cost of private home telehealth services, and
and/or their families, payers, care providers, etc.
any co-pay for the occasional physician office visit,
lab tests, and prescriptions.
However, the financial savings and ROI, depend
on a number of factors including the care delivery
6.8.2
ROI to Payers
model, the payment/reimbursement model, the
technology, and of course costs. Te first and most
ROI Payer = Net Gains Payer ⁄ Investment Payer
important step in calculating ROI is to consider the
For dual Medicare and Medicaid eligible patients
different stakeholders, identify the investors, and
who are nursing home eligible, for example, the
calculate the gains and savings netted/accrued to
financial gains of home telehealth and RPM under a
each investing stakeholder under each particular
Medicaid Waiver program that accrue to Medicaid,
care delivery and payment model. When calculat-
which would otherwise be liable for the costs of
ing ROI, one should only include the gains that
nursing home room and board costs, lie in remain-
accrued to that particular stakeholder minus all
ing in their own home with home health, home
expenses, relative to that stakeholder’s own invest-
care and other supportive services. Medicaid’s
ment/cost. Ofen the reduction of hospital days is
investment is the monthly rate of home telehealth
erroneously included in the providers’ ROI, which
services and additional supportive services aimed at
is not true under the traditional fee-for-service
keeping the individual independent.
reimbursement model and can be misleading; such
a reduction usually accrues to the payer.
In this particular example there may be additional
savings, like reductions in hospitalization and
hospital readmission costs that accrue to Medicare,
Telehealth and Remote Patient Monitoring for Long-Term and Post-Acute Care:
A Primer and Provider Selection Guide 2013
22
which is liable for and covers health care costs.
they get to keep plus any additional fee-for-service
Consequently, such savings or gains should not be
payments due to more frequent office-based ser-
included in calculating Medicaid’s ROI, which is
vices minus the actual costs of services they deliver
investing in the home telehealth and supportive
(for example in medication reconciliation or care
services in this case.
coordination), relative to the portion of incentives
they pass through to the LTPAC provider.
6.8.3
ROI to Care Provider
In contrast, a partnership between an LTPAC pro-
ROI to care providers can be calculated as:
vider and hospital under the traditional fee-for-ser-
vice model, for example, the LTPAC provider may
ROI Care Provider = Net Gains Care Provider ⁄
help their hospital partners reduce 30-day readmis-
Investment Care Provider
sion rates for pneumonia, congestive heart failure
For the care provider who makes investments in
and acute myocardial infarction (heart attack) pa-
tients, hence helping the hospital avoid Medicare’s
information and communications technology
payment penalties under the HRRP. Te hospital
infrastructure, the telehealth technology, as well as
may contract with and pay the LTPAC provider a
the clinical and care services, benefits may include:
percentage of the penalties saved for delivering tele-
lower costs in delivering the same services includ-
health that lead to reducing 30-day readmissions
ing staff efficiencies, staff travel costs (if the payer
for patients discharged from the hospital afer being
covers the remote services, rather than just the
admitted for one of the above mentioned three
in-person visit), and higher reimbursements/pay-
conditions. Te LTPAC’s net gain is again the sum
ment from the payer or strategic partner in terms
of all gains accruing to the LTPAC provider in staff
of incentive payments for avoiding more costly care
efficiencies, increased referrals from the hospital,
settings, procedures, events, or penalties.
traditional fee-for-service payments, and additional
For example an LTPAC provider partnering with a
payments received from the hospital, minus the
physician group ACO to manage a chronically ill
costs of leasing the home telehealth equipment and
patient population can potentially get a percentage
actual costs of services delivered. Te hospital’s
of the incentives or shared savings payments the
ROI is the portion of avoided penalties they get to
ACO receives from the payer for reducing hospi-
keep plus any additional fee-for-service payments
talizations and hospital readmissions, which can be
they gain for more referrals due to improved qual-
significant for certain populations. Te LTPAC pro-
ity ratings minus the actual costs of services they
vider’s net gain is the sum of all gains accruing to
deliver, relative to the portion of avoided penalties
the LTPAC provider in staff efficiencies, increased
they passed through to the LTPAC provider plus
referrals from the ACO, traditional fee-for-service
any additional costs incurred for staff time in care
payments, and additional incentive payments
coordination, medication reconciliation, or health
received from the ACO, minus the costs of leasing
information exchange, for example.
the home telehealth equipment and actual costs of
services delivered. Te physician group ACO’s ROI
is the portion of the payer’s incentive payment that
LeadingAge Center for Aging Services Technologies (CAST)
23
6.8.4
Online ROI Calculator for RPM
Te tool bases its calculation of savings on
whether patients change their health care
Once individual investors have been clearly identi-
utilization as a result of the program. One of
fied, an estimate of the ROI to the different stake-
the advantages of the tool is that it allows users
holders can be calculated. Te Center for Technolo-
to identify the stakeholder that will bear the
gy and Aging and the Center for Connected Health
financial risks or enjoy the financial gains when
service utilization changes. It is important to
lating ROI for a RPM program for the management
precede any anticipated increase in utilization
of chronic conditions, like Congestive Heart Failure
(home visits, for example) with a minus (-) sign
(CHF). Te tool was funded by the California
to have the correct results, as the calculator as-
Healthcare Foundation60.
sumes savings, i.e. decrease in utilization.
Te online ROI calculator asks users to enter data
Once users answer the ROI Calculator’s 5 questions,
in 5 areas:
the tool provides 4 reports:
1.
Patient Enrollment: Users specify the size of
1. A Cost Summary gives users a quick overview
patient enrollment in the RPM program in year
of the RPM program’s total cost by year and
1 and project what enrollment will be in year 5.
total cost per patient per year.
2.
Technology: Users estimate their investments
2. A Savings Summary charts the potential cost
in HIT. Tese estimates include 1-time invest-
savings to the stakeholders identified in ques-
ments in medical devices and infrastructure; if
tion 5.
applicable, an amortization period for purchas-
3. An ROI Evaluation compares the RPM pro-
es/expenditures can be specified. Te tool also
gram’s financial gains to its financial costs.
asks for recurring costs like hardware rental,
Te tool provides a score indicating the extent
data costs and server hosting.
to which the RPM intervention will generate
3.
Staffing: Users enter the RPM program’s
enough savings to cover the cost of the pro-
staffing requirements. Tis includes fixed man-
gram.
agement costs, as well as clinical and support
4. A Sensitivity Analysis allows users to see how
staff costs that will change with the number of
the ROI at year 5 would change if patient en-
patients enrolled.
rollment and costs changed.
4.
Other Costs: Users can enter other RPM-
related costs, including costs for services,
subscriptions, travel, administration, patient
materials and external monitoring services.
5.
Outcomes: Te final step helps users estimate
their potential savings from the RPM program.
Telehealth and Remote Patient Monitoring for Long-Term and Post-Acute Care:
A Primer and Provider Selection Guide 2013
24
Te following areas should be considered as part of
7
Planning for Telehealth and
an organization’s initial vision and strategic plan-
RPM Solutions
ning:
Telehealth and RPM technologies help manage and
•
Care Setting and Business Goals
monitor health conditions to improve the care of
Visioning and planning process starts with
chronically ill patients and people who have trouble
understanding the care settings in which the
accessing care. Initiating, expanding or integrating
telehealth as a service is complex and begins with
organization is considering implementing
understanding organizational strategic goals and vi-
telehealth and RPM vis-à-vis the strategic and
sion for a telehealth program in order to strategical-
business goals of the organization. The setting
ly plan for this initiative. Te next step is evaluating
will have implications on the availability
operational readiness and conducting operational
of professional caregivers, the technologies
planning, followed by due diligence in selecting a
that fit the setting and operational needs, the
vendor partner with experience in strategic plan-
characteristics of the patient/user population,
ning, program design and ongoing program devel-
and operational, care and business model for
opment to support unique organizational goals and
the telehealth initiatives. For example, the
needs to help ensure success.
organization’s strategic goals may be making
their skilled nursing facility a strategic partner
and a preferred discharge destination to
the local hospital, or offering cost-effective
7.1
Visioning and Strategic Planning
home health services into the broader local
Visioning and strategic planning is a key founda-
community.
tional step to the success of a telehealth program.
•
Target Population
Telehealth should be viewed as a tool to achieve
specific organizational goals and part of a well-
Have a vision for the population that will be
founded overall organizational strategy. Getting
impacted by telehealth program. Different
true value from telehealth comes from the orga-
targeted patient populations should have
nization’s ability to align the telehealth and RPM
different telehealth solutions, care delivery
initiatives with the organizational strategic goals,
and support services. When it comes to
understand their operational needs, set operational
telehealth, one size does not fit all and having
goals, engage all stakeholders, including strategic
the flexibility to match proper technology
care partners (e.g., hospitals and physician groups),
to the targeted patient population is a key
and plan for such an initiative ensuring that the
factor to success. It is important to stratify the
plan is realistic in terms of timeline and resources.
population, based on health condition, acuity,
Ten selecting and implementing one or more of
risk, utilization of health care services, etc.61
the numerous types of telehealth and RPM tech-
Examples of target patient populations that
nologies and solutions.
should receive different types of technology
may include patients who are high-risk, with
LeadingAge Center for Aging Services Technologies (CAST)
25
specific conditions, post-acute, rural, facility-
the software products and will result in lower
based, those that require video-based visits,
telehealth program operating costs.
or those that require additional activity and/
Be sure to understand internet and mobile
or safety monitoring. Many organizations will
access requirements, interfacing opportunities
have a need to address several different types
with current EHR systems, potential
of patient populations so it is critical to select
customization requests, reporting options,
a vendor partner that can match the telehealth
inventory management systems and any other
solution that will meet the organization’s
systems-specific factors that will potentially
needs.
assist in the organization’s successful
implementation of a telehealth program.
•
Technology Review
Learn about the types of telehealth and
•
Access Requirements
RPM technologies, how they functionally
Understand how the organization and provider
operate and what network infrastructure
partners will access the telehealth information,
and connectivity they require. For example,
who will need to access the information
some technologies are designed to help
and what unique types of information each
individuals with chronic care management and
recipient will need to access. It is important
post-acute care management by identifying
to understand not only whether the telehealth
disease exacerbation risks and alerting health
solution meets the unique organizational
care professionals with a goal to help avoid
needs, but also the requirements of any care
unnecessary hospitalization, provide chronic
partners (e.g., a partner physician practice)
condition education, and promote self-
and the lead time should needs change from
management. Others are designed for health
the initiation of the program. Since telehealth
care professionals to connect with more
requires broad data sharing, organizations
specialized or experienced clinicians to seek
should ensure that such data sharing is done
guidance, advice, or interventions. In addition
in compliance with all the applicable Health
it is important to understand the technology
Insurance Portability and Accountability
transmission requirements and what
Act (HIPAA) Privacy and Security Rule
alternatives are available should the technology
requirements. Under the new HIPAA
not be able to be utilized in some specific
Omnibus Rule, which became effective in
patient environments.
March 2013, business associates of covered
entities (including telehealth vendors) are now
•
Software Considerations
directly liable for compliance with certain
Software considerations should not only
of the HIPAA Privacy and Security Rules’
include the user’s experience but also the
requirements. These measures include “a
operational efficiency it may provide. Different
mechanism to authenticate,” “a mechanism
telehealth software products will actually allow
to encrypt and decrypt electronic protected
organizations to manage many more patients
health information (EPHI),” and “policies and
because of operational efficiencies built into
Telehealth and Remote Patient Monitoring for Long-Term and Post-Acute Care:
A Primer and Provider Selection Guide 2013
26
procedures to protect EPHI from improper
the fact that existing staff with current job
alteration or destruction.”
assignments often do not appreciate how their
work will change (for example, how staff will
•
Program Support
input new data, how messages will be shared
Program Support includes the internal
with the health care team, how much new data
requirements to set-up, operate and maintain
will be incoming, etc.).
the support of the telehealth program within
There are several different models of
organizations as well as the ongoing support
agreements and fee requirements available
provided by the vendor selected. Not only is it
from vendors, including purchase or lease
critical for organizations to understand their
of hardware and software. Consider the
infrastructure options and requirements but it
long-term and short-term advantages and
is important to understand the level of clinical
disadvantages of these different options
expertise needed to operate the program,
when considering purchase versus lease
availability of such expertise internally or
options. Technology changes very rapidly and
from care partners and any clinical support
understanding the opportunities included
services offered by the vendor (if applicable).
in upgrades and replacements are critical to
It is also critical to understand the burden of
future success. Keep an eye out for hidden
support that will be expected by any internal
costs not only with the telehealth unit,
IT support staff or development resources to
but other items such as additional staffing
support the ongoing program.
requirements because of lack of operational
Another key consideration regarding support
efficiencies in the software, maintenance,
is the level of support the vendor provides to
repair, lost units, fees associated with ordering
the customer, including technical support.
new units and any training fees for additional
Keep organizational operating hours and
or replacement staff.
access in mind. For example, if an organization
•
Remember the Future
operates seven days a week it is important
to match those operating hours with vendor
Be a visionary when it comes to telehealth
support availability.
in general and in particular within your
organization. Telehealth programs evolve over
•
Budget Considerations
time due to the changing landscape of health
There are many items to think about when
care, market and technology; it is critical to
creating a budget for telehealth including per-
select a vendor partner that can support, grow
unit cost, software and user-licensure cost,
and change with your organization’s needs.
ongoing maintenance and repairs, staffing, and
training to name a few. One additional budget
issue rarely planned up front is the changes
to work flow that impact staff training and
accountabilities. Organizations often overlook
LeadingAge Center for Aging Services Technologies (CAST)
27
•
Patient Management Registered Nurse -
7.2
Organizational Readiness
have a clear plan for who will be responsible
Assessment
for receiving and monitoring the telehealth
Determining organizational readiness to initiate
and RPM information. Consider items such
and operate or expand a telehealth program is a
as 24-hour coverage, business days-only
basic step towards ensuring success. Planning and
coverage, seven days a week coverage, or
developing a comprehensive telehealth program
holiday coverage and always ensure that there
takes time, resources and dedication. Many ven-
is backup staff fully trained to take over at
dor partners offer turnkey solutions with program
any time. There are a few vendor partners
materials available for telehealth policy and pro-
that offer patient management as a service
cedures, staffing models, patient population selec-
to help meet organizational needs. Consider
tion and eligibility criteria, participant enrollment
what interventions the clinical team will
process, evaluation methods, outcome measures,
implement and who will be responsible for
data sources, and analysis plan. Even with all of the
implementing them; keep in mind that there
supporting materials, it is important to understand
are very few vendors who provide clinician or
that there is still a need for leadership engagement
clinical support services. In addition, consider
and a significant time commitment required in
the full scope of clinical interventions the
both planning and ongoing program support.
team plans to deliver, as some intervention
plans may require partnerships, or at least
Designating individuals that are accountable,
coordination, with other health care providers
qualified and available for the required areas of
and professionals, such as physicians,
responsibilities is a first step in evaluating the state
hospitals, pharmacies, etc. In these cases, make
of an organization’s preparedness for telehealth.
sure those other providers are on board with
Review staffing resources and determine if there are
and would be willing to work, coordinate and
significant staff shortages or excessive staff turnover
collaborate with the team.
that may influence whether to initiate or expand a
telehealth program. Some key roles to consider are:
•
Inventory Control - consider utilizing
administrative staff for equipment control to
• Leadership - the engagement of a senior-
help reduce operational costs. This is especially
level leader that articulates the organization’s
important for individual home telehealth
strategic visions and goals as well as ensuring
as well as wearable telehealth/mobile health
staff accountability will be key to the success
(mHealth) units, contrasted with telehealth
of a telehealth initiative. A leader will help the
kiosks.
organization influence the adoption of the
•
Marketing and Business Development -
telehealth program to help achieve its goals
involve business development teams early
for telehealth. The telehealth program may be
in the planning process to help ensure
led by the chief executive officer (CEO), chief
engagement, marketing support, ongoing
operations officer (COO), chief medical officer
(CMO), or a senior/executive vice president.
Telehealth and Remote Patient Monitoring for Long-Term and Post-Acute Care:
A Primer and Provider Selection Guide 2013
28
growth and ultimately success of the telehealth
program.
7.2.1
Staff Competencies
Competency-based training programs to demon-
strate the ability to perform the above roles is an-
other element to success. Te individual designated
initially may not always be the right person to help
ensure success. What makes people learn most ef-
fectively differs from one person to another. Ensure
that there are multiple options offered for training
to guarantee competencies, which may include
self-learning modules, video-based training mod-
ules, webinar training modules, and live training.
Competency-based training is an avenue to achieve
a highly knowledgeable and skilled telehealth team
which will contribute to the goals of a telehealth
program.
LeadingAge Center for Aging Services Technologies (CAST)
29
7.2.2
IT Infrastructure
Selecting the appropriate telehealth solution will depend on an organization’s IT infrastructure and needs.
Typical options include purchasing and locally hosting the telehealth sofware onsite at the organization’s
data center, purchasing the sofware and having a 3rd party host it in their data center, or the vendor host-
ing and offering their own Sofware as a Service (SaaS). Each has pros and cons depending on the size of
an organization and its current IT infrastructure.
Some things to consider when evaluating these options are:
Local/Locally Hosted Software
3rd Party Hosted
SaaS
•
Software and license are
•
Software (including com-
•
Leased software installed
purchased and installed on
mercial packages origi-
on remote servers and
each desktop/client device
nally designed for individual
accessed via desktop com-
or local servers
users) installed on remote
puters or thin client device,
servers and accessed via
but special browser-like
•
Software updates must be
desktop computers or thin
software may need to be
downloaded and installed
client devices to multiple
installed on local machines
users on a lease or per-use
•
Central server onsite; infor-
basis; but software may
•
Allows for immediate soft-
mation stored locally at
ware updates
need to be installed on
individual computer level
local machines
and/or local servers
•
Information stored offsite in
•
Software updates on
the cloud
•
Onsite IT support needed
remotely hosted applica-
for clients and servers
•
Onsite IT support generally
tions are managed by the
not needed
application/hosting service
•
Internet connectivity
provider; updates to local
not required except for
•
Internet connectivity
software may need to be
exchanging information
required; downtime without
downloaded and installed
with other sites; no down-
Internet
time without Internet
•
Information stored offsite in
•
Cost: Low upfront invest-
the cloud
•
Cost: High upfront invest-
ment in hardware and
ment in hardware and
software, ongoing use fees,
•
Onsite IT support needed
software, ongoing licensing
and low IT staffing cost.
for clients
fees, and high IT staffing
cost.
•
Internet connectivity
required; downtime without
Internet
•
Cost: Medium upfront
investment in hardware and
software, ongoing host-
ing and licensing fees, and
medium IT staffing cost.
Telehealth and Remote Patient Monitoring for Long-Term and Post-Acute Care:
A Primer and Provider Selection Guide 2013
30
7.2.3
Operating Environment
timelines, resource requirements, and deliverables
will lead to success.
Te type of sofware solution will most likely be di-
rectly influenced by the type of operating environ-
7.3.2
Goal Setting
ment required to meet your business needs. Under-
standing and defining organizational, provider and
Defining goals of the telehealth program is critical
family access will help determine the most effective
to measure success. Each organization will have
operating environment. Items to consider include:
different ideas of what success looks like based on
internal operations. Before starting a telehealth
• Required access to the system remotely from
program, the organization should set a clear series
any web-enabled device.
of goals and metrics.
• Provider access, including partner providers.
Keep in mind that goals should be measurable
and routinely reported on within your operations.
• Family portal access.
Te fundamentals to setting goals are to ensure
• Storing all information securely behind firewall
that they are SMART goals (specific, measurable,
protection.
attainable, realistic and track-able). Setting both
short-term and long-term goals for the telehealth
program is highly recommended. Telehealth
It is important to consider unique organizational
programs will naturally change and progress over
needs and applications to ensure selection and
time. Organizational goals set at the initiation of the
setup of the appropriate operating environment.
program will likely be different six to twelve months
post implementation. Telehealth program goals
should continuously be evaluated and updated as
7.3
Operational Planning
programs change. It is also important to understand
that a new program will have the ability to achieve
7.3.1
Project Team
several major goals during the initial adoption of
Successful implementation of telehealth relies on a
the program.
wide array of stakeholders on the project. Te most
Goals for each organization should be unique and
successful telehealth programs incorporate the
may incorporate ideas from the following categories:
program into the day-to-day operations of the or-
ganization and provide all staff with some involve-
Clinical Outcomes
ment with and exposure to the telehealth program.
Since telehealth is enabling a new care delivery
• Improved control of chronic conditions.
model, most staff will need to be involved, includ-
• Improved integration/coordination of care.
ing executive leadership, clinical teams, technical
representatives, DME/logistics, finance, operations
• Reduction of hospitalizations.
and marketing/business development. Getting all
• Hospital readmission reduction.
of these groups on board with a clear set of goals,
LeadingAge Center for Aging Services Technologies (CAST)
31
• Increased chronic condition education.
Be sure to define outcome measures that will help
in evaluating the success of the program in the
• Improved self-management skills.
short- and long-term. Afer program goals have
been determined, ensure that baseline data has
Satisfaction Outcomes
been captured and discussed during telehealth
planning sessions. Tese goals and metrics should
• Improved patient satisfaction scores.
be periodically reviewed and updated throughout
the planning and implementation process.
• Improved provider satisfaction scores.
• Employee satisfaction and retention.
7.3.3
Program Design
• Increased trust from the patient.
Telehealth programs should be designed with the
organizations’ short- and long-term goals in mind
• Provide security in the home environment.
to help ensure success. In addition to the orga-
nization’s goals, care coordination, collaboration
Operational Outcomes
and communication to enhance patient care and
outcomes with other care providers along the con-
• Increased staff productivity/efficiencies.
tinuum of care should also influence the program
• Focused intervention and needs.
design. Te design of each program should always
consider how to align objectives, strategies, and
• Attracting new talents.
technical plans with care partners by using tele-
health and the EHR, as a source of information and
• Positioning and market advantage.
a facilitator of communications. Be sure to share ex-
periences from other similar organizations to assist
Financial Outcomes
in strategies to build a telehealth program within
the organization or strengthen an already existing
• Readmission reductions.
telehealth program (please see the companion case
• Increased productivity.
studies that CAST is collecting).
• Decreased travel time.
7.3.3.1 Operating Model, Workflow, and
Change Management
• Increased market share/referrals.
When a new telehealth program is implemented,
• Increased occupancy.
it does not just mean adding technology into an
• Opportunity for new lines of business.
existing care model; on the contrary, care models
themselves change because the delivery of patient
care is being done via telehealth technology. Tis is
particularly significant for the clinical care model.
Before starting any program, make sure that the
Telehealth and Remote Patient Monitoring for Long-Term and Post-Acute Care:
A Primer and Provider Selection Guide 2013
32
new model of care is clearly defined and that staff
7.4
Technology Review and Selection
have been prepared with training and support
plans. To gain the most benefit out of telehealth,
Once an organization has completed the visioning
ensure it is used as a tool for changing care delivery
and strategic planning exercise, assessed organi-
and workflows, both inside the organization and
zational readiness, assembled the project team, set
with outside partners, and not simply an add-on.
the project’s goals and designed the program, then
Adding telehealth, or any other technology for that
the team needs to develop a set of requirements to
matter, without assessing and redesigning processes
use as criteria to review and select the appropriate
and workflows to take advantage of the technolo-
telehealth technology solution that can help achieve
gies’ capabilities and efficiencies, will likely fail to
desired program’s goals and meets an organization’s
produce the anticipated benefits.
needs. When reviewing possible telehealth technol-
ogy options, it is important to know what type of
7.3.3.2 Patient Population
telehealth technology embodiment fits within an
organization’s care setting and planned care delivery
Identifying the patient population an organization
model, etc. In the CAST Telehealth and RPM Selec-
wants to reach with telehealth-enabled care should
tion Matrix that follows, we outline options that
be done at the earliest stages of planning. As part
will help narrow down the selection to a limited
of this process, ensure that there is a process for
number of vendors that can be invited to submit
patient identification, enrollment and gathering of
request for proposals.
their consents. Demonstrating the value of tele-
health and making sure that patients understand
their care will be improved, not diminished, is at
8
Telehealth and RPM
the heart of the consent process.
Selection Matrix Components
7.3.3.3 Business Model: Expenses and Revenue
CAST’s Telehealth Workgroup, consisting of pro-
Sources
viders, vendors and consultants, compiled a list of
telehealth and RPM products that serve the LT-
Consider the care deliver and payment model(s)
PAC market, as well as a list of functionalities and
being proposed for the telehealth program. Identify
capabilities that would help providers choose the
all expenses including technology infrastructure,
telehealth and RPM product that fits their business
connectivity, telehealth system expenses, installa-
line and functional requirements best. Each of the
tion, troubleshooting, maintenance and support,
telehealth and RPM vendors was then provided
change management, training, clinical services and
the opportunity to complete a self-review of the
support. Identify all the revenue sources (private
workgroup’s pre-determined questions. Some of
pay, payer, strategic partner), and carefully calculate
these vendors chose not to participate. Tose who
the organization’s ROI, as well as the other stake-
did participate were then offered the opportunity to
holders’ (please see section 6.8).
nominate a case study from a provider’s perspective
on the use of the vendor’s telehealth/RPM product.
LeadingAge Center for Aging Services Technologies (CAST)
33
Some telehealth and RPM vendors have multiple
User/Patient Home Base Unit, Single-User/Patient
embodiments of their products (Single-User/Pa-
Mobile/Wearable Unit, Staff-Operated Multi-User
tient Home Base Unit, Single-User/Patient Mobile/
Mobile Unit, and/or Multi-User Unit/Kiosk.
Wearable Unit, Staff-Operated Multi-User Mobile
Program Development & Support Offered includes
Unit, and/or Multi-User Unit/Kiosk). In this case,
Program Development (Planning, Business Model
the vendor was asked to provide information on
Templates, etc.), Telehealth/RPM Nurse Services,
each product separately.
Other Store-and-Forward Clinician Services, Real-
Te Telehealth and RPM Selection Matrix includes
Time Interactive Video Conferencing with Physi-
the following sections:
cian/Clinician Services, Physician Engagement
Services, Patient Education, Patient Engagement,
Business Line/Care Applicability lists all the various
and Family Engagement.
business lines to which the telehealth/RPM solu-
tion is applicable, including Physicians’ Offices,
Available Ancillary Sensors/Devices covers Sensor
Emergency Department, Hospitals, Housing with
Types (Stethoscope, Temperature Probe, Blood
Services, Home Health/Home Care, Hospice, Adult
Pressure Cuff, Weight Scale, Heart Rate, Peak Flow,
Day Care/Senior Centers, Assisted Living Facili-
Glucometer, Pulse Oximeter, Pulse Waveform, Spi-
ties, Acute Rehab Facilities, Long-term Acute Care
rometer, EKG/ECG, High-Definition Still Camera,
Hospitals, Long-term Care Rehab Facilities, Skilled
High-Definition Video Camera, Other Sensors
Nursing Facilities, Intermediate Care Facilities,
listed, and Notes on Specialty Sensors Offered),
Intellectual Disabilities/Mental Retardation/Devel-
and Sensor Connectivity (Wired, Wireless, and/or
opmental Disabilities (ID/MR/DD) Facilities, Con-
Others).
tinuing Care Retirement Communities (CCRC),
Front-End Hardware Unit User/Patient Interface &
Program of All-Inclusive Care for the Elderly
Communications identifies the unit’s functionalities,
(PACE), Accountable Care Organizations (ACOs),
user interface capabilities, and communications
and Multiple Site Integration.
modalities with the user/patient including Touch
System Type defines the basic function of the solu-
Screen, Audible Prompts, Visual Prompts, Standard
tion and includes Store-and-Forward: Interactive
Disease-Specific Questionnaires, Customizable
Voice Response System (IVR), Store-and-Forward:
Questionnaires, Biometric Tresholds are Custom-
Biometric Remote Patient Monitoring, Other
izable, and Branching Logic Based on Biometric
Store-and-Forward Systems: Other than IVR &
Data and User’s/Patient’s Responses. Additionally,
Biometrics (e.g., Imaging, Consultation Notes, etc.),
the various Communications Modality options are
Real-Time Biometric Remote Patient Monitoring
listed as Plain Old Telephone System (POTS) Line,
(exists with Store-and-Forward as well) and Real-
DSL Internet Connectivity, High-Speed Internet
Time Interactive Two-Way Video Conferencing
Connectivity, Wi-Fi Connectivity, Cellular Connec-
with Clinician.
tivity, and Minimum Internet Connectivity Speed
Required.
Embodiment provides information about the
physical system and includes the options of Single-
Telehealth and Remote Patient Monitoring for Long-Term and Post-Acute Care:
A Primer and Provider Selection Guide 2013
34
Hardware and Sofware Requirements - Front End
or Other).
lists the required Desktop/Laptop specifications for
Alerts and Chronic Disease Management Deci-
Sofware-Only Solutions including requirements
sion Support includes to whom Alerts can be sent
for Minimum Processor, Minimum Processor
(Client/Patient’s Physician, Client/Patient’s Nurse/
Speed, Minimum RAM, Minimum Hard Disk Stor-
Other Licensed Clinician, Client/Patient/User/Self,
age, Operating System (OS) - Windows, Operating
Care Manager/Professional Caregiver, Family, and/
System (OS) -Apple, and/or Operating System (OS)
or Other) and the Alert Sending Modality, which
- Unix/Linux. Other features compared include
includes options for Pager, E-Mail, Text Message,
Network Specifications, Wireless Specifications,
and/or Other.
Browser Based Requirements, Minimum Internet/
Bandwidth Specifications, Miscellaneous Sofware/
Single Condition Clinical Decision Support System
Applets Needed (i.e. Citrix), Miscellaneous Report-
has options for Congestive Heart Failure (CHF),
ing Specifications (i.e. Crystal Reports), Scalability,
Myocardial Infarction, Pneumonia, Chronic Ob-
Local Model, Hosted Model, Sofware as a Service
structive Pulmonary Disease (COPD), Diabetes,
Model (SaaS), Remote Access, Off-Line Functional-
Hypertension, Asthma, Arrhythmia, Stroke, Pres-
ity Support, Ability to Store/Handle Attachments
sure Ulcers/Wound Care, End-Stage Renal Disease,
(Insurance card, Historical Notes, etc.), Available
Depression or Other.
for Purchase, and Available for Lease. Last, Mobile
Customizable Pathways and Clinical Decision Sup-
options are listed as Cellular Carriers that Support
port Systems for Multiple Chronic Conditions and
Solution, Mobile OS - Android, Mobile OS - Black-
Comorbidities builds upon the previous section and
berry, Mobile OS - iOS, Mobile OS - Unix/Linux,
lists all comorbidities. Vendors were instructed to
and/or Mobile OS - Windows.
only check comorbidity options that can be handled
Front-End Unit Support lists materials delivered
simultaneously. Options included Congestive Heart
through the front-end unit, including On-Screen
Failure (CHF), Myocardial Infarction, Pneumonia,
Educational Self-Management Material, Self-
Chronic Obstructive Pulmonary Disease (COPD),
Management Educational Audios, and/or Self-
Diabetes, Hypertension, Asthma, Arrhythmia,
Management Educational Videos. Front-End Unit
Stroke, Pressure Ulcers/Wound Care, End-Stage
Multi-Language Support section lists the available
Renal Disease, Depression or Other.
languages. Te final options here include Remote
Interfacing, Integration and Add-Ons looks into the
Updates and/or Remote Configuration Capability.
telehealth/RPM solution with Electronic Health
Report and Personal Health Record (PHR)/EHR
Records (EHRs), Medication Adherence Monitor-
examines options to provide Customizable Reports
ing Dispensers, Safety Monitoring Systems (e.g.,
or Ability to Schedule Automatic Reports, and to
Personal Emergency Response Systems (PERS)),
whom Health Record/Report Access is provided
Wellness, Behavior and Activity Monitoring Sys-
(Client/Patient’s Physician, Client/Patient’s Nurse/
tems, or Others.
Other Licensed Clinician, Client/Patient/User/Self,
Care Manager/Professional Caregiver, Family and/
LeadingAge Center for Aging Services Technologies (CAST)
35
Interoperability, Interoperability Standards and
Legal/Regulatory/Cyberliability touches on FDA Ap-
Certification begins with Type of Interoperability
proval (Approved, Cleared, Pending, Listed, None),
Supported (None, Export Data Only, Import Data
FDA Classification (Class I, Class II, etc.), HI-
Only, or Bi-Directional data import and export),
TECH, HIPAA, Security - List HIPAA & HITECH
Supported Interoperability Standards: HL7 Personal
Act Requirements Met, List Applicable Regulatory
Health Monitoring Report and/or Other, Back-End
Requirements Met, Provide a Link to Company’s
EHR/PHR Certification in the form of ONC-ATCB,
Cyberliability Policy, and List Any Other Legal
Comprehensive CCHIT-LTPAC: Home Health and/
Requirements, as well as an option to Provide a link
or Comprehensive CCHIT-LTPAC: Nursing Home.
to Sample Contract.
Te section ends with information on Front-End
Hardware and Sofware Requirements - Back End
System Certification, namely the Continua Health
provides required specifications for Desktop/Lap-
Alliance Certification.
top systems including requirements for Minimum
Program Support Services includes options for
Processor, Minimum Processor Speed, Minimum
Equipment Delivery/Pick Up, Site/Home Instal-
RAM, Minimum Hard Disk Storage, Operating
lation, IT/Network Troubleshooting & Support,
System (OS) - Windows, Operating System (OS)
Front-End System Set-up, Front-End System
-Apple, and/or Operating System (OS) - Unix/
Customization, Back-End System Set-up, Back-
Linux. Other features compared include Network
End System Customization, Onsite Staff Training,
Specifications, Wireless Specifications, Browser
Online Staff Training, Onsite User/Patient Training,
Based Requirements, Minimum Internet/Band-
Online User/Patient Training, Equipment Cleaning,
width Specifications, Miscellaneous Sofware/Ap-
Equipment Refurbishing and/or Other.
plets Needed (i.e. Citrix), Miscellaneous Reporting
Specifications (i.e. Crystal Reports), Scalability,
Clinical Supportability includes options for 24-Hour
Local Model, Hosted Model, Sofware as a Service
Support-Phone, Limited Hours Support - Phone,
Model (SaaS), Remote Access, Off-Line Functional-
24-Hour Support - Web, Limited Hours Support -
ity Support, Ability to Store/Handle Attachments
Web, E-Mail Support, Listserv and/or Usergroup,
(Insurance card, Historical Notes, etc.), Available
Online Training, Onsite Training, and/or Other.
for Purchase, and Available for Lease. Last, Mobile
options are listed as Cellular Carriers that Support
Technical Supportability and Warranty Information
Solution, Mobile OS - Android, Mobile OS - Black-
includes technical support options for 24-Hour
berry, Mobile OS - iOS, Mobile OS - Unix/Linux,
Support-Phone, Limited Hours Support - Phone,
and/or Mobile OS - Windows.
24-Hour Support - Web, Limited Hours Support -
Web, E-Mail Support, Listserv and/or Usergroup,
Company’s Experience and Viability includes Num-
Online Training, Onsite Training, and/or Other,
ber of Years in Business, Release Date of Current
as well as warranty options that include Length of
Version, Number of Patients served, Core Customer
Product Warranty and goes onto share what is cov-
Base, Focus of Line of Business, as well as Links to
ered under warranty: Parts, Parts & Labor, or Parts,
Additional Case Studies.
and In-Field/On-Site Labor.
Telehealth and Remote Patient Monitoring for Long-Term and Post-Acute Care:
A Primer and Provider Selection Guide 2013
36
Te last section of the matrix is dedicated for
Scott Flacks, Ideal Life, Inc.
Strengths, Areas for Improvement, Ongoing Devel-
Stacey Force, HoneyWell HomMed
opment and References.
Cory Fosco, WoundRounds
Bryan Fuhr, Healthsense
9
Acknowledgement of
Contributors
Lynette Ladenburg, LeadingAge Washington
Pete Larson, HealthInterlink
9.1
Contributing Writers
Ben Laub, Sholom
Majd Alwan, LeadingAge CAST
David Loveland, WoundRounds
Jennifer Bravinder, Cardiocom
Shannon McIntyre Hooper, Intel-GE Care Innova-
Paul Burnstein, LeadingAge CAST
tions
Eric Eiting, GrandCare Systems
Regina Melly, Jewish Home Lifecare
David Loveland, WoundRounds
Laura Mitchell, GrandCare Systems
Shannon McIntyre Hooper, Intel-GE Care Innova-
Brian Robbins, Westminster
tions
John Ryan, Philips Medical Systems
Laura Mitchell, GrandCare Systems
Andy Schoonover, Monitoring Care
Linda Spokane, LeadingAge New York
John Schumacher, Biosign Technologies Inc.
9.2
Workgroup Members
Linda Spokane, LeadingAge New York
Majd Alwan, LeadingAge CAST
9.3
Participating Telehealth and RPM
Harry Bailes, Family Health Network
Vendors
Andrea Bellis, HoneyWell HomMed
Ambio Health, Kevin Jones
Jennifer Bravinder, Cardiocom
Biosign - Healthanywhere, Michelle Violette, John
Schumacher
Paul Burnstein, LeadingAge CAST
Cardiocom, Jennifer Bravinder, Jen Farrell, Chris
David Dring, Selfelp Community Services
Taylor
Eric Eiting, GrandCare Systems
CJPS Medical Systems, LLC, Christophe Sevrain
Jen Farrell, Cardiocom
LeadingAge Center for Aging Services Technologies (CAST)
37
Family Health Network, Harry Bailes
GrandCare Systems, Laura Mitchell, Eric Eiting
HealthInterlink (Beacon), Pete Larson
Healthsense, Bryan Fuhr
HoneyWell HomMed, Andrea Bellis, Stacey Force
Ideal Life, Scott Flacks, Julianne Wassong
Independa, Becky Wheeler
Intel-GE Care Innovations, Shannon McIntyre
Hooper
Philips Medical Systems, John Ryan
Tunstall America, Christina Coons, Brian Verban
VRI, Andy Schoonover
WoundRounds, David Loveland, Cory Fosco
Telehealth and Remote Patient Monitoring for Long-Term and Post-Acute Care:
A Primer and Provider Selection Guide 2013
38
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Telehealth and Remote Patient Monitoring for Long-Term and Post-Acute Care:
A Primer and Provider Selection Guide 2013
11 Telehealth and RPM Selection Matrix
42
Telehealth and Remote Patient Monitoring
(RPM) Selection Matrix
Disclaimer
The information included in this paper is meant to assist care providers in the
understanding and selection of telehealth and remote patient monitoring (RPM)
solutions, but cannot possibly include all systems that may be available. Products
mentioned in this paper serve as illustrative examples. Information about the
functionalities and capabilities for this effort were provided by participating vendors
of telehealth and RPM solutions. A few telehealth and RPM vendors chose not to
participate. Functionalities and capabilities of listed telehealth and RPM products
have not been verified, tested, independently evaluated or endorsed by LeadingAge or
LeadingAge CAST. Please use this as general guidelines in understanding functionalities
and examples of current telehealth and RPM systems. The Telehealth and RPM
Selection Matrix may help providers identify potential telehealth and RPM solutions
that may meet their requirements, and is intended to help them target vendors to
submit a Request for Proposal (RFP). Where appropriate, provider case studies were
identified and published separately. However, providers are strongly advised to verify
functionalities of the telehealth and RPM solutions prior to final selection through
demonstrations, site visits, reference checking and other due diligence steps.
Acute Care Settings
Business Line/Care Applicability
Ambio Health
Yes
No
No
Yes
Yes
Yes
Yes
Yes
No
Beacon® by HealthInterlink
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Biosign - Healthanywhere
Yes
No
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Cardiocom - Commander FLEX
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Cardiocom - Link View
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
No
Cardiocom - TeleResponse
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
No
Cardiocom - NetResponse
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
No
Cardiocom - Attentiv
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
No
Cardiocom - Telescale
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
No
CJPS Medical Systems (VitalPoint HOME)
Yes
No
Yes
Yes
Yes
Yes
Yes
Yes
No
Family Health Network Connected for Life
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
GrandCare Systems
Yes
Yes
Yes
Yes
Yes
Yes
No
Yes
Yes
Business Line/Care Applicability
Ambio Health
Yes
Yes
Yes
Yes
Yes
Yes
No
Yes
Yes
Beacon® by HealthInterlink
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Biosign - Healthanywhere
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Cardiocom - Commander FLEX
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Cardiocom - Link View
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Cardiocom - TeleResponse
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Cardiocom - NetResponse
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Cardiocom - Attentiv
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Cardiocom - Telescale
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
CJPS Medical Systems (VitalPoint HOME)
Yes
No
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Family Health Network Connected for Life
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
GrandCare Systems
Yes
Yes
Yes
Yes
Yes
Yes
No
Yes
No
Acute Care Settings
Business Line/Care Applicability
Healthsense, Inc.
No
No
No
Yes
Yes
Yes
Yes
Yes
Yes
Honeywell HomMed - Genesis DM
No
No
No
Yes
Yes
Yes
Yes
Yes
Yes
Honeywell HomMed - Genesis Touch
No
No
No
Yes
Yes
Yes
Yes
Yes
Yes
IDEAL LIFE, INC.
Yes
No
Yes
Yes
Yes
Yes
Yes
Yes
No
Independa
No
No
No
Yes
Yes
No
No
Yes
Yes
Intel-GE Care Innovations™ Guide
Yes
No
Yes
Yes
Yes
Yes
No
Yes
Yes
Philips
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
telehealth.philips.com
Tunstall - Contact Center Services/IVR
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
americas.tunstall.com/Contact-Center
Tunstall - Telehealth
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
americas.tunstall.com/Telehealth
VRI TeleHealth
No
No
No
Yes
Yes
Yes
Yes
Yes
No
WoundRounds (Telemedicine Solutions)
No
No
Yes
No
Yes
Yes
No
Yes
Yes
Business Line/Care Applicability
Healthsense, Inc.
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Honeywell HomMed - Genesis DM
No
Yes
Yes
Yes
No
Yes
No
Yes
Yes
Honeywell HomMed - Genesis Touch
No
Yes
Yes
Yes
No
Yes
No
Yes
Yes
IDEAL LIFE, INC.
No
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Independa
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Intel-GE Care Innovations™ Guide
No
Yes
Yes
Yes
No
Yes
Yes
Yes
Yes
Philips
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
telehealth.philips.com
Tunstall - Contact Center Services/IVR
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
americas.tunstall.com/Contact-Center
Tunstall - Telehealth
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
americas.tunstall.com/Telehealth
VRI TeleHealth
No
No
No
Yes
Yes
Yes
Yes
Yes
Yes
WoundRounds (Telemedicine Solutions)
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Other Store-and-Forward Systems: Other
Real-Time Biometric Remote Patient
Store and Forward: Interactive Voice
Store-and-Forward: Biometric Remote
Real-Time Interactive Two-Way Video
System Type
than IVR & Biometrics (e.g. Imaging,
Monitoring (exists with Store-and-Forward
Response System (IVR)
Patient Monitoring
Conferencing with Clinician
Consultation Notes, etc.) (Please List)
as well)
Ambio Health
Yes
Yes
Yes; Motion data
Yes
No
Beacon® by HealthInterlink
Yes
Yes
No
Yes
No
Biosign - Healthanywhere
No
Yes
Yes; Consultation notes
Yes
No
Cardiocom - Commander FLEX
No
Yes
No
Yes
No
Cardiocom - Link View
No
Yes
No
Yes
Yes
Cardiocom - TeleResponse
Yes
Yes
No
Yes
No
Cardiocom - NetResponse
No
Yes
No
Yes
No
Cardiocom - Attentiv
No
Yes
No
Yes
No
Cardiocom - Telescale
No
Yes
No
Yes
No
Yes; Audio/Video messaging including video
CJPS Medical Systems (VitalPoint HOME)
No
Yes
clips, assessment questionnaire, responses
Yes
Yes
to Q&A via touchscreen
Family Health Network Connected for Life
No
Yes
Yes; Daily patient journals and surveys
Yes
Yes
GrandCare Systems
No
Yes
No
Yes
Yes
Other Store-and-Forward Systems: Other
Real-Time Biometric Remote Patient
Store and Forward: Interactive Voice
Store-and-Forward: Biometric Remote
Real-Time Interactive Two-Way Video
System Type
than IVR & Biometrics (e.g. Imaging,
Monitoring (exists with Store-and-Forward
Response System (IVR)
Patient Monitoring
Conferencing with Clinician
Consultation Notes, etc.) (Please List)
as well)
Healthsense, Inc.
Yes
Yes
No
Yes
No
Honeywell HomMed - Genesis DM
No
Yes
No
No
No
Honeywell HomMed - Genesis Touch
No
Yes
No
No
Yes
Ideal Life, Inc.
No
No
No
Yes
No
Independa
No
Yes
Yes; Environmental and safety sensors
Yes
Yes
Intel-GE Care Innovations™ Guide
No
Yes
No
No
Yes
Philips
Yes; Medication adherence, International
Yes
Yes
Yes
Yes
telehealth.philips.com
Normalized Ratio (INR)
Tunstall - Contact Center Services/IVR
Yes
No
No
No
No
americas.tunstall.com/Contact-Center
Tunstall - Telehealth
No
Yes
No
Yes
No
americas.tunstall.com/Telehealth
VRI TeleHealth
Yes
Yes
Yes; Triage notes
Yes
Yes
WoundRounds (Telemedicine Solutions)
No
No
Yes; Data, wound imaging, notes
No
No
Embodiment
Single-User/Patient Home Unit
Single-User/Patient Mobile/wearable Unit
Staff-Operated Multi-User Mobile Unit
Multi-User Unit/Kiosk
Ambio Health
Yes
No
No
No
Beacon® by HealthInterlink
Yes
Yes
Yes
Yes
Biosign - Healthanywhere
Yes
No
Yes
Yes
Cardiocom - Commander FLEX
Yes
Yes
No
No
Cardiocom - Link View
Yes
Yes
No
No
Cardiocom - TeleResponse
Yes
Yes
No
No
Cardiocom - NetResponse
Yes
Yes
Yes
No
Cardiocom - Attentiv
Yes
Yes
No
No
Cardiocom - Telescale
Yes
Yes
No
No
CJPS Medical Systems (VitalPoint HOME)
Yes
No
Yes
Yes
Family Health Network Connected for Life
Yes
No
Yes
Yes
GrandCare Systems
Yes
No
Yes
Yes
Embodiment
Single-User/Patient Home Unit
Single-User/Patient Mobile/wearable Unit
Staff-Operated Multi-User Mobile Unit
Multi-User Unit/Kiosk
Healthsense, Inc.
Yes
Yes
Yes
Yes
Honeywell HomMed - Genesis DM
Yes
No
No
Yes
Honeywell HomMed - Genesis Touch
Yes
No
No
No
Ideal Life, Inc.
Yes
Yes
No
Yes
Independa
Yes
Yes
Yes
Yes
Intel-GE Care Innovations™ Guide
Yes
No
No
No
Philips
Yes
Yes
No
No
telehealth.philips.com
Tunstall - Contact Center Services/IVR
Yes
Yes
No
No
americas.tunstall.com/Contact-Center
Tunstall - Telehealth
Yes
Yes
Yes
Yes
americas.tunstall.com/Telehealth
VRI TeleHealth
Yes
Yes
No
Yes
WoundRounds (Telemedicine Solutions)
No
No
Yes
No
Program Development & Support
Offered
Ambio Health
Yes
Yes
No
No
No
No
Yes
Yes
N/A
Beacon® by HealthInterlink
Yes
No
No
No
No
No
Yes
No
Clinical content is customizable by provider.
Biosign - Healthanywhere
Content completely customizable by the provider - existing
Yes
Yes
Yes
No
Yes
Yes
Yes
Yes
content can be brought into the system
Cardiocom - Commander FLEX
Yes
Yes
Yes
No
Yes
Yes
Yes
Yes
Turn-key materials and ongoing program development
Cardiocom - Link View
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Turn-key materials and ongoing program development
Cardiocom - TeleResponse
Yes
Yes
Yes
No
Yes
Yes
Yes
Yes
Turn-key materials and ongoing program development
Cardiocom - NetResponse
Yes
Yes
Yes
No
Yes
Yes
Yes
Yes
Turn-key materials and ongoing program development
Cardiocom - Attentiv
Yes
Yes
Yes
No
Yes
Yes
Yes
Yes
Turn-key materials and ongoing program development
Cardiocom - Telescale
Yes
Yes
Yes
No
Yes
Yes
Yes
Yes
Turn-key materials and ongoing program development
CJPS Medical Systems (VitalPoint HOME)
Yes
Yes
Yes
Yes
No
No
No
No
Alerts and data can be sent to patient, family members, etc.
Family Health Network Connected for Life
Yes
No
No
Yes
Yes
Yes
Yes
Yes
N/A
GrandCare Systems
Content completely customizable by the provider - existing
Yes
No
No
Yes
Yes
Yes
Yes
Yes
content can be brought into the system.
Program Development & Support
Offered
Healthsense, Inc.
Yes
Yes
No
No
No
No
Yes
Yes
N/A
Honeywell HomMed - Genesis DM
Channel Marketing Support Program, Online training and
Yes
Yes
No
Yes
Yes
Yes
Yes
Yes
resources
Honeywell HomMed - Genesis Touch
Channel Marketing Support Program, Online training and
Yes
Yes
No
Yes
Yes
Yes
Yes
Yes
resources
Ideal Life, Inc.
Yes
Yes
No
No
No
Yes
Yes
Yes
N/A
Independa
Yes
No
No
Yes
Yes
Yes
Yes
Yes
Social engagement
Additional optional professional services, including: logistics,
Intel-GE Care Innovations™ Guide
Yes
Yes
No
Yes
Yes
Yes
Yes
No
hardware recommissioning, managed wireless service as a
connectivity option
Philips
Yes
Yes
No
No
Yes
Yes
Yes
Yes
Transitional care services
telehealth.philips.com
Augment & extend telehealthcare services i.e. appointment
Tunstall - Contact Center Services/IVR
Yes
Yes
Yes
No
Yes
Yes
Yes
Yes
scheduling & reminders, referral processing, patient & provider
americas.tunstall.com/Contact-Center
surveys
Tunstall - Telehealth
Complete spectrum of programs, health interviews, and client
Yes
Yes
Yes
No
Yes
Yes
Yes
Yes
americas.tunstall.com/Telehealth
customization
VRI TeleHealth
Yes
Yes
Yes
No
Yes
Yes
Yes
Yes
N/A
WoundRounds (Telemedicine Solutions)
No
No
Yes
No
No
No
No
No
N/A
Available Ancillary Sensors/
Devices
Ambio Health
No
No
Yes
Yes
Yes
No
Yes
No
No
No
No
No
Beacon® by HealthInterlink
No
Yes
Yes
Yes
Yes
Yes
Yes
Yes
No
Yes
No
No
Biosign - Healthanywhere
No
Yes
Yes
Yes
Yes
No
Yes
Yes
Yes
Yes
No
No
Cardiocom - Commander FLEX
No
No
Yes
Yes
Yes
Yes
Yes
Yes
No
Yes
No
No
Cardiocom - Link View
No
No
Yes
Yes
Yes
Yes
Yes
Yes
No
Yes
No
No
Cardiocom - TeleResponse
No
No
No
No
No
No
No
No
No
No
No
No
Cardiocom - NetResponse
No
No
No
No
No
No
No
No
No
No
No
No
Cardiocom - Attentiv
No
No
Yes
Yes
Yes
Yes
Yes
Yes
No
No
No
No
Cardiocom - Telescale
No
No
No
Yes
No
No
No
No
No
No
No
No
CJPS Medical Systems (VitalPoint HOME)
No
Yes
Yes
Yes
Yes
No
Yes
Yes
Yes
No
Yes
Yes
Family Health Network Connected for Life
No
No
Yes
Yes
Yes
Yes
Yes
Yes
No
No
No
Yes
GrandCare Systems
No
No
Yes
Yes
Yes
No
Yes
Yes
No
No
No
No
Healthsense, Inc.
No
No
Yes
Yes
Yes
No
Yes
Yes
No
No
No
No
Honeywell HomMed - Genesis DM
No
Yes
Yes
Yes
Yes
Yes
Yes
Yes
No
No
No
No
Honeywell HomMed - Genesis Touch
No
No
Yes
Yes
Yes
Yes
No
Yes
No
No
No
Yes
Ideal Life, Inc.
No
No
Yes
Yes
Yes
Yes
Yes
Yes
No
No
No
No
Independa
No
No
Yes
Yes
Yes
No
Yes
Yes
No
No
No
No
Intel-GE Care Innovations™ Guide
No
No
Yes
Yes
Yes
Yes
Yes
Yes
No
Yes
No
No
Philips
No
Yes
Yes
Yes
Yes
Yes
Yes
Yes
No
Yes
Yes
No
telehealth.philips.com
Sensor Connectivity
Available Ancillary Sensors/
Devices
Ambio Health
No
Yes; Motion sensors
N/A
No
Yes
N/A
Beacon® by HealthInterlink
No
N/A
Custom Bluetooth or manual options available
No
Yes
Manual entry
Biosign - Healthanywhere
No
N/A
N/A
Yes
Yes
NA
Cardiocom - Commander FLEX
No
N/A
Bluetooth HDP Option
Yes
Yes
N/A
Cardiocom - Link View
Yes
N/A
Bluetooth HDP Option
Yes
Yes
N/A
Cardiocom - TeleResponse
No
N/A
Manual entry for other values
No
No
N/A
Cardiocom - NetResponse
No
N/A
Manual entry for other values
No
No
N/A
Cardiocom - Attentiv
No
N/A
Bluetooth HDP Option
Yes
Yes
N/A
Cardiocom - Telescale
No
N/A
N/A
Yes
No
N/A
CJPS Medical Systems (VitalPoint HOME)
Yes; Fluid status,
Yes
N/A
Yes
Yes
Manual entry
prothrombin
Family Health Network Connected for Life
Yes
N/A
N/A
Yes
Yes
Bluetooth
GrandCare Systems
No
Yes; Webcam
Also ADL sensors
No
Yes
N/A
Healthsense, Inc.
Yes; Motion, door contact,
No
eNeighbor algorithms provide automatic call for help
No
Yes
N/A
bed, toilet
Honeywell HomMed - Genesis DM
No
N/A
N/A
Yes
No
N/A
Honeywell HomMed - Genesis Touch
Yes
N/A
N/A
No
Yes
N/A
Ideal Life, Inc.
No
N/A
N/A
No
Yes
N/A
Independa
Yes
Yes; Webcam
ADL + Environmental Sensors
Yes
Yes
N/A
Intel-GE Care Innovations™ Guide
No
N/A
N/A
Yes
Yes
N/A
Philips
Yes; INR and holter
Yes
N/A
Yes
Yes
N/A
telehealth.philips.com
monitoring (5 lead)
Available Ancillary Sensors/
Devices
Tunstall - Contact Center Services/IVR
No
No
No
No
No
No
No
No
No
No
No
No
americas.tunstall.com/Contact-Center
Tunstall - Telehealth
No
Yes
Yes
Yes
Yes
Yes
Yes
Yes
No
Yes
Yes
No
americas.tunstall.com/Telehealth
VRI TeleHealth
No
No
Yes
Yes
Yes
Yes
Yes
Yes
No
Yes
No
No
WoundRounds (Telemedicine Solutions)
No
No
No
No
No
No
No
No
No
No
No
Yes
Sensor Connectivity
Available Ancillary Sensors/
Devices
Tunstall - Contact Center Services/IVR
No
No
N/A
No
No
N/A
americas.tunstall.com/Contact-Center
Tunstall - Telehealth
No
N/A
N/A
No
Yes
N/A
americas.tunstall.com/Telehealth
VRI TeleHealth
No
Yes; Asthma sensors
N/A
Yes
Yes
N/A
Integrated into
WoundRounds (Telemedicine Solutions)
No
N/A
N/A
No
No
the mobile
device.
Communications Modality (R=Required, P=Preferred, A=Available, N/A= Not Available/
Adequate)
Front-End Hardware Unit User/Patient
Interface & Communications
Ambio Health
No
Yes
Yes
Yes
Yes
Yes
No
N/A
A
A
A
N/A
1 Mbs
Beacon® by HealthInterlink
Yes
Yes
Yes
Yes
Yes
Yes
No
A
A
A
P
A
1 Mbs
Biosign - Healthanywhere
28.8 Kbps (minimum) and 1 Mbs
Yes
Yes
Yes
Yes
Yes
Yes
No
A
A
A
A
A
for video streaming
Cardiocom - Commander FLEX
No
Yes
Yes
Yes
Yes
Yes
Yes
A
A
A
A
A
POTS
Cardiocom - Link View
Recommend 1.5 Mb/s+ when using video
Yes
Yes
Yes
Yes
Yes
Yes
Yes
N/A
A
A
A
A
capabilities
Cardiocom - TeleResponse
No
Yes
No
Yes
Yes
Yes
Yes
A
A
A
A
A
POTS
Cardiocom - NetResponse
Yes
No
Yes
Yes
Yes
Yes
Yes
N/A
A
A
A
A
1 Mbs
Cardiocom - Attentiv
No
Yes
Yes
Yes
Yes
Yes
Yes
A
A
A
A
A
POTS
Cardiocom - Telescale
No
Yes
Yes
Yes
Yes
Yes
Yes
R
N/A
N/A
N/A
N/A
N/A
CJPS Medical Systems (VitalPoint HOME)
Yes
Yes
Yes
Yes
Yes
Yes
Yes
A
A
A
A
A
POTS
Family Health Network Connected for Life
Yes
Yes
Yes
Yes
Yes
Yes
Yes
N/A
A
A
A
A
2 Mbs
GrandCare Systems
Yes
Yes
Yes
Yes
Yes
Yes
No
N/A
A
P
A
A
1 Mbs
Communications Modality (R=Required, P=Preferred, A=Available, N/A= Not Available/
Adequate)
Front-End Hardware Unit User/Patient
Interface & Communications
Healthsense, Inc.
No
Yes
No
Yes
Yes
Yes
Yes
N/A
A
A
A
A
256 Kbs
Honeywell HomMed - Genesis DM
No
Yes
Yes
Yes
Yes
Yes
Yes
A
N/A
N/A
N/A
A
POTS
Honeywell HomMed - Genesis Touch
When Using Video recommend 1.0 Mbs
Yes
Yes
Yes
Yes
Yes
Yes
Yes
A
N/A
N/A
A
A
Up/4.0 Mbs Down
Ideal Life, Inc.
Yes
Yes
Yes
Yes
Yes
Yes
Yes
A
A
A
A
A
64 kbs
Independa
No minimum - if no video use. When
Yes
Yes
Yes
No
Yes
Yes
Yes
A
A
P
A
A
using video, recommend 128 Kbps
Intel-GE Care Innovations™ Guide
Yes
Yes
Yes
Yes
Yes
Yes
Yes
A
A
P
A
A
.06 Mbs
Philips
Yes
Yes
Yes
Yes
Yes
Yes
Yes
A
A
N/A
N/A
A
POTS
telehealth.philips.com
Tunstall - Contact Center Services/IVR
No
Yes
No
Yes
Yes
Yes
Yes
A
N/A
N/A
N/A
A
N/A
americas.tunstall.com/Contact-Center
Tunstall - Telehealth
Yes
Yes
Yes
Yes
Yes
Yes
Yes
A
N/A
A
N/A
A
POTS
americas.tunstall.com/Telehealth
VRI TeleHealth
No
Yes
Yes
No
Yes
Yes
Yes
A
A
A
N/A
P
3 Mbs
WoundRounds (Telemedicine Solutions)
Yes
No
Yes
Yes
No
No
No
N/A
N/A
P
A
N/A
3 Mbs
Desktop/Laptop Specifications for Software-Only
Solutions
Hardware and Software
Requirements - Front End
Ambio Health
Any web
Any web
Any web
Any web
IE 9.0+, Firefox, Chrome,
Yes
Yes
Yes
Ethernet
Proprietary
1 Mbs
None
N/A
Yes
browser
browser
browser
browser
Safari
Beacon® by HealthInterlink
Internet
802.11
Internet
Adobe Acrobat Reader;
Any
1.5 Ghz
1 GB
2 GB
Yes
Yes
Yes
IE 9.0+, Firefox, Chrome
N/A
Yes
Connectivity
b/g/n
Connectivity
Javascript
28.8 Kbs
Biosign - Healthanywhere
802.11
IE 8.0+, Chrome, Firefox,
(min),
Windows OS required for
Pentium III
1 Ghz
1 GB
500 MB
Yes
No
No
Ethernet
N/A
Yes
b/g/n
Opera, Safari
Broadband
device connectivity
preferred
Cardiocom - Commander FLEX
Internet
IE 6.0+, Firefox, Chrome,
Internet
Adobe Acrobat Reader;
N/A
N/A
N/A
N/A
Yes
N/A
N/A
N/A
N/A
Yes
Connectivity
Safari
Connectivity
Javascript
Cardiocom - Link View
Broadband
IE 6.0+, Firefox, Chrome,
Broadband
Adobe Acrobat Reader;
N/A
N/A
N/A
N/A
Yes
N/A
N/A
N/A
N/A
Yes
(1.5Mb/s+)
Safari
(1.5Mb/s+)
Javascript
Cardiocom - TeleResponse
Internet
IE 6.0+, Firefox, Chrome,
Internet
Adobe Acrobat Reader;
N/A
N/A
N/A
N/A
Yes
N/A
N/A
N/A
N/A
Yes
Connectivity
Safari
Connectivity
Javascript
Cardiocom - NetResponse
Internet
IE 6.0+, Firefox, Chrome,
Internet
Adobe Acrobat Reader;
N/A
N/A
N/A
N/A
Yes
N/A
N/A
N/A
N/A
Yes
Connectivity
Safari
Connectivity
Javascript
Cardiocom - Attentiv
Internet
IE 6.0+, Firefox, Chrome,
Internet
Adobe Acrobat Reader;
N/A
N/A
N/A
N/A
Yes
N/A
N/A
N/A
N/A
Yes
Connectivity
Safari
Connectivity
Javascript
Cardiocom - Telescale
Internet
IE 6.0+, Firefox, Chrome,
Internet
Adobe Acrobat Reader;
N/A
N/A
N/A
N/A
Yes
N/A
N/A
N/A
N/A
Yes
Connectivity
Safari
Connectivity
Javascript
70 MB
CJPS Medical Systems (VitalPoint HOME)
(data kept
Internet
Any
Any
Any
Yes
No
No
Ethernet
802.11
IE 6.0+, Firefox, Chrome
RDC
N/A
Yes
on vendor
Connectivity
servers)
Family Health Network Connected for Life
802.11
IE 9.0+, Firefox, Chrome,
Intel Core i3
2 GHz
2 GB
5 GB
Yes
Yes
No
Broadband
1.5 Mbs
None
N/A
Yes
a/b/g/n
Safari
GrandCare Systems
802.11
IE 9.0+, Firefox, Chrome,
Intel Atom
1 GHz
1 GB
10 GB
No
No
Yes
Ethernet
1 Mbs
N/A
N/A
Yes
b/g/n
Safari
Healthsense, Inc.
Healthsense
802.11
Internet
N/A
N/A
N/A
N/A
Yes
N/A
N/A
IE, Firefox, Chrome
None
N/A
Yes
SSID
b/g/n
Connectivity
Mobile
Hardware and Software
Requirements - Front End
Ambio Health
No
Yes
Yes
Yes
Yes
No
No
Yes
N/A
Yes
No
Yes
No
Yes
Locally hosted and
Beacon® by HealthInterlink
enterprise license options
Yes
Yes
Yes
Yes
Yes
No
Yes
Yes
Multiple
Yes
No
Yes
Yes
Yes
based on individual
customer environment.
Biosign - Healthanywhere
No
Yes
Yes
Yes
Yes
Yes
Yes
No
N/A
No
No
No
No
No
Cardiocom - Commander FLEX
Yes
Yes
Yes
Yes
No
Yes
No
Yes
Multiple
Yes
Yes
Yes
Yes
Yes
Cardiocom - Link View
Yes
Yes
Yes
Yes
No
Yes
No
Yes
Multiple
No
No
No
No
No
Cardiocom - TeleResponse
Yes
Yes
Yes
Yes
No
Yes
No
Yes
Multiple
Yes
Yes
Yes
Yes
Yes
Cardiocom - NetResponse
Yes
Yes
Yes
Yes
No
Yes
No
Yes
Multiple
Yes
Yes
Yes
Yes
Yes
Cardiocom - Attentiv
Yes
Yes
Yes
Yes
No
Yes
No
Yes
Multiple
Yes
Yes
Yes
Yes
Yes
Cardiocom - Telescale
Yes
Yes
Yes
Yes
No
Yes
No
Yes
No
Yes
Yes
Yes
Yes
Yes
CJPS Medical Systems (VitalPoint HOME)
Yes
No
Yes
Yes
No
Yes
Yes
Yes
N/A
No
No
No
No
No
Family Health Network Connected for Life
Yes
Yes
Yes
Yes
No
Yes
Yes
Yes
Agnostic
Yes
No
Yes
No
No
GrandCare Systems
Yes
Yes
Yes
Yes
No
No
Yes
No
Agnostic
No
No
No
No
No
Healthsense, Inc.
No
No
Yes
Yes
No
No
Yes
Yes
Agnostic
Yes
Yes
Yes
Yes
Yes
Desktop/Laptop Specifications for Software-Only
Solutions
Hardware and Software
Requirements - Front End
Honeywell HomMed - Genesis DM
LifeStream
Any
400 MHz
1 GB
1 GB
Yes
No
No
Ethernet
Bluetooth
None
Internet Connectivity
Integrated
Yes
Manager
Honeywell HomMed - Genesis Touch
LifeStream
Any
400 MHz
1 GB
1 GB
Yes
No
No
Ethernet
Bluetooth
None
Internet Connectivity
Integrated
Yes
Manager
Ideal Life, Inc.
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
Bluetooth
IE 7+, Firefox, Chrome, Safari
N/A
N/A
N/A
Yes
Independa
Any web
Any web
Any web
Any web
Any web
Any web
Any web
Internet
N/A
Any web-enabled browser
Internet Connectivity
None
N/A
Yes
browser
browser
browser
browser
browser
browser
browser
Connectivity
Intel-GE Care Innovations™ Guide
Internet
Minimum Dial-up
Intel Atom
1.66 GHz
2 GB
250 GB
Yes
No
No
802.11 b/g/n
No
No
N/A
Yes
Connectivity
speeds
Philips
Internet
N/A
N/A
N/A
N/A
N/A
N/A
N/A
Minimum 3G
No
Internet Connectivity
None
N/A
Yes
telehealth.philips.com
Connectivity
Tunstall - Contact Center Services/IVR
Any web
Any web
Any web
Any web
Any web
Any web
Any web
Internet
Exporting
N/A
IE 6+, Chrome, Firefox
Internet Connectivity
PDF Reader
Yes
americas.tunstall.com/Contact-Center
browser
browser
browser
browser
browser
browser
browser
Connectivity
enabled
Tunstall - Telehealth
Any web
Any web
Any web
Any web
Any web
Any web
Any web
Internet
Bluetooth
IE 6+, Chrome, Firefox
Internet Connectivity
PDF Reader
N/A
Yes
americas.tunstall.com/Telehealth
browser
browser
browser
browser
browser
browser
browser
Connectivity
VRI TeleHealth
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
WoundRounds (Telemedicine Solutions)
Adobe
N/A
N/A
N/A
N/A
Yes
Yes
No
Ethernet
N/A
IE 8 minimum
N/A
N/A
Yes
Acrobat 10+
Mobile
Hardware and Software
Requirements - Front End
eDevice,
Honeywell HomMed - Genesis DM
No
Yes
Yes
Yes
Yes
Yes
Yes
Yes
AT&T,
Yes
No
No
No
No
Verizon
eDevice,
Honeywell HomMed - Genesis Touch
No
Yes
Yes
Yes
Yes
Yes
Yes
Yes
AT&T,
Yes
No
No
No
No
Verizon
Ideal Life, Inc.
GSM and
No
Yes
Yes
Yes
Yes
No
Yes
Yes
Yes
Yes
Yes
Yes
Yes
CDMA
Verizon
Independa
tablet.
No
Yes
Yes
Yes
Yes
No
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Agnostic
otherwise.
Single
Intel-GE Care Innovations™ Guide
Yes
No
No
No
Yes
No
Yes
Yes
Verizon
No
No
No
No
No
purpose
device
Philips
No
Yes
Yes
Yes
Yes
No
Yes
Yes
Multiple
Yes
No
Yes
No
No
telehealth.philips.com
Tunstall - Contact Center Services/IVR
N/A
N/A
N/A
Yes
Yes
N/A
Yes
Yes
N/A
N/A
N/A
N/A
N/A
N/A
americas.tunstall.com/Contact-Center
Tunstall - Telehealth
Yes
Yes
Yes
Yes
No
Yes
No
Yes
Agnostic
No
No
No
No
Yes
americas.tunstall.com/Telehealth
AT&T,
VRI TeleHealth
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
Verizon,
N/A
N/A
N/A
N/A
N/A
T-Mobile
WoundRounds (Telemedicine Solutions)
No
No
Yes
Yes
Yes
No
No
Yes
N/A
Yes
No
Yes
No
Yes
Educational
Front-End Unit Multi-Language Support
Self-Management Materials
Front-End Unit Support
Ambio Health
Yes
No
No
Yes
Yes
No
No
No
No
No
No
No
No
No
No
No
N/A
Yes
Yes
Beacon® by HealthInterlink
Additional languages
No
No
No
Yes
Yes
No
No
No
No
Yes
No
No
No
No
No
No
Yes
Yes
by customer request
Additional Languages
Biosign - Healthanywhere
Yes
Yes
Yes
Yes
Yes
No
No
No
No
Yes
Yes
No
No
No
No
No
can be supported via
Yes
Yes
localizing
Additional languages
Cardiocom - Commander FLEX
Yes
Yes
No
Yes
Yes
No
No
No
No
No
No
No
No
No
No
No
can be developed as
Yes
Yes
required
Additional languages
Cardiocom - Link View
Yes
Yes
Yes
Yes
Yes
No
No
No
No
No
No
No
No
No
No
No
can be developed as
Yes
Yes
required
Additional languages
Cardiocom - TeleResponse
No
Yes
No
Yes
Yes
No
No
No
No
No
No
No
No
No
No
No
can be developed as
Yes
Yes
required
Additional languages
Cardiocom - NetResponse
Yes
No
No
Yes
Yes
No
No
No
No
No
No
No
No
No
No
No
can be developed as
Yes
Yes
required
Additional languages
Cardiocom - Attentiv
Yes
Yes
No
Yes
Yes
No
No
No
No
No
No
No
No
No
No
No
can be developed as
Yes
Yes
required
Additional languages
Cardiocom - Telescale
Yes
Yes
No
Yes
Yes
No
No
No
No
No
No
No
No
No
No
No
can be developed as
Yes
Yes
required
CJPS Medical Systems (VitalPoint HOME)
No
No
No
Yes
Yes
No
No
No
No
Yes
Yes
No
No
Yes
Yes
No
Italian
Yes
Yes
Family Health Network Connected for Life
Yes
Yes
Yes
Yes
Yes
No
No
No
No
No
No
No
No
No
No
No
N/A
Yes
Yes
UK English; additional
GrandCare Systems
Yes
Yes
Yes
Yes
No
No
No
No
No
No
Yes
No
No
No
No
No
languages added upon
Yes
Yes
request
Educational
Front-End Unit Multi-Language Support
Self-Management Materials
Front-End Unit Support
Healthsense, Inc.
Yes
Yes
Yes
Yes
No
No
No
No
No
No
No
No
No
No
No
No
N/A
Yes
Yes
UK English, Armenian,
Honeywell HomMed - Genesis DM
Yes
Yes
No
Yes
Yes
No
No
No
Yes
Yes
Yes
Yes
Yes
Yes
No
No
Polish, Italian, Welsh,
Yes
Yes
Bengali, Punjabi, Dutch
Honeywell HomMed - Genesis Touch
Yes
Yes
No
Yes
Yes
No
No
No
No
Yes
Yes
Yes
Yes
No
No
No
N/A
Yes
Yes
Ideal Life, Inc.
Yes
No
No
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
No
No
Yes
No
Yes
N/A
Yes
No
Supports both US
Independa
Yes
Yes
Yes
Yes
No
No
No
No
No
No
No
No
No
No
No
No
standards and metric
Yes
Yes
units
Dutch, Italian,
Intel-GE Care Innovations™ Guide
Canadian-French, UK
Yes
Yes
Yes
Yes
Yes
No
No
No
No
Yes
Yes
No
No
No
No
No
Yes
Yes
English, Canadian
English
Philips
Yes
Yes
Yes
Yes
Yes
No
No
No
No
No
No
No
No
No
No
No
N/A
Yes
Yes
telehealth.philips.com
Multi-Language
Tunstall - Contact Center Services/IVR
No
Yes
No
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
No
No
No
No
No
Support Available Upon
No
No
americas.tunstall.com/Contact-Center
Request
Multi-Language
Tunstall - Telehealth
Yes
Yes
No
Yes
Yes
No
No
No
No
No
No
No
No
No
No
No
Customization
Yes
Yes
americas.tunstall.com/Telehealth
Available
Use Pacific Interpreters
VRI TeleHealth
No
No
No
Yes
Yes
No
No
No
No
No
No
No
No
No
No
No
for
Yes
No
all other languages
WoundRounds (Telemedicine Solutions) www.
Yes
No
Yes
Yes
No
No
No
No
No
No
No
No
No
No
No
No
N/A
Yes
Yes
woundrounds.com
Health Record/Report Access provided to the Following External Parties
Reports and Personal Health
Record (PHR)/EHR Access
Ambio Health
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Anyone authorized
Beacon® by HealthInterlink
Yes
No
Yes
Yes
Yes
Yes
Yes
HL7 interface to EMR/EHR or export to enterprise data warehouse.
Biosign - Healthanywhere
Yes
Yes
Yes
Yes
Yes
Yes
Yes
EMR interface support exists and can be developed upon request.
Cardiocom - Commander FLEX
Multiple EMR interfaces available, others can be developed upon
Yes
No
Yes
Yes
Yes
Yes
Yes
request.
Cardiocom - Link View
Multiple EMR interfaces available, others can be developed upon
Yes
No
Yes
Yes
Yes
Yes
Yes
request.
Cardiocom - TeleResponse
Multiple EMR interfaces available, others can be developed upon
Yes
No
Yes
Yes
Yes
Yes
Yes
request.
Cardiocom - NetResponse
Multiple EMR interfaces available, others can be developed upon
Yes
No
Yes
Yes
Yes
Yes
Yes
request.
Cardiocom - Attentiv
Multiple EMR interfaces available, others can be developed upon
Yes
No
Yes
Yes
Yes
Yes
Yes
request.
Cardiocom - Telescale
Multiple EMR interfaces available, others can be developed upon
Yes
No
Yes
Yes
Yes
Yes
Yes
request.
CJPS Medical Systems (VitalPoint HOME)
Yes
Yes
Yes
Yes
Yes
Yes
Yes
N/A
Family Health Network Connected for Life
Yes
No
Yes
Yes
Yes
Yes
Yes
Social worker
GrandCare Systems
No
No
Yes
Yes
Yes
Yes
Yes
Ability to integrate into existing EHR/EMR platforms
Health Record/Report Access provided to the Following External Parties
Reports and Personal Health
Record (PHR)/EHR Access
Healthsense, Inc.
Yes
Yes
Yes
Yes
Yes
Yes
Yes
N/A
Honeywell HomMed - Genesis DM
Yes
Yes
Yes
Yes
Yes
Yes
Yes
N/A
Honeywell HomMed - Genesis Touch
Yes
Yes
Yes
Yes
Yes
Yes
Yes
N/A
Ideal Life, Inc.
Yes
Yes
Yes
Yes
Yes
Yes
Yes
N/A
Independa
No
No
Yes
Yes
Yes
Yes
Yes
Ability to integrate with existing EMR/EHR platforms.
Intel-GE Care Innovations™ Guide
Yes
Yes
Yes
Yes
No
Yes
No
N/A
Philips
Yes
Yes
Yes
Yes
No
Yes
No
N/A
telehealth.philips.com
Tunstall - Contact Center Services/IVR
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Wide range of external, multi-channel communications available
americas.tunstall.com/Contact-Center
Tunstall - Telehealth
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Wide range of external, multi-channel communications available
americas.tunstall.com/Telehealth
VRI TeleHealth
Yes
Yes
Yes
Yes
Yes
Yes
Yes
N/A
WoundRounds (Telemedicine Solutions)
Yes
No
Yes
Yes
No
No
No
N/A
Alerts can be sent to the Following External Parties
Alert Sending Modality
Alerts and Chronic Disease
Management Decision Support
Alert
Ambio Health
services
Yes
Yes
Yes
Yes
Yes
No
Yes
Yes
Telephone
may be
customized
Beacon® by HealthInterlink
Yes
Yes
No
Yes
No
N/A
No
No
No
Alerts within system.
Biosign - Healthanywhere
Yes
Yes
Yes
Yes
Yes
N/A
Yes
Yes
Yes
Telephone
Cardiocom - Commander FLEX
Yes
Yes
Yes
Yes
Yes
N/A
No
Yes
No
Monitoring software available from any web-enabled device.
Cardiocom - Link View
Yes
Yes
Yes
Yes
Yes
N/A
No
Yes
No
Monitoring software available from any web-enabled device.
Cardiocom - TeleResponse
Yes
Yes
Yes
Yes
Yes
N/A
No
Yes
No
Monitoring software available from any web-enabled device.
Cardiocom - NetResponse
Yes
Yes
Yes
Yes
Yes
N/A
No
Yes
No
Monitoring software available from any web-enabled device.
Cardiocom - Attentiv
Yes
Yes
Yes
Yes
Yes
N/A
No
Yes
No
Monitoring software available from any web-enabled device.
Cardiocom - Telescale
Yes
Yes
Yes
Yes
Yes
N/A
No
Yes
No
Monitoring software available from any web-enabled device.
CJPS Medical Systems (VitalPoint HOME)
Yes
Yes
Yes
Yes
Yes
N/A
No
Yes
Yes
Dashboard from PC
Family Health Network Connected for Life
Yes
Yes
Yes
Yes
Yes
Care circle
Yes
Yes
Yes
Monitoring software available from any web-enabled device.
GrandCare Systems
Call or text to resident OR caregiver(s) - Message direct to resident's
Yes
Yes
Yes
Yes
Yes
N/A
No
Yes
Yes
touchscreen
Alerts can be sent to the Following External Parties
Alert Sending Modality
Alerts and Chronic Disease
Management Decision Support
Healthsense, Inc.
Yes
Yes
Yes
Yes
Yes
N/A
No
Yes
No
Telephone
Honeywell HomMed - Genesis DM
No
Yes
Yes
Yes
No
N/A
No
No
No
Alerts sent ONLY through system
Honeywell HomMed - Genesis Touch
No
Yes
Yes
Yes
No
N/A
No
No
No
Alerts sent ONLY through system
Ideal Life, Inc.
Yes
Yes
Yes
Yes
Yes
N/A
Yes
Yes
Yes
N/A
Call, text or e-mail alerts to formal and/or informal caregiver(s). Reminders
Independa
Yes
Yes
Yes
Yes
Yes
N/A
Yes
Yes
Yes
(med., calendar, ADL, other) to care recipient via embedded TV solution, tablet
and/or telephone.
Intel-GE Care Innovations™ Guide
Yes
Yes
No
Yes
No
N/A
No
Yes
No
N/A
Philips
Yes
Yes
Yes
Yes
No
N/A
No
Yes
Yes
N/A
telehealth.philips.com
Alert
Tunstall - Contact Center Services/IVR
services
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Alert Sending Modalities can be customized based on client requirements
americas.tunstall.com/Contact-Center
may be
customized
Alert
Tunstall - Telehealth
services
Yes
Yes
Yes
Yes
No
Yes
Yes
Yes
Alert Sending Modalities can be customized based on client requirements
americas.tunstall.com/Telehealth
may be
customized
VRI TeleHealth
Yes
Yes
Yes
Yes
Yes
N/A
No
Yes
Yes
Telephone/Fax
WoundRounds (Telemedicine Solutions)
No
No
No
No
No
N/A
No
No
No
N/A
Single Condition Clinical
Decision Support System
Ambio Health
No
No
No
No
No
No
No
No
No
No
No
No
N/A
Beacon® by HealthInterlink
No
No
No
No
No
No
No
No
No
No
No
No
Customizable by provider.
Biosign - Healthanywhere
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
All Care plans are customizable by the client (defaults provided).
Cardiocom - Commander FLEX
Bi-Polar Disease, Schizophrenia, CKD. Can customize new Disease
Yes
Yes
Yes
Yes
Yes
Yes
Yes
No
Yes
No
Yes
Yes
Management Protocols upon request.
Cardiocom - Link View
Bi-Polar Disease, Schizophrenia, CKD. Can customize new Disease
Yes
Yes
Yes
Yes
Yes
Yes
Yes
No
Yes
No
Yes
Yes
Management Protocols upon request.
Cardiocom - TeleResponse
Bi-Polar Disease, Schizophrenia, CKD. Can customize new Disease
Yes
Yes
Yes
Yes
Yes
Yes
Yes
No
Yes
No
Yes
Yes
Management Protocols upon request.
Cardiocom - NetResponse
Bi-Polar Disease, Schizophrenia, CKD. Can customize new Disease
Yes
Yes
Yes
Yes
Yes
Yes
Yes
No
Yes
No
Yes
Yes
Management Protocols upon request.
Cardiocom - Attentiv
Bi-Polar Disease, Schizophrenia, CKD. Can customize new Disease
Yes
Yes
Yes
Yes
Yes
Yes
Yes
No
Yes
No
Yes
Yes
Management Protocols upon request.
Cardiocom - Telescale
Yes
No
No
Yes
Yes
Yes
Yes
No
No
No
Yes
No
N/A
CJPS Medical Systems (VitalPoint HOME)
Yes
Yes
No
Yes
Yes
Yes
No
Yes
Yes
Yes
Yes
No
Customization available
Family Health Network Connected for Life
Yes
Yes
Yes
Yes
Yes
Yes
Yes
No
Yes
No
No
Yes
Platform supports providers implementing own rules.
GrandCare Systems
Customizable to support any chronic conditions - add on ANY medical
Yes
No
No
Yes
Yes
No
No
No
No
No
No
Yes
information available on the Internet or from a health provider.
Single Condition Clinical
Decision Support System
Healthsense, Inc.
No
No
No
No
No
No
No
No
No
No
No
No
N/A
Honeywell HomMed - Genesis DM
Yes
Yes
Yes
Yes
Yes
Yes
No
No
Yes
No
No
No
N/A
Honeywell HomMed - Genesis Touch
Yes
Yes
Yes
Yes
No
Yes
No
No
Yes
No
No
No
N/A
Ideal Life, Inc.
Yes
No
No
Yes
Yes
Yes
Yes
No
No
No
No
No
N/A
Can integrate with medical devices to support any chronic condition.
Independa
Yes
No
No
No
Yes
Yes
No
No
No
No
No
Yes
Includes ability to present medical or educational information available
from provider or payor system.
Intel-GE Care Innovations™ Guide
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Customizable
Philips
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
No
No
Yes
Yes
N/A
telehealth.philips.com
Tunstall - Contact Center Services/IVR
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Customizable to support client needs.
americas.tunstall.com/Contact-Center
Tunstall - Telehealth
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Customizable to support client needs.
americas.tunstall.com/Telehealth
VRI TeleHealth
Yes
No
Yes
Yes
Yes
Yes
Yes
No
Yes
No
Yes
Yes
N/A
WoundRounds (Telemedicine Solutions)
No
No
No
No
No
No
No
No
No
Yes
No
No
N/A
Customizable Pathways and Clinical
Decision Support Systems for Multiple
Chronic Conditions and Comorbidities*
Ambio Health
No
No
No
No
No
No
No
No
No
No
No
No
N/A
Beacon® by HealthInterlink
No
No
No
No
No
No
No
No
No
No
No
No
Customizable by provider.
Care Plan capability for comorbidities is
Biosign - Healthanywhere
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
available but for dynamic decision tree
logic, programming would be required.
Bi-Polar Disease, Schizophrenia, CKD.
Cardiocom - Commander FLEX
Yes
Yes
Yes
Yes
Yes
Yes
Yes
No
Yes
No
Yes
Yes
Can customize new Disease Management
Protocols upon request.
Bi-Polar Disease, Schizophrenia, CKD.
Cardiocom - Link View
Yes
Yes
Yes
Yes
Yes
Yes
Yes
No
Yes
No
Yes
Yes
Can customize new Disease Management
Protocols upon request.
Bi-Polar Disease, Schizophrenia, CKD.
Cardiocom - TeleResponse
Yes
Yes
Yes
Yes
Yes
Yes
Yes
No
Yes
No
Yes
Yes
Can customize new Disease Management
Protocols upon request.
Bi-Polar Disease, Schizophrenia, CKD.
Cardiocom - NetResponse
Yes
Yes
Yes
Yes
Yes
Yes
Yes
No
Yes
No
Yes
Yes
Can customize new Disease Management
Protocols upon request.
Bi-Polar Disease, Schizophrenia, CKD.
Cardiocom - Attentiv
Yes
Yes
Yes
Yes
Yes
Yes
Yes
No
Yes
No
Yes
Yes
Can customize new Disease Management
Protocols upon request.
Cardiocom - Telescale
Yes
No
No
Yes
Yes
Yes
Yes
No
No
No
Yes
No
N/A
CJPS Medical Systems (VitalPoint HOME)
Yes
Yes
No
Yes
Yes
Yes
No
Yes
No
Yes
Yes
No
N/A
Family Health Network Connected for Life
Platform supports providers implementing
No
No
No
No
No
No
No
No
No
No
No
No
own rules.
GrandCare Systems
Yes
No
No
No
Yes
No
No
No
No
No
No
No
N/A
*Important Note: Selection includes all comorbidities that can be handled simultaneously.
Customizable Pathways and Clinical
Decision Support Systems for Multiple
Chronic Conditions and Comorbidities*
Healthsense, Inc.
No
No
No
No
No
No
No
No
No
No
No
No
N/A
Honeywell HomMed - Genesis DM
Yes
Yes
Yes
Yes
Yes
Yes
No
No
Yes
No
No
No
N/A
Honeywell HomMed - Genesis Touch
Yes
Yes
Yes
Yes
No
Yes
No
No
Yes
No
No
No
N/A
Ideal Life, Inc.
Yes
No
No
Yes
Yes
Yes
Yes
No
No
No
No
No
N/A
Independa
Yes
No
No
No
Yes
Yes
No
No
No
No
No
Yes
N/A
Intel-GE Care Innovations™ Guide
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Additional customization available.
Philips
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
No
No
Yes
Yes
N/A
telehealth.philips.com
Care plan capability for comorbidities is
Tunstall - Contact Center Services/IVR
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
available but for dynamic decision tree
americas.tunstall.com/Contact-Center
logic, programming would be required.
Options for validated clinical pathways
and/or customer specific protocols, include
Tunstall - Telehealth
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
branching logic for multiple comorbidities
americas.tunstall.com/Telehealth
with individual patient prompt feature in
response to biometric alerts.
VRI TeleHealth
Yes
Yes
Yes
Yes
Yes
Yes
Yes
No
Yes
No
Yes
Yes
N/A
WoundRounds (Telemedicine Solutions)
No
No
No
No
No
No
No
No
No
No
No
No
N/A
*Important Note: Selection includes all comorbidities that can be handled simultaneously.
Interfacing, Integration and
Safety Monitoring Systems (e.g.
Medication Adherence Monitoring
Wellness, Behavior and Activity
Electronic Health Records (EHRs)
Personal Emergency Response
Other (Please List)
Dispensers
Monitoring Systems
Add-Ons
Systems (PERS))
Ambio Health
Yes
No
Yes
Yes
Motion and door sensors
Beacon® by HealthInterlink
Yes
No
No
No
HL7 interface, data export & customization capabilities.
Biosign - Healthanywhere
No
No
No
No
N/A
Cardiocom - Commander FLEX
Yes
No
Yes
No
Can be integrated with other home sensors
Cardiocom - Link View
Yes
No
Yes
No
Can be integrated with other home sensors
Cardiocom - TeleResponse
Yes
No
No
No
N/A
Cardiocom - NetResponse
Yes
No
No
No
N/A
Cardiocom - Attentiv
Yes
No
Yes
No
Can be integrated with other home sensors
Cardiocom - Telescale
Yes
No
No
No
N/A
Bluetooth weight scale, Bluetooth pulse oximeter, and Bluetooth
CJPS Medical Systems (VitalPoint HOME)
Yes
Yes
No
Yes
glucose meter, HL7, customizable integration to existing EMR
systems
Family Health Network Connected for Life
Yes
Yes
Yes
Yes
N/A
Can be set up to interface with other systems, technologies,
GrandCare Systems
Yes
Yes
Yes
Yes
databases & EMR/EHRs - can integrate with music, video,
socialization tools & brain fitness programs.
Interfacing, Integration and
Safety Monitoring Systems (e.g.
Medication Adherence Monitoring
Wellness, Behavior and Activity
Electronic Health Records (EHRs)
Personal Emergency Response
Other (Please List)
Dispensers
Monitoring Systems
Add-Ons
Systems (PERS))
Healthsense, Inc.
Yes
Yes
Yes
Yes
Integrates with wander guard, fire life safety systems
Honeywell HomMed - Genesis DM
Yes
No
Yes
No
N/A
Honeywell HomMed - Genesis Touch
Yes
No
Yes
No
N/A
Ideal Life, Inc.
Yes
Yes
No
Yes
N/A
Social engagement tools, environmental sensors, health sensors,
Independa
safety sensors, ADL sensors and other technologies. Can integrate
Yes
Yes
Yes
Yes
with other data sources, including EMR/EHRs, cognitive programs
and music therapy solutions.
Intel-GE Care Innovations™ Guide
Clinical information systems, business intelligence and anaytics,
Yes
No
No
No
etc.
Philips
Yes
Yes
Yes
Yes
N/A
telehealth.philips.com
Tunstall - Contact Center Services/IVR
Yes
No
No
Yes
Varied reporting options
americas.tunstall.com/Contact-Center
Tunstall - Telehealth
Yes
Yes
Yes
No
Medication Dispenser
americas.tunstall.com/Telehealth
VRI TeleHealth
Yes
Yes
Yes
Yes
Fall detection
WoundRounds (Telemedicine Solutions)
Yes
No
No
No
N/A
Type of Interoperability Supported (N=None, E= Export Data Only,
Supported Interoperability
Front-End System
Back-End EHR/PHR Certification
I= Import Data Only, or B=Bi-Directional data import and export)
Standards
Certification
Interoperability, Interoperability
Interoperability Supported (N=None, E= Export Data Only, I= Import Data Only,
or B=Bi-Directional data import and export)
Standards and Certification
Ambio Health
E
Yes
HL7, CCD
No
No
No
No
Beacon® by HealthInterlink
B
No
HL7, CCD
No
No
No
No
Biosign - Healthanywhere
E
No
N/A
No
No
No
No
Cardiocom - Commander FLEX
B
Yes
HL7, CCD
No
No
No
No
Cardiocom - Link View
B
Yes
HL7, CCD
No
No
No
No
Cardiocom - TeleResponse
B
Yes
HL7, CCD
No
No
No
No
Cardiocom - NetResponse
B
Yes
HL7, CCD
No
No
No
No
Cardiocom - Attentiv
B
Yes
HL7, CCD
No
No
No
No
Cardiocom - Telescale
B
Yes
HL7, CCD
No
No
No
No
CJPS Medical Systems (VitalPoint HOME)
B
Yes
N/A
No
No
No
No
Family Health Network Connected for Life
B
Yes
HL7, CCD
No
No
No
No
GrandCare Systems
B
No
N/A
No
No
No
No
Healthsense, Inc.
E
No
N/A
No
No
No
No
HL7 and can
Honeywell HomMed - Genesis DM
B
Yes
create custom
No
No
No
No
as needed
HL7 and can
Honeywell HomMed - Genesis Touch
B
Yes
create custom
No
No
No
No
as needed
Ideal Life, Inc.
B
Yes
N/A
No
No
No
No
Independa
B
No
N/A
No
No
No
No
Intel-GE Care Innovations™ Guide
HL7 CCD / HL7
B
Yes
No
No
No
No
ORU
Philips
B
Yes
HL7, CCD
No
No
No
No
telehealth.philips.com
Type of Interoperability Supported (N=None, E= Export Data Only,
Supported Interoperability
Front-End System
Back-End EHR/PHR Certification
I= Import Data Only, or B=Bi-Directional data import and export)
Standards
Certification
Interoperability, Interoperability
Interoperability Supported (N=None, E= Export Data Only, I= Import Data Only,
or B=Bi-Directional data import and export)
Standards and Certification
Tunstall - Contact Center Services/IVR
B
No
N/A
No
No
No
No
americas.tunstall.com/Contact-Center
Tunstall - Telehealth
E
No
N/A
No
No
No
Yes
americas.tunstall.com/Telehealth
VRI TeleHealth
B
Yes
N/A
No
No
No
No
WoundRounds (Telemedicine Solutions)
I
No
N/A
No
No
No
Program Support Services
Ambio Health
Yes
No
Yes
Yes
Yes
Yes
Yes
Yes
Yes
No
Yes
No
No
N/A
Beacon® by HealthInterlink
Yes
No
Yes
Yes
Yes
Yes
Yes
Yes
Yes
No
No
No
No
Customized monitoring kits or BYOD options available.
Biosign - Healthanywhere
Customized program suport to meet unique
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
organizational needs.
Cardiocom - Commander FLEX
Customized program suport to meet unique
Yes
No
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
organizational needs.
Cardiocom - Link View
Customized program suport to meet unique
Yes
No
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
organizational needs.
Cardiocom - TeleResponse
Customized program suport to meet unique
Yes
No
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
organizational needs.
Cardiocom - NetResponse
Customized program suport to meet unique
Yes
No
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
organizational needs.
Cardiocom - Attentiv
Customized program suport to meet unique
Yes
No
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
organizational needs.
Cardiocom - Telescale
Customized program suport to meet unique
Yes
No
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
organizational needs.
CJPS Medical Systems (VitalPoint HOME)
Yes
No
Yes
Yes
Yes
Yes
Yes
Yes
Yes
No
No
Yes
Yes
Trade-Ins
Family Health Network Connected for Life
No
No
Yes
Yes
Yes
Yes
Yes
Yes
No
Yes
Yes
Yes
No
N/A
GrandCare Systems
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
No
No
N/A
Healthsense, Inc.
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
No
Yes
N/A
Honeywell HomMed - Genesis DM
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
No
Yes
No
Yes
Yes
Customizable based on requirements.
Honeywell HomMed - Genesis Touch
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
No
Yes
No
Yes
Yes
Customizable based on requirements.
Ideal Life, Inc.
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
N/A
Independa
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
No
No
N/A
Intel-GE Care Innovations™ Guide
Equipment and peripheral sensor kitting and shipping,
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
direct-to-patient installation and training
Philips
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
N/A
telehealth.philips.com
Program Support Services
Tunstall - Contact Center Services/IVR
N/A
N/A
Yes
Yes
Yes
Yes
Yes
Yes
Yes
No
No
N/A
N/A
Customizable to support client needs.
americas.tunstall.com/Contact-Center
Tunstall - Telehealth
Comprehensive and customizable support services.
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
No
Yes
Yes
americas.tunstall.com/Telehealth
Global knowhow.
VRI TeleHealth
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
N/A
WoundRounds (Telemedicine Solutions)
No
No
Yes
Yes
Yes
No
No
Yes
Yes
Yes
Yes
No
No
N/A
Clinical Supportability
Ambio Health
No
Yes
Yes
No
Yes
No
Yes
Yes
N/A
Beacon® by HealthInterlink
No
No
No
No
No
No
No
No
3rd party partner options for some of these services
Biosign - Healthanywhere
No
Yes
Yes
No
Yes
No
Yes
Yes
N/A
Cardiocom - Commander FLEX
Yes
No
Yes
No
Yes
No
Yes
Yes
Patient management and monitoring services
Cardiocom - Link View
Yes
No
Yes
No
Yes
No
Yes
Yes
Patient management and monitoring services
Cardiocom - TeleResponse
Yes
No
Yes
No
Yes
No
Yes
Yes
Patient management and monitoring services
Cardiocom - NetResponse
Yes
No
Yes
No
Yes
No
Yes
Yes
Patient management and monitoring services
Cardiocom - Attentiv
Yes
No
Yes
No
Yes
No
Yes
Yes
Patient management and monitoring services
Cardiocom - Telescale
Yes
No
Yes
No
Yes
No
Yes
Yes
Patient management and monitoring services
CJPS Medical Systems (VitalPoint HOME)
Yes
No
No
Yes
Yes
No
Yes
Yes
Web-based audio/video conferencing and videos
Family Health Network Connected for Life
Yes
No
Yes
No
Yes
Yes
Yes
Yes
N/A
GrandCare Systems
24/7 support, in-home caregiving & real time monitoring. Online help
No
Yes
Yes
No
Yes
Yes
Yes
Yes
videos & user guides.
Healthsense, Inc.
Established a membership organization of customers that provides best
Yes
No
Yes
No
Yes
Yes
Yes
Yes
practices for implementing technology-enabled care.
Honeywell HomMed - Genesis DM
Yes
No
Yes
No
Yes
No
Yes
Yes
N/A
Honeywell HomMed - Genesis Touch
Yes
No
Yes
No
Yes
No
Yes
Yes
N/A
Ideal Life, Inc.
No
Yes
No
No
Yes
No
Yes
Yes
N/A
Independa
No
Yes
Yes
No
Yes
Yes
Yes
Yes
N/A
Intel-GE Care Innovations™ Guide
No
Yes
No
No
Yes
No
Yes
Yes
Clinical services monitoring available
Philips
No
Yes
No
Yes
Yes
No
Yes
Yes
N/A
telehealth.philips.com
Clinical Supportability
Tunstall - Contact Center Services/IVR
Yes
No
Yes
No
Yes
No
Yes
Yes
Yes
americas.tunstall.com/Contact-Center
Tunstall - Telehealth
Yes
No
Yes
No
Yes
No
Yes
Yes
Yes
americas.tunstall.com/Telehealth
VRI TeleHealth
Yes
No
Yes
No
Yes
No
Yes
Yes
Yes
WoundRounds (Telemedicine Solutions)
No
Yes
No
Yes
Yes
No
Yes
Yes
Yes
Warranty Information
Technical Supportability
Ambio Health
No
Yes
Yes
No
Yes
No
Yes
Yes
N/A
1 year
N/A
Yes
No
Beacon® by HealthInterlink
No
Yes
No
Yes
Yes
No
Yes
Yes
N/A
Manufacturer Warranty
N/A
N/A
N/A
Biosign - Healthanywhere
No
Yes
Yes
No
Yes
No
Yes
Yes
N/A
1 year
Yes
No
No
Cardiocom - Commander FLEX
Yes
No
No
No
Yes
No
Yes
Yes
N/A
Term of Contract
N/A
Yes
No
Cardiocom - Link View
Yes
No
No
No
Yes
No
Yes
Yes
N/A
Term of Contract
N/A
Yes
No
Cardiocom - TeleResponse
Yes
No
No
No
Yes
No
Yes
Yes
N/A
Term of Contract
N/A
Yes
No
Cardiocom - NetResponse
Yes
No
No
No
Yes
No
Yes
Yes
N/A
Term of Contract
N/A
Yes
No
Cardiocom - Attentiv
Yes
No
No
No
Yes
No
Yes
Yes
N/A
Term of Contract
N/A
Yes
No
Cardiocom - Telescale
Yes
No
No
No
Yes
No
Yes
Yes
N/A
Term of Contract
N/A
Yes
No
CJPS Medical Systems (VitalPoint HOME)
Web-based audio/video
1 year (5-Year and 10-Year
Yes
No
No
Yes
Yes
No
Yes
Yes
N/A
N/A
Yes
conferencing and videos
extended warranty available)
Family Health Network Connected for Life
Yes
No
Yes
No
Yes
Yes
Yes
Yes
N/A
Manufacturer Warranty
N/A
N/A
Yes
GrandCare Systems
No
Yes
Yes
No
Yes
Yes
Yes
Yes
N/A
1 year
Yes
No
No
Healthsense, Inc.
Yes
No
Yes
No
Yes
Yes
Yes
Yes
N/A
1 year
N/A
N/A
Yes
Honeywell HomMed - Genesis DM
Yes
No
Yes
No
Yes
No
Yes
Yes
N/A
1-5 years
N/A
Yes
No
Honeywell HomMed - Genesis Touch
Yes
No
Yes
No
Yes
No
Yes
Yes
N/A
1-2 years
N/A
Yes
No
Ideal Life, Inc.
No
Yes
No
No
Yes
No
Yes
Yes
N/A
1 year
N/A
N/A
Yes
Term of Contract for software.
Independa
Varies by
Varies by
No
Yes
Yes
No
Yes
Yes
Yes
Yes
N/A
Manufacturer warranty on
Yes
Manufacturer
Manufacturer
hardware.
Intel-GE Care Innovations™ Guide
Yes
No
No
No
Yes
No
No
Yes
N/A
14 months
N/A
N/A
Yes
Philips
No
Yes
No
Yes
Yes
No
Yes
Yes
N/A
Term of Contract
N/A
N/A
Yes
telehealth.philips.com
Warranty Information
Technical Supportability
Tunstall - Contact Center Services/IVR
Yes
no
Yes
No
Yes
No
Yes
Yes
N/A
N/A
N/A
N/A
N/A
americas.tunstall.com/Contact-Center
Tunstall - Telehealth
No
Yes
No
Yes
Yes
No
Yes
Yes
N/A
1 year
N/A
Yes
No
americas.tunstall.com/Telehealth
VRI TeleHealth
Yes
No
No
Yes
Yes
No
Yes
Yes
N/A
1 year
N/A
N/A
Yes
WoundRounds (Telemedicine Solutions)
Yes
No
Yes
no
Yes
No
Yes
Yes
N/A
Term of Contract
N/A
N/A
N/A
Provide a Link to
Legal/Regulatory/
List Applicable Regulatory
Provide link to Sample
Company's Cyberliability
List Any Other Legal Requirements
Requirements Met
Contract
Cyberliability
Policy
Ambio Health
Cleared
Class II
Yes
Yes
All are met.
Medicare and Medicaid Regulations Met
Meets federal record retention requirements
Available upon request
pages/terms
Beacon® by HealthInterlink
ISO 13485, FDA MDDS, Medicare and
Listed
Class I
Yes
Yes
All are met.
Available upon request
Record retention among others.
Available upon request
Medicaid Regulations met.
Available
Biosign - Healthanywhere
Cleared
Class II
Yes
Yes
upon
Medicare and Medicaid Regulations Met
Available upon request
N/A
Available upon request
request.
Cardiocom - Commander FLEX
Cleared
Class II
Yes
Yes
All are met.
Medicare and Medicaid Regulations Met
Available upon request
Meets FDA signature and record retention requirements
Available upon request
Cardiocom - Link View
Cleared
Class II
Yes
Yes
All are met.
Medicare and Medicaid Regulations Met
Available upon request
Meets FDA signature and record retention requirements
Available upon request
Cardiocom - TeleResponse
None
N/A
Yes
Yes
All are met.
Medicare and Medicaid Regulations Met
Available upon request
Meets FDA signature and record retention requirements
Available upon request
Cardiocom - NetResponse
None
N/A
Yes
Yes
All are met.
Medicare and Medicaid Regulations Met
Available upon request
Meets FDA signature and record retention requirements
Available upon request
Cardiocom - Attentiv
Cleared
Class II
Yes
Yes
All are met.
Medicare and Medicaid Regulations Met
Available upon request
Meets FDA signature and record retention requirements
Available upon request
Cardiocom - Telescale
None
Class I
Yes
Yes
All are met.
Medicare and Medicaid Regulations Met
Available upon request
Meets FDA signature and record retention requirements
Available upon request
CJPS Medical Systems (VitalPoint HOME)
FDA procedures and requirements, ISO procedures and
Cleared
Class II
No
Yes
All are met.
N/A
N/A
Available upon request
requirements, U.S. Government (GSA Advantage) - approved
Family Health Network Connected for Life
Listed
Class I
Yes
Yes
All are met.
Our component is a software platform
Available upon request
N/A
Available upon request
GrandCare Systems
Listed
Class I
Yes
Yes
All are met.
ISO 13485, FDA MDDS, FDA QSR
N/A
Available upon request
privacy-policy/
Healthsense, Inc.
Listed
Class I
No
Yes
All are met.
UL-1069, UL-1637
N/A
N/A
Available upon request
Honeywell HomMed - Genesis DM
Cleared
Class II
Yes
Yes
All are met.
Medicare and Medicaid regulations
N/A
Available upon request
privacy-statement/
Honeywell HomMed - Genesis Touch
Cleared
Class II
Yes
Yes
All are met.
Medicare and Medicaid regulations
N/A
Available upon request
privacy-statement/
Ideal Life, Inc.
Cleared
Class I & II
No
Yes
HIPAA
FDA, CAMDCAS, ISO 13485
N/A
N/A
Available upon request
Independa
None
N/A
No
Yes
All are met.
N/A
N/A
Available upon request
privacy-policy
Intel-GE Care Innovations™ Guide
Meets requirements of California Health and Safety Code,
Reserved for customer
Cleared
Class II
Yes
Yes
All are met.
FDA
careinnovations.com/
Division 104, Part 15, Chapter 8, Sections 119400-119402
engagements
privacy
Philips
Cleared
Class II
Yes
Yes
All are met.
Medicare and Medicaid regulations
N/A
N/A
Available upon request
telehealth.philips.com
Provide a Link to
Legal/Regulatory/
List Applicable Regulatory Requirements
Provide link to Sample
Company's Cyberliability
List Any Other Legal Requirements
Met
Contract
Cyberliability
Policy
Available
Tunstall - Contact Center Services/IVR
None
N/A
N/A
Yes
upon
Available upon request
Available upon request
N/A
Available upon request
americas.tunstall.com/Contact-Center
request.
Available
Tunstall - Telehealth
Cleared
Class II
N/A
Yes
upon
Available upon request
Available upon request
N/A
Available upon request
americas.tunstall.com/Telehealth
request.
VRI TeleHealth
Cleared
Class I
No
Yes
All are met.
Medicare and Medicaid regulations
N/A
Available upon request
Available upon request
WoundRounds (Telemedicine Solutions)
None
N/A
No
Yes
All are met.
HIPAA Privacy
Available upon request
N/A
N/A
Desktop/Laptop Specifications
Hardware and Software
Requirements - Back End
Ambio Health
Any web
Any web
Any web
Internet
IE 9.0+, Firefox,
Any web browser
Yes
Yes
Yes
Proprietary
1 Mbs
None
N/A
Yes
No
No
browser
browser
browser
Connectivity
Chrome, Safari
Beacon® by HealthInterlink
Internet
802.11
IE 9.0+, Firefox,
Any
1.5 Ghz
1 GB
2 GB
Yes
Yes
Yes
1 Mbs
None
N/A
Yes
Yes
Yes
Connectivity
b/g/n
Chrome
Windows
IE 8.0+, Chrome,
28.8 Kps (min),
Biosign - Healthanywhere
OS required
Pentium III
1 Ghz
1 GB
500 MB
Yes
No
No
Ethernet
802.11 b/g/n
Firefox, Opera,
Broadband
N/A
Yes
No
Yes
for device
Safari
preferred
connectivity
Adobe Acrobat
Cardiocom - Commander FLEX
Internet
IE 6.0+, Firefox,
Broadband (1.5
Intel Core i3
2 Ghz
2 GB
20 GB
Yes
Yes
No
N/A
Reader;
N/A
Yes
Yes
Yes
Connectivity
Chrome, Safari
Mbs+)
Javascript
Adobe Acrobat
Cardiocom - Link View
Broadband
IE 6.0+, Firefox,
Broadband (1.5
Intel Core i3
2 Ghz
2 GB
20 GB
Yes
Yes
No
N/A
Reader;
N/A
Yes
Yes
Yes
(1.5Mb/s+)
Chrome, Safari
Mbs+)
Javascript
Adobe Acrobat
Cardiocom - TeleResponse
Internet
IE 6.0+, Firefox,
Broadband (1.5
Intel Core i3
2 Ghz
2 GB
20 GB
Yes
Yes
No
N/A
Reader;
N/A
Yes
Yes
Yes
Connectivity
Chrome, Safari
Mbs+)
Javascript
Adobe Acrobat
Cardiocom - NetResponse
Internet
IE 6.0+, Firefox,
Broadband (1.5
Intel Core i3
2 Ghz
2 GB
20 GB
Yes
Yes
No
N/A
Reader;
N/A
Yes
Yes
Yes
Connectivity
Chrome, Safari
Mbs+)
Javascript
Adobe Acrobat
Cardiocom - Attentiv
Internet
IE 6.0+, Firefox,
Broadband (1.5
Intel Core i3
2 Ghz
2 GB
20 GB
Yes
Yes
No
N/A
Reader;
N/A
Yes
Yes
Yes
Connectivity
Chrome, Safari
Mbs+)
Javascript
Adobe Acrobat
Cardiocom - Telescale
Internet
IE 6.0+, Firefox,
Broadband (1.5
Intel Core i3
2 Ghz
2 GB
20 GB
Yes
Yes
No
N/A
Reader;
N/A
Yes
Yes
Yes
Connectivity
Chrome, Safari
Mbs+)
Javascript
70 MB
Dial-Up /
CJPS Medical Systems (VitalPoint HOME)
(data kept
Any
Any
Any
Yes
No
No
Ethernet
802.11
Any
Internet /
RDC
N/A
Yes
Yes
Yes
on vendor
Cellular
servers)
Family Health Network Connected for Life
IE 9.0+, Firefox,
Intel Core i3
2 Ghz
2 GB
5 GB
Yes
Yes
No
Broadband
802.1.1 a/b/g/n
1.5 Mbs
None
N/A
Yes
Yes
Yes
Chrome, Safari
GrandCare Systems
IE 9.0+, Firefox,
Intel Atom
1 GHz
1 GB
10 GB
No
No
Yes
Ethernet
802.11 b/g/n
1 Mbs
N/A
N/A
Yes
Yes
Yes
Chrome, Safari
Healthsense, Inc.
Internet
IE, Firefox,
N/A
N/A
N/A
N/A
Yes
N/A
N/A
802.11 b/g/n
Any
None
N/A
Yes
No
No
Connectivity
Chrome
Honeywell HomMed - Genesis DM
LifeStream
Any
400 MHz
1 GB
1 GB
Yes
No
No
Ethernet
Bluetooth
None
Any
Integrated
Yes
No
Yes
Manager
Honeywell HomMed - Genesis Touch
LifeStream
Any
400 MHz
1 GB
1 GB
Yes
No
No
Ethernet
Bluetooth
None
Any
Integrated
Yes
No
Yes
Manager
Mobile
Hardware and Software
Notes
Requirements - Back End
Ambio Health
Yes
Yes
Yes
No
No
Yes
N/A
Yes
No
Yes
No
Yes
Beacon® by HealthInterlink
Yes
Yes
No
No
Yes
Yes
Multiple
Yes
No
Yes
Yes
Yes
Web-based clinical care access.
Biosign - Healthanywhere
Yes
Yes
Yes
Yes
Yes
No
N/A
No
No
No
No
No
Cardiocom - Commander FLEX
Turn-key solution for hosting the home telehealth system. Local
Yes
Yes
No
No
No
Yes
N/A
Yes
Yes
Yes
Yes
Yes
hosted requirements may be unique based customer environment.
Cardiocom - Link View
Turn-key solution for hosting the home telehealth system. Local
Yes
Yes
No
No
No
Yes
N/A
No
No
No
No
No
hosted requirements may be unique based customer environment.
Cardiocom - TeleResponse
Turn-key solution for hosting the home telehealth system. Local
Yes
Yes
No
No
No
Yes
N/A
Yes
Yes
Yes
Yes
Yes
hosted requirements may be unique based customer environment.
Cardiocom - NetResponse
Turn-key solution for hosting the home telehealth system. Local
Yes
Yes
No
No
No
Yes
N/A
Yes
Yes
Yes
Yes
Yes
hosted requirements may be unique based customer environment.
Cardiocom - Attentiv
Turn-key solution for hosting the home telehealth system. Local
Yes
Yes
No
No
No
Yes
N/A
Yes
Yes
Yes
Yes
Yes
hosted requirements may be unique based customer environment.
Cardiocom - Telescale
Turn-key solution for hosting the home telehealth system. Local
Yes
Yes
No
No
No
Yes
N/A
Yes
Yes
Yes
Yes
Yes
hosted requirements may be unique based customer environment.
CJPS Medical Systems (VitalPoint HOME)
Yes
Yes
No
Yes
Yes
Yes
Verizon
No
No
No
No
Yes
Family Health Network Connected for Life
Yes
Yes
No
Yes
Yes
Yes
Agnostic
Yes
No
Yes
No
No
GrandCare Systems
Yes
Yes
No
No
Yes
No
Agnostic
No
No
No
No
No
Healthsense, Inc.
Yes
Yes
No
No
Yes
Yes
Agnostic
Yes
Yes
Yes
Yes
Yes
Honeywell HomMed - Genesis DM
eDevice, AT&T,
Yes
Yes
Yes
Yes
Yes
Yes
Yes
No
No
No
No
Verizon
Honeywell HomMed - Genesis Touch
eDevice, AT&T,
Yes
Yes
Yes
Yes
Yes
Yes
Yes
No
No
No
No
Verizon
Desktop/Laptop Specifications
Hardware and Software
Requirements - Back End
IE7 or higher,
Ideal Life, Inc.
Internet
Internet
N/A
N/A
N/A
N/A
No
Yes
Yes
802.11 b/g/n
Firefox,
None
N/A
Yes
No
Yes
Connectivity
Connectivity
Chrome
Any
Any web-
Independa
Any web
Any web
Any web
Any web
Any web
Internet
Any web browser
web
802.11 b/g/n
enabled
Any
None
N/A
Yes
No
Yes
browser
browser
browser
browser
browser
Connectivity
browser
browser
Intel-GE Care Innovations™ Guide
Internet
Adobe Acrobat
Any
1.8 GHz
1 GB
N/A
Yes
No
No
802.11 b/g/n
IE 8.0, 9.0
1 Mb/s
N/A
Yes
No
Yes
Connectivity
Reader
Philips
Internet
LAN to public
Any
1 Ghz
2 GB
20 GB
Yes
No
No
802.11 b/g/n
IE 6.0 or higher
None
N/A
Yes
Yes
Yes
telehealth.philips.com
Connectivity
internet
Any
Tunstall - Contact Center Services/IVR
Any web
Any web
Any web
Any web
Any web
Internet
IE 6+, Chrome,
Exporting
Any web browser
web
N/A
Any
PDF Reader
Yes
N/A
N/A
americas.tunstall.com/Contact-Center
browser
browser
browser
browser
browser
Connectivity
FireFox
enabled
browser
Any
Tunstall - Telehealth
Any web
Any web
Any web
Any web
Any web
Internet
IE 6+, Chrome,
Any web browser
web
N/A
Any
PDF Reader
N/A
Yes
Yes
Yes
americas.tunstall.com/Telehealth
browser
browser
browser
browser
browser
Connectivity
FireFox
browser
VRI TeleHealth
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
No
No
WoundRounds (Telemedicine Solutions)
Adobe Acrobat
N/A
N/A
N/A
N/A
Yes
Yes
No
Ethernet
N/A
IE 8 minimum
N/A
N/A
Yes
No
No
10+
Mobile
Hardware and Software
Notes
Requirements - Back End
Ideal Life, Inc.
Yes
Yes
No
No
No
Yes
N/A
No
No
No
No
No
Independa
Agnostic. Verizon for
Yes
Yes
Yes
No
Yes
Yes
Yes
Yes
Yes
Yes
Yes
tablet.
Intel-GE Care Innovations™ Guide
No
Yes
No
No
Yes
No
Verizon
No
No
No
No
No
Philips
Yes
Yes
Yes
No
Yes
Yes
Multiple
Yes
No
No
No
No
telehealth.philips.com
Tunstall - Contact Center Services/IVR
N/A
Yes
Yes
N/A
Yes
Yes
N/A
N/A
N/A
N/A
N/A
N/A
americas.tunstall.com/Contact-Center
Tunstall - Telehealth
Any web-enabled
Yes
Yes
No
Yes
No
Yes
No
No
No
No
Yes
Client operational requirements and specifcations can be supported.
americas.tunstall.com/Telehealth
browser can access
VRI TeleHealth
AT&T, Verizon,
Yes
N/A
N/A
N/A
Yes
Yes
Yes
Yes
Yes
Yes
Yes
T-Mobile
WoundRounds (Telemedicine Solutions)
Yes
Yes
Yes
No
No
Yes
N/A
Yes
No
Yes
No
Yes
Company’s Experience
Number of Patients (Regardless of
Number of Years in Business
Release Date of Current Version
Core Customer Base, Focus of Line of Business
Link/s to Additional Case Study/ies
setting)
and Viability
ACO/IDNs, Assisted Living, Chronic Disease Management,
Ambio Health
2
December 2012
Available on Request
Home Health, Person Centered Medical Homes, Post-
None
Acute Care
Beacon® by HealthInterlink
ACO/IDNs, CCRCs, Health Plans, Home Health, Hospital,
3
August 2013
Available on Request
None
PACE, Person Centered Medical Homes
Biosign - Healthanywhere
Chronic Disease Management, Home Care, Post-Acute
10
January 2012
Available on Request
Care, Independent Living, Skilled Nursing Facilities
media/1777/Thompson-Telemedicine-and-
eHealth-2011.pdf
Cardiocom - Commander FLEX
15
February 2011
1,000,000 Patient Months of Service
ACO/IDNs, Health Plans, Home Care, Special Needs Plans
Cardiocom - Link View
15
June 2013
1,000,000 Patient Months of Service
ACO/IDNs, Health Plans, Home Care, Special Needs Plans
Cardiocom - TeleResponse
15
November 2011
1,000,000 Patient Months of Service
ACO/IDNs, Health Plans, Home Care, Special Needs Plans
Cardiocom - NetResponse
15
November 2012
1,000,000 Patient Months of Service
ACO/IDNs, Health Plans, Home Care, Special Needs Plans
Cardiocom - Attentiv
15
June 2013
1,000,000 Patient Months of Service
ACO/IDNs, Health Plans, Home Care, Special Needs Plans
Cardiocom - Telescale
15
January 2005
1,000,000 Patient Months of Service
ACO/IDNs, Health Plans, Home Care, Special Needs Plans
CJPS Medical Systems (VitalPoint HOME)
Home Care, Hospice, Hospitals, Independent Living,
Device/Software = 9 years; Entity = 6 years
February 2013
Not Disclosed
None
Physicians' Offices, Skilled Nursing Facilities
Family Health Network Connected for Life
ACO/IDNs, Health Care Systems, Home Health, Person
4
May 2013
Available on Request
None
Centered Medical Homes, Skilled Nursing Facilities
GrandCare Systems
Assisted Living, CCRCs, Health Care Providers, Home Care,
8
April 2013
Not Disclosed
Home Health, Hospital Transitions, Independent Living
Company’s Experience
Number of Patients (Regardless of
Number of Years in Business
Release Date of Current Version
Core Customer Base, Focus of Line of Business
Link/s to Additional Case Study/ies
setting)
and Viability
Healthsense, Inc.
10
April 2013
Not Disclosed
Assisted Living, Housing with Services
material/white-papers
Honeywell HomMed - Genesis DM
17
April 2012
Available on Request
ACO/IDNs, Home Health, Hospice, Telehealth Operators
Honeywell HomMed - Genesis Touch
17
February 2013
Available on Request
ACO/IDNs, Home Health, Hospice, Telehealth Operators
Ideal Life, Inc.
11
July 2007
Available on Request
ACO/IDNs, Home Care, Home Health, Indpendent Living
Independa
ACO/IDNs, Assisted Living, CCRC, Home Care, Home
4
February 2013
Not Disclosed
None
Health, Hospice, Hospital Transitions, Independent Living
downloads/Guide_Product/guide_stvincent_
Intel-GE Care Innovations™ Guide
Client: December 2012
ACO/IDNs, Large Providers, Medicare Advantage Health
profile.pdf
2
Not Disclosed
Backend: July 2012
Plans
downloads/Guide_Product/guide_customer-
profile.pdf
Philips
ACO/IDNs, CCRCs, Health Plans, Home Health, Hospital,
120
May 2013
Available on Request
telehealth.philips.com
PACE, Skilled Nursing Facilities
Tunstall - Contact Center Services/IVR
ACO/IDNs, Health Plans, Hospitals Systems, MCOs,
55
August 2012
Over 3 million supported worldwide
americas.tunstall.com/Contact-Center
Pharmaceuticals
Tunstall - Telehealth
ACO/IDNs, CCRCs, Health Plans, Home Care, Hospital
55
August 2012
Over 3 million supported worldwide
americas.tunstall.com/Telehealth
Systems, Independent Living, MCOs
VRI TeleHealth
24
August 2012
100,000
Home Care, Home Health
None
WoundRounds (Telemedicine Solutions)
Intermediate Rehab Care, Long-term Acute Care Hospitals,
7
December 2012
200,000
Skilled Nursing Facilities
clinical-study-0/
Strengths, Areas for Improvement,
Strengths
Areas for Improvement
Ongoing Development
References
Ongoing Development and References
• Cellular gateway option
• Most affordable remote monitoring system
Ambio Health
• Continue to enhance capabilities
• Wireless pedometer with fall detection
References are generally part of the RFP
• No extra steps for patient to send readings
based on customer and market needs
• Additional health meters and ADL
process.
• Functionality for population health mangement
sensors
• Flexible software deployment options (tablets, smartphones, touch-
• Decision support/
• Clinical workflow optimization
Beacon® by HealthInterlink
tone phones, IVR/text)
References are generally part of the RFP
branching logic (pending)
• Data warehouse integration
• Modern, easy to use, patient and clinician interfaces
process.
• Clinician support features
• Clinician/decision support features
• Multiple sensor device options
• Platform modernization
• Platform independence
• Self-management functional
Biosign - Healthanywhere
References are generally part of the RFP
• Supports every stage in the continuum of care
• R&D roadmap functionality delivery
enhancements
process.
• Supports commercially available Bluetooth medical devices
• Clinical CDM case management
enhancements
• Comprehensive health communication platform
and patient advocacy and support services
Cardiocom - Commander FLEX
• Expanding into other areas of
• Invest 9% - 10% of annual revenue in
• 1,000,000 patient months of service over past 15 years
Available on Request
wellness
research and development
• Proven results in home care, health plans, SNPs, ACOs, integrated
systems and government services
• Comprehensive health communication platform
and patient advocacy and support services
Cardiocom - Link View
• Expanding into other areas of
• Invest 9% - 10% of annual revenue in
• 1,000,000 patient months of service over past 15 years
Available on Request
wellness
research and development
• Proven results in home care, health plans, SNPs, ACOs, integrated
systems and government services
• Comprehensive health communication platform
and patient advocacy and support services
Cardiocom - TeleResponse
• Expanding into other areas of
• Invest 9% - 10% of annual revenue in
• 1,000,000 patient months of service over past 15 years
Available on Request
wellness
research and development
• Proven results in home care, health plans, SNPs, ACOs, integrated
systems and government services
• Comprehensive health communication platform
and patient advocacy and support services
Cardiocom - NetResponse
• Expanding into other areas of
• Invest 9% - 10% of annual revenue in
• 1,000,000 patient months of service over past 15 years
Available on Request
wellness
research and development
• Proven results in home care, health plans, SNPs, ACOs, integrated
systems and government services
• Comprehensive health communication platform
and patient advocacy and support services
Cardiocom - Attentiv
• Expanding into other areas of
• Invest 9% - 10% of annual revenue in
• 1,000,000 patient months of service over past 15 years
Available on Request
wellness
research and development
• Proven results in home care, health plans, SNPs, ACOs, integrated
systems and government services
• Comprehensive health communication platform
and patient advocacy and support services
Cardiocom - Telescale
• Expanding into other areas of
• Invest 9% - 10% of annual revenue in
• 1,000,000 patient months of service over past 15 years
Available on Request
wellness
research and development
• Proven results in home care, health plans, SNPs, ACOs, integrated
systems and government services
• Patient compliance and readmissions reduction
• More interfaces
Available upon request (although our policy
CJPS Medical Systems (VitalPoint HOME)
• Approved GPO and government supplier
• Increase name recognition
• More languages
is not to use/bother existing customers for
• Cost
• More peripherals
the sake of getting new contracts).
• BlueButton+ Intergration
• Incorporates vitals inside communication platform
Family Health Network Connected for Life
• Population management
References are generally part of the RFP
• Population management
• Intergration with EMR
• Hospital/health care provider
process.
• Patient Dialog Engine
relationships
• Penetration of international markets
• Mature & proven product - retailed in 2006
• Congregate analytics
GrandCare Systems
• EHR/EMR integration partnerships
References are generally part of the RFP
• Flexible, interoperable, protocol-driven
• Clinical assessments
• Hospital/health care provider
process.
• Easily scalable
• Complex rule sets
relationships
Strengths, Areas for Improvement,
Strengths
Areas for Improvement
Ongoing Development
References
Ongoing Development and References
• Decision support systems that
• Scalable platform
• Additional sensors to round out data set
Healthsense, Inc.
combine biometric and activity data
Reference are generally part of the client
• Intelligent/Adaptive
• Increasingy flexible reporting
• Using the information to redesign
acquisition process.
• No additional network (operates over WiFi)
• Flexible UI/Dashboarding
provider workflows
• Complete solutions for remote patient monitoring from telehealth
• Improving user device to incorporate
to telecare
• Continously improving products to
video/touch screen
Honeywell HomMed - Genesis DM
• An efficient way to improve patient care while streamlining clinical
meet the changing needs of the health
• Evolving to better, more efficiently
Available on request.
workflows
care marketplace.
manage large populations of people
• Flexible/customizable care plans
• Improving workflows and scheduling
• One touch video visits
capabilities to improve efficiencies
• Complete solutions for remote patient monitoring from telehealth
• Continously improving products to
Honeywell HomMed - Genesis Touch
• Evolving to better, more efficiently
to telecare
meet the changing needs of the health
Available on request.
manage large populations of people
• An efficient way to improve patient care while streamlining clinical
care marketplace.
• Expanding diseases managed
workflows
• Expanding beyond our current
• Most diverse and complete ecosystem of products and services
Ideal Life, Inc.
target conditions that already include:
• Expansion of health records
• Complete end to end affordable solution
Available on request.
congestive heart railure, hypertension,
• Additional medical devices
• Customizable platform easily integrated
diabetes, asthma, COPD and obesity
• First and only television with embedded eldercare services
• Constantly strive to improve the
• Expanding integrations to include
Independa
• Integrated and holistic solution
product to meet the needs of the
an even broader and diverse set of
Available on request.
• Central monitoring and alerting on health, activity, environmental
enterprise and the individual care
technologies to continue to deliver a
and safety information
managers and care recipients
holistic and integrated solution
• Enterprise-class clinical care management
Intel-GE Care Innovations™ Guide
application
• Not well-suited for small
• Disease protocol expansion, cost
Available on request.
• Easy-to-use in-home solution on touchscreen tablet
implementations
reduction, care team expansion
• Professional clinical program design services
• Breadth of leading health care solutions from hospital to home
• We are continously improving our
Philips
• Invest billions of dollars every year in
• Deep health care domain experience
products to meet the changing needs
Please contact us.
telehealth.philips.com
R&D to improve products for customers
• Exceptional customer service
of the health care marketplace.
• Increasing solution platforms to
• Dedicated telehealthcare specialists with over 55 years global
expand wellness and client program
• USA deployment of products & solutions
Tunstall - Contact Center Services/IVR
experience
support tools
•
already proven at scale in Europe
References are generally part of the RFP
americas.tunstall.com/Contact-Center
• Personalized, flexible, & customizable solutions that build to scale
Integrating our successful global
• Patient and professional portals,
process.
• Partner in building clients’ success and brands
solutions within North America (30+
integration, business intelligence
countries/3 million supported)
• Increasing solution platforms to
• Dedicated telehealthcare specialists with over 55 years global
expand wellness and client program
• USA deployment of products & solutions
Tunstall - Telehealth
experience
support tools
•
already proven at scale in Europe
References are generally part of the RFP
americas.tunstall.com/Telehealth
• Personalized, flexible, & customizable solutions that build to scale
Integrating our successful global
• Patient and professional portals,
process.
• Partner in building clients’ success and brands
solutions within North America (30+
integration, business intelligence
countries/3 million supported)
• Device agnostic, service based model
• Mountain state ability to install
VRI TeleHealth
• Upfront rental and financing
• Limited video due to high cost and
• Mobile apps
Available upon request.
• Ability to triage 90% of alerts to ensure clinical resources are
limited connectivity of high cost
• PT/INR
focused on actionable alerts
Medicare eligible members
• Refine functionality for home health
• Deliver application on Android & iOS
• Nurses save time
WoundRounds (Telemedicine Solutions)
market
• Refine
platforms
• Meet
References are generally part of the RFP
• Patients achieve better outcomes
functionality for acute care maket
HL7 interoperability standards
process.
• Providers reduce risk and liability
• Provide advanced analytic solutions
• Develop patient-centric data model
