Summit Report Outlines Steps to Address Home Healthcare Technology Challenges

December 31, 2012

As increasing numbers of patients receive care outside hospitals, clinicians, regulators, and others have seen how home-use settings pose a unique set of complex challenges with healthcare technology.

To help address these challenges—and move the discussion forward—AAMI and the U.S. Food and Drug Administration organized a two-day summit in October on home healthcare, the findings of which now are available in a new report.

The release of the report, A Vision for Anywhere, Everywhere Healthcare, comes a little more than two months after a crowd of roughly 170 clinicians, home care providers, manufacturers, healthcare technology management professionals, and other interested parties came together for the AAMI/FDA Summit on Healthcare Technology in Nonclinical Settings in Herndon, VA.

Because the summit took place during the government shutdown, federal employees were not able to attend. Many submitted their presentations in advance, and their perspectives are included throughout the publication.

An overarching theme echoed throughout the summit was the need for regulators to reassess what many call the “wheelchair” model for healthcare delivery. In times past, perhaps the only piece of equipment that hospitals considered in discharging a patient was a wheelchair.

Now, however, an increasing number of complex medical devices have moved into the home and other nonclinical settings as patients and caregivers manage chronic or long-term conditions. That fact is fundamentally altering how technology is being used and by whom. Manufacturers have new factors to consider in their design of devices, clinicians and healthcare technology experts must give more thought to transition and training challenges, and insurers and agencies face a host of new payment and reimbursement challenges.

As with previous AAMI summit reports, the publication lists the “clarion themes” identified by those in attendance. It also spells out what steps need to be taken and who is accountable. For example, the participants said they want to enhance stakeholder understanding of use environments outside the traditional healthcare setting. They noted there is a lack of information about patient outcomes in nonclinical settings, as best practices have yet to be identified. One priority action they came up with to combat this problem is to research and analyze the full range of use environments outside controlled clinical settings and compare patient outcomes in clinical and nonclinical settings.

Another theme identified was to adopt a systems approach to redesign the full spectrum of healthcare in nonclinical settings. “We need a systems approach—and this goes beyond the device,” said Vicki Lewis, associate director and usability division chief at the National Center for Human Factors Engineering in Healthcare. “If all we’re thinking about is the technology, we’re completely missing the boat.”

The audience said there is an absence of checks and balances for preventive maintenance, repair, and management for home care devices. They suggested creating a medical equipment management plan and standards to cover all aspects of supportability, including device recalls.

AAMI President Mary Logan encouraged those who are interested in the topic of healthcare delivery in nonclinical environments to read this publication and share it with others. “As before, this year’s summit was a community event, and this publication belongs to the community,” Logan said.

A printed version of the publication is being mailed to all AAMI members and summit attendees.

A pdf version of this report is available here.