In-Home Health Monitoring Options for Seniors

In the past 3 years, the number of products available to provide in-home health and safety surveillance for seniors has exploded within the telehealth market. While the technology is not new, the cost has come down, and the variety of surveillance devices issomewhat overwhelming. Here are some groupings that can help you sort through the maze.

1. Home-based vital-signs monitors: Tabletop monitors can measure blood pressure, weight, temperature, pulse, blood sugar, blood oxygenation, respiratory capacity and EKG. Depending on your needs, there are other add-on pieces of equipment that are either physically attached or wirelessly connected to the tabletop unit. The tabletop units require either a land phone line or cable Internet connection. Once per day, the tabletop unit (which is a computer) will "wake up" and alert the user to collect vital-sign data.

The user applies a blood-pressure cuff or stands on a connected scale to collect readings. The tabletop unit receives the data and then transmits it to a centralized computer for display to a clinician interpreter. Summarized information is posted on a private website. The tabletop unit can be programmed to display questions such as "How did you sleep last night?" The user taps buttons on the device to answer. These systems are meant to take intermittent (usually daily) readings, and are not designed to collect information constantly, like a monitor you would see in a hospital.

These systems are intended for professional use and are not sold (at this time) directly to the public. They are available from home health agencies, clinics and physician groups. They require a health-care provider's oversight of the vital-signs information. The purpose is to catch dangerous or abnormal vital-sign trends in advance, to avoid or prevent a health-care emergency. The cost of these systems is borne by the health-care provider in some cases, although they may charge you for surveillance. The provider typically pays about $300 per month for the machines, not counting the surveillance cost. Medicare does not currently pay for vital-signs monitors.

2. Mobile vital-signs monitors. Recently, developments have been made that place monitoring software on commercial cell phones. The advantage to these applications is that the user does not have stay home to be monitored. Vital signs (mainly heart rate) are collected via wireless, wearable sensors embedded in watches or other small devices for those on the go. Data is collected and sent to a central station that displays on a private website, just like the home-based monitors. Wearable devices are new to the market and can be purchased by the public; watches cost approximately $100. You can purchase a watch on the Internet and pay a subscription fee for remote oversight by a professional health-care provider. Feedback about abnormal readings takes place via cell phone. (Simpler forms of wearable devices like watches display heart-rate readings but do not connect to any surveillance plan.)

3. Reminder systems. There are many types of reminder systems available today. Most are home-based, although some reminder software is now available for mobile phones as well. Medication-reminder software is embedded in computerized pill boxes that wake up the user and alert him when it's time to take a pill. Computerized pill bottles can track compliance, send alerts and let you know when supplies are running low. Daily task reminders are now available in computerized photo frames. Frames scroll through digital pictures as normal, but interrupt and show (or speak) reminder prompts. These products are designed to help with specific memory needs, and most do not yet communicate with the monitoring systems mentioned above. They do not require professional oversight, although you may need a professional pharmacist or nurse to replenish medications in pill boxes. You can purchase them via the Internet.

Buying the right combination of home-monitoring devices requires research. All the information you will need is available on the Internet, including pricing. The first step is to determine what oversight is appropriate to meet your individual needs. Consult your medical provider to understand what health or safety measures are best to monitor. You can then choose the device that meets yet does not exceed recommendations, so you can manage the costs. Medicare currently does not pay for any of these systems.