1. Chetney, Rhonda MS, RN, Guest Editor

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These are exciting times for home telehealth. Hundreds of agencies have thrown their hats into the ring and joined the swelling ranks of those stepping out into the technology world. State Medicaid programs and commercial payers nationwide are reimbursing for telehealth visits. Demonstration projects are occurring that assess the cost-effectiveness of home telehealth in Medicare patients.


As we face the growing number of aging patients who want to stay at home, technology and telehealth provides agencies with the ability to reach more patients, reach them quicker, and provide the clinician the tools needed for good practice, efficiency, and positive patient outcomes.


Just as we've relied on blood pressure cuffs, stethoscopes, IV pumps, and beepers to do our job, today's new technology of laptops, point-of-care systems, and home telehealth are our new tools. Without these advanced technologies, agencies will not be able to keep up with the steady influx of the aging baby boomers.


Home health researchers across the country are documenting studies that show the benefits of home telehealth in improving patient care. Just as our children today would be "out of the loop" if they couldn't play video games with their friends or advance in school without knowledge of computers, I'm convinced that agencies that refuse to stay current with technology will not survive.


It has been exciting to work with the talented authors who have contributed to this special issue. These are people who can gain insight from the past and deal with the present while seeking ways to improve care in the future. Their expertise in the area of technology and telehealth is expansive and will help you understand not only the basics but how technology and telehealth will influence your practice and patient care.


In this issue you'll find disease management telehealth programs that work, providing the details you need to use them in your agency. Several articles will help clinicians and clinical managers determine what type of telehealth technology fits different patients, which patients should be targeted for the technology, how to use established telehealth program clinical guidelines, and how to protect your agency from legal problems when using telehealth.


Improving care with technology is addressed through numerous venues; from using digital camcorder technology in wound care, successful interventions for heart failure, to computer-based patient education programs. You'll also find advice on choosing the right technology to provide efficient and cost-effective care, and ways to coordinate care with the physician.


As in most new activities, several terms have arisen in describing technology and telehealth. The articles in this issue are replete with terms such as telehealth, telemedicine, telehome care, and telenursing. Carolyn and I have decided that the authors should have the flexibility to use the terms that most apply to their subject and approach. However, it is important to understand that the American Telemedicine Association, Home Care Special Interest Group has adopted definitions (Figure 1). These definitions were used when possible for consistency in all the articles.

Figure 1 - Click to enlarge in new window

Having been involved in home telehealth since the mid 1990s, I have seen improvement and growth in the technology available to home care clinicians and the telehealth options for various home care patients. Our agency has used various telehealth technologies to effectively improve patient care and positively affect the agency's bottom line. It can be done!


To those of you who are still wondering whether to climb aboard the Telehealth and Technology Express, I encourage you to read this issue, examine the research, talk to agencies that are successfully implementing programs, involve your clinicians and managers, estimate the cost effectiveness, and then start running to catch up! Or in the words of the porter, "All aboard!"