The purpose of this quantitative study was to examine costs and implementation factors associated with development of telemonitoring programs in eight rural home health agencies. although the telemonitoring group (n = 1,513) averaged fewer visits per episode than the control group (n = 1,573), cost analysis data, including labor, travel, and equipment costs, failed to support the hypothesis that decreased utilization of skilled nursing visits alone could offset the costs of the telemonitoring technology. this study indicates that agencies must achieve savings through improved outcome performance to offset telemonitoring expenses.

Three home health agencies conducted daily telemonitoring of patients in western Montana. The agencies all used monitoring equipment of the same type, which provided up to six vital-signs measurements (heart rate, oxygen saturation, systolic blood pressure, diastolic blood pressure, glucose and bodyweight). There were 337 patients in all, two-thirds of whom were female. These patients were monitored for a total of 16,999 person-days. The rate of occurrence of any vital-sign measurement falling outside acceptable ranges was 33.8 per patient per 60-day period. The highest alert rate for a specific vital sign was for decreased SpO(2) (6.4 per patient per 60-day period). The central station nurse took follow-up action at a rate of 26.0 per patient per 60-day period; case manager nurses took follow-up action at a rate of 8.2 per patient per 60-day period. There were some differences between male and female patients in the alert rates, and between the agencies. The alert rates measured in the present study are expected to be useful to home care administrators in estimating the staffing requirements for telemonitoring.

We have examined the hypothesis that home telemonitoring, when added to conventional home care in rural settings, results in less acute care hospitalization and more discharge to the community. Five US rural home health agencies of different types participated in the study. All agencies were not-for-profit and served low-income patients in designated health professional shortage areas or medically underserved areas/populations. A prospective treatment group was telemonitored daily in the home during the period 1 October 2006 to 31 May 2009 (n = 1419). An historical control group was selected sequentially backwards from 30 September 2006 (n = 1502). Both groups had home health services for approximately 50 days (P = 0.76). We used logistic regression modelling, with covariate data captured from the Outcome and Assessment Information Set (OASIS) data set, to assess the effect of group on outcome. Home telemonitoring was found to reduce the odds of any acute care hospitalization (OR = 0.59, P < 0.001) and to increase the odds of discharge to the community (OR = 1.36, P = 0.003).