• Colleen Cartwright, Rachael Wade, Kelly Shaw
• Baptist Community Services

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01 August 2011This report outlines the findings of a randomised controlled trial of Telehealth and Telecare in the management of frail older people who are receiving post-acute care in their own homes under the Transition Care Program (TCP). Results of this study demonstrate numerous benefits to clients receiving post-acute care augmented by Telehealth and Telecare solutions. In particular, clients experienced improvements in personal wellbeing, particularly in perceptions of health, safety and future security.

Older people who participated in this study were willing and able to use Telehealth and Telecare products reliably. Clients demonstrated a positive attitude towards the use of technology and that age per se was not a barrier to the reliable use of technology for home monitoring of vital signs.

Carers of clients receiving Telehealth and Telecare viewed the use of these products favourably. Carers felt that the person they cared for was safer as a result of using Telehealth and Telecare and that their care overall was improved through better monitoring of their clinical condition.

Additional observed benefits to clients who used the technology included increased utilisation of general practice services and a significant reduction in the use of personal assistance services such as help with housework and gardening. No significant changes in use of personal assistance services were observed in participants in the Control Group.

A range of factors were identified that GPs reported should be addressed in order to improve the appropriate use of Telehealth solutions in post-acute care of frail older people. These include the provision of information to the GP that is timely and relevant to the patient’s care, in a format that is preferred by their GP. According to GPs, the model of care should be adapted so that monitoring data is first reviewed by trained nursing personnel to ensure patients are appropriately triaged and only receive GP intervention if clinically indicated.

The study did not have sufficient recruitment of participants to enable the impacts of Telehealth and Telecare on service utilisation to be definitively established. A number of areas of further research enquiry were identified, including establishing the differential effects of Telehealth and Telecare in improving outcomes for patients with different clinical conditions, particularly for patients with diabetes and cardiovascular disease who are receiving post-acute care. Further, the insight of frail older people who are receiving postacute care into their vulnerability and the impact this has on compliance with ongoing monitoring of their clinical condition also needs to be investigated.