Caveat emptor: the need for evidence, regulation, and certification of home telehealth systems for the management of chronic conditions.
The home telehealth market is rapidly expanding. The technology and capabilities currently available have the potential to significantly affect the clinical management of an aging population, particularly, the large number with multiple coexisting disease processes. Potential benefits of home-monitoring systems for patients with heart failure range from decreased rates of mortality and improved quality of life to providing third party payers, including the federal government (ie, Centers for Medicare and Medicaid Services), with significant long-term cost savings. The current regulatory process does not provide adequate oversight and standards for these systems that transmit and process data (telehealth systems) critical for patient management. Home telehealth vendors must address the possibility that increased utilization increases their risk of liability due to patient safety issues. In all, 5 major areas need to be addressed to maximize the benefits and safety of this technology: effectiveness of patient management; evidence-based outcomes; regulation; cost, including cost effectiveness and reimbursement; and certification to ensure reliability.
Farberow
Bonne
B
University of Pennsylvania, Division of Heart Failure/Transplant, Philadelphia, Pennsylvania, USA.
Hatton
Valerie
V
Leenknecht
Cindy
C
Goldberg
Lee R
LR
Hornung
Carlton A
CA
Reyes
Bernardo
B
D002908:Chronic Disease / Q000628:therapy*; D004869:Equipment Safety; D006333:Heart Failure / Q000628:therapy; D006699:Home Care Services / Q000458:organization & administration / Q000592:standards*; D006801:Humans; D008991:Monitoring, Physiologic / Q000295:instrumentation; D011787:Quality of Health Care / Q000458:organization & administration / Q000592:standards*; D012051:Reimbursement Mechanisms; D017216:Telemedicine / Q000458:organization & administration / Q000592:standards*; D014481:United States; D014486:United States Food and Drug Administration