The Future of Home Care

Next Monday, October 24th, it will be my honor to address the National Association for Home Care and Hospice at their annual meeting in Seattle. More than 5000 people are expected to attend the 24th annual conference. This year's theme "Claiming the Future of Health Care" seems more appropriate than ever in light of our national focus on advancing the use of information technology and electronic records in healthcare.

There are about 25,000 home care agencies and hospices in the United States, employing about 2 million workers. 10,000 home care agencies participate in Medicare and every year, some $91 billion dollars are paid for home care and hospice services. By comparison, there are only about 6000 US hospitals.

With healthcare affordability on everyone's mind, we must ponder how information technologies, now and in the future, can be used to facilitate the dissemination of health information and medical services more efficiently. Does it make sense to always require elderly, disabled or chronically ill people to travel to hospitals and clinics to receive care? How do we develop better support systems that will allow people to age in place and live longer independently? How do we turn around our sickness-oriented healthcare system to one that anticipates illness before it happens and makes the most appropriate interventions with just the right levels of care? What adjustments can we apply to a system that rewards clinicians for performing procedures yet often under-compensates them for the provision of cognitive services? How do we reimburse clinicians for care that is provided outside of the traditional hospital or clinic setting? How can we harness the power of broadband internet, instant messaging, e-mail, smart devices, IP audio and video, home computers, web services architecture, and digital television for the delivery of care?

With ER visits costing upwards of $5000 per episode, hospital days running well above $1000, and nursing home charges of $300 a day or more, the marriage of home care with advanced communication and information technologies appears to offer great promise for driving down the cost of care. It would certainly improve access to care and be more convenient for our patients. With that, satisfaction should also improve. And with more "touches", whether in-person by care providers in the home or virtual using current and future technologies, I believe care quality, safety and outcomes are likely to improve as well. What do you think?

Bill Crounse, MD, Global Healthcare Industry Manager, Microsoft Healthcare and Life Sciences