Home Healthcare’s AI-Enabled Future
Home Healthcare’s AI-Enabled Future
ISE Magazine January 2020 Volume: 52 Number: 3
By Laura Czuba
In-home healthcare is no different from many other industries expecting signiﬁcant changes in the upcoming decades. Technology will change the ways in which we interact with and care for our patients. Industrial and systems engineers will be essential to this transformation working to integrate the people, processes and technology. Here is a scenario with ideas on how it will change.
Imagine a nurse receives a phone call from a home health agency to visit a new patient, Kathy, who needs assistance with daily living activities and physical therapy for a new walker. Some estimates show 117 million Americans will need assistance with daily living this year (Forbes, 2018).
A nurse, Nancy, arrives at Kathy’s home with a laptop to complete the initial assessment. Kathy is taking seven medications and does not “like” taking one of them, so she doesn’t take it.
Nancy makes a “best guess” on how many visits Kathy needs. She decides a nurse should visit three times a week and a physical therapist twice a week. A home health aide will assist with showers.
The assessment data stays in the agency’s electronic health record. The monitoring of Kathy’s progress occurs only when Nancy or the physical therapist are in the home, visits planned based on one single data collection time point, the initial assessment. As ISEs know, when making data-driven decisions a sample of data points is necessary and a single data point should not drive decisions.
What if wearable devices are introduced?
Now imagine a future in which Nancy walks into Kathy’s home with a bag of wearable devices and a device called LUCY, a Logging Utility Caring for You. LUCY would be like an Amazon Echo Dot or a Google Home to record Nancy’s assessment as well as other activities in the home. LUCY would stay in Kathy’s home to monitor and check in with her and share information with Kathy’s caregiving team.
While Nancy talks with Kathy during the assessment, LUCY captures key data used to generate a plan for the number of visits Kathy needs. “LUCY Knows” is a feature powered by artiﬁcial intelligence, and as data is collected daily, what LUCY knows changes and alters Kathy’s plan.
Nancy sets Kathy up with a Fitbit to record her steps, heart rate and sleep patterns. Other wearable devices were considered but were not necessary. This particular Fitbit acts as an emergency response system if Kathy were to fall.
Encouraging Kathy to take her medications is critical because she does not like taking one of her pills. Nancy sets up the medication compliance feature in LUCY, which is a gamiﬁcation for medication management.
Kathy’s daughter is unable to join the assessment in person so Nancy calls her via LUCY’S video chat feature, allowing her to be part of the assessment. Nancy teaches them how LUCY is available to talk to, gather information on how Kathy’s care is progressing and make care requests such as a visit from a home health aide. The daughter can access LUCY on her phone and invite others onto her caregiving team.
Video chats, telehealth and data analytics to prevent problems
Now, back to reality. Here’s the way it really happens today.
A few days after care starts, Kathy’s daughter notices her mother’s leg is swollen and she calls to leave a message for the nurse. When they ﬁnally connect, Kathy’s leg is so swollen she is unable to bend it or walk.
With LUCY available, when the daughter notices Kathy’s leg is swollen, she says, “LUCY, my mom’s leg is swollen. Can I show a nurse?” A nurse would come on via video on LUCY to look at the leg immediately and walk the daughter through some basic assessment questions to help determine a plan of action.
LUCY now knows to ask Kathy about her leg every morning. If a response indicates a need for an in-person visit, an alert on the in-ofﬁce dashboard will be added to the queue and the nurse is notiﬁed.
Back to reality again. Later in the week, the daughter ﬁnds out from Kathy that the physical therapist saw her about the new walker. The therapist did not know about the leg swelling and the daughter did not know about the plan for Kathy’s new walker. The nurse leaves a message for the therapist about Kathy’s leg.
In addition, a home health aide has been visiting to assist with showers but today the agency is not able to ﬁnd one so Kathy does not get a shower.
A reason for this is that the home healthcare industry is facing a crucial shortage of caregivers, a need that will grow as baby boomers age. From 2016 to 2026, the projected employment growth for home health aides and personal care aides is expected to grow by 41% (Bureau of Labor Statistics, Occupational Outlook, 2018). To complicate this workforce problem, the turnover rate in home healthcare was 67% in 2017 (Leading Home Care, 2018).
Source: IISE Magazine (https://www.iise.org/iemagazine/2020-02/html/czuba/czuba.html)