Why go see the Doctor?:Care Goes From Office to Home as Technology Divorces Function from Geography

Abstract

Two functions of home care, assistance to improve disabled and aged patients' mobility and function, and self-care that includes treatment, screening-monitoring, exercise assistance, and information exchange, are described, as are the technologies used for these functions. Social and economic pressures as well as professional rationales that expand the use of technologies at home are noted, as is their impact on the site of care and on the patient-doctor relationship.

Factors Influencing the Use of Mobility Technology in Community-Based Long-Term Care

“…Finally, although this article focuses mainly on the use of established, relatively simple technologies, new innovations in assistive technologies are becoming available every day. The development of increasingly sophisticated diagnostic and monitoring equipment for use in the home has contributed to a shift in the location of medical care from the hospital to the physician's office and even into the home (Stoeckle & Lorch, 1998;Wilson, 1999). These trends imply not only that the demand for assistive technologies will increase in the future but also that these technologies are increasingly likely to be used for a more disabled home care population.…”

A telecommunication monitoring system for clinical and research practice.

“…The information was stored in the individual's medical record, and a nurse called if there were concerns. This type of intervention was found to significantly reduce office visits (Stoeckle & Lorch, 1997).…”

“…Most telecommunication systems are modified voice mail products that have features such as outbound calling and can be customized to call individuals routinely and store data. Stoeckle and Lorch (1997) provided an example of the use of "programmed telephone calls" as a way of reminding, monitoring, and recording a patient's progress with medical treatment. They presented a patient with hypertension and diabetes who received monthly telephone calls by an automatic system that provided a medication reminder as well as a way for vital signs to be recorded.…”

Clustering and inertia: structural integration of home care in Swedish elderly care

“…An increasing proportion of elderly people in the population, improved conditions of living, and medical technological advances during the 20 th century have raised the demands and expectations on the services provided by the health care system [4–6]. Medical advances have made it possible to move health care partly from hospital to primary care, and often directly into patients' private homes [7, 8]. Today both rehabilitation and advanced palliative care can be provided in patients' private homes [9].…”