A model for nurse case-managed home care using televideo

OBJECTIVE: To determine the feasibility of implementing a home care program, utilizing two-way interactive televideo, as a lower cost alternative to traditional in-home care. SETTING: Registered nurses used a proprietary telehome care system to provide home care services to patients in congregate senior apartments and individual patient homes during 1996. PARTICIPANTS: A total of 46 patients from five sites in Kansas and Missouri, with multiple medical problems, who were living at home, were enrolled in the program. INTERVENTION: All enrolled patients received an individualized, computer integrated, nursing care plan that utilized outcome-based clinical pathways and scheduled televideo nursing interventions. All enrolled patients received a comprehensive initial in-home assessment as well as comprehensive follow-up in-home assessments every 60 days. Patients received an average of four telehome care visits per week for an average of 12.25 minutes per visit. Nurses were estimated to be able to perform approximately 24 telehome care visits per day using the system. CONCLUSIONS: A comprehensive home care program that combines two-way interactive televideo with standardized, computerized patient assessments and care planning can provide nursing services in the home effectively. Telehome care may be a cost-effective complement to traditional, in-home care.