title: Client Satisfaction with Telehealth in Assisted Living and Homecare.
abstract: BACKGROUND
  The Evangelical Lutheran Good Samaritan Society launched LivingWell@Home (LW@H) to provide telehealth services to clients in assisted living and home healthcare. LW@H assures client safety through remote monitoring of physiological parameters and assessment of nonbiometric parameters. Public policies increasingly support aging in place by allowing older adults with greater levels of impairment avoid or delay nursing home placement through alternative services offered in assisted living facilities and home healthcare agencies. Provider organizations face challenges caring for frail seniors with complex medical needs. Telehealth services may be helpful in supporting frail seniors living at home.
  
  
  METHODS
  Seniors were recruited into a randomized trial. Telehealth services were provided to 820 experimental subjects. Control subjects (n=762) received usual care. Clients rated their satisfaction at three points in time postimplementation: baseline, 6 months, and 12 months. Fisher's exact test compared client ratings at each measurement interval.
  
  
  RESULTS
  No statistically significant differences were found between experimental and control subjects at baseline. Statistically significant differences emerged at follow-up. Experimental subjects in home healthcare agencies reported higher levels of satisfaction relative to controls, whereas experimental subjects in assisted living facilities reported lower levels of satisfaction.
  
  
  CONCLUSIONS
  Telehealth services increased the probability that clients will be more satisfied compared with those without telehealth in homecare agencies. The opposite effect resulted among assisted living residents. Value propositions among community-dwelling older adults may influence their satisfaction with telehealth services postimplementation. More research is needed to examine the clinical efficacy and cost-effectiveness of these services.
authors.affiliation: Division of Health Policy and Management, School of Public Health, University of Minnesota , Minneapolis, Minnesota.
authors.forename: Leslie A
authors.initials: LA
authors.lastname: Grant
authors.affiliation: Division of Health Policy and Management, School of Public Health, University of Minnesota , Minneapolis, Minnesota.
authors.forename: Todd
authors.initials: T
authors.lastname: Rockwood
authors.affiliation: Division of Health Policy and Management, School of Public Health, University of Minnesota , Minneapolis, Minnesota.
authors.forename: Leif
authors.initials: L
authors.lastname: Stennes
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D040561:Assisted Living Facilities; D005260:Female; D006699:Home Care Services; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D017216:Telemedicine
keywords: home health monitoring; sensor technology; telehealth; telenursing