Joint ef­fort

NRC wants team­work for home-health regs

Modern Healthcare - - The Week in Healthcare - Joseph Conn

Anot-for-profit group is call­ing on two fed­eral agen­cies to work to­gether to reg­u­late and cer­tify home-health de­vices that in­cor­po­rate health in­for­ma­tion tech­nol­ogy sys­tems. In a re­port re­leased last week, the Na­tional Re­search Coun­cil, an arm of the Na­tional Academies of Science, seeks a joint ef­fort by HHS’ Of­fice of the Na­tional Co­or­di­na­tor for Health In­for­ma­tion Tech­nol­ogy and the U.S. Food and Drug Ad­min­is­tra­tion to fill in reg­u­la­tory gaps and help en­sure that IT-re­liant home-health tools are user-friendly.

The 203-page re­port, “Health Care Comes Home: The Hu­man Fac­tors,” is based on a study spon­sored by the Agency for Health­care Re­search and Qual­ity and con­ducted by the coun­cil’s Com­mit­tee on the Role of Hu­man Fac­tors in Home Health Care.

“As it is now, the ONC has the re­spon­si­bil­ity for the cre­den­tial­ing and over­sight for health in­for­ma­tion tech­nol­ogy and the FDA over de­vices,” com­mit­tee chair­man David Weg­man said. “The gap is when those de­vices are in­ter­con­nected.” For its part, the FDA this week is­sued draft guid­ance for de­vel­op­ers of mo­bile health ap­pli­ca­tions that in part ad­dresses this NRC rec­om­men­da­tion (see side­bar), one of 11 in the coun­cil’s re­port.

The coun­cil also rec­om­mends that the ONC work with the Na­tional In­sti­tute of Stan­dards and Tech­nol­ogy and the AHRQ to set de­sign guide­lines and stan­dards for home health de­vices based on ex­ist­ing guide­lines “for con­tent, ac­ces­si­bil­ity, func­tion­al­ity and us­abil­ity.”

“The is­sue is how well are those sys­tems de­signed for use in the home,” said Weg- man, pro­fes­sor emer­i­tus of work en­vi­ron­ment at the Univer­sity of Mas­sachusetts at Low­ell’s School of Health and En­vi­ron­ment. Given that the sys­tems are used not only by pro­fes­sional home care­givers but also by not-med­i­cally trained con­sumers, they may be more likely to be mis­used or not main­tained, he said.

Mo­bile and home-health tools hold im­por­tant po­ten­tial to boost in­di­vid­u­als’ over­all well-be­ing by let­ting them bet­ter mon­i­tor per­sonal health met­rics be­tween physi­cian and hos­pi­tal vis­its, said Mike Critel­lis, CEO of Dos­sia, a not-for-profit con­sor­tium launched in 2006 by a group of large U.S. em­ploy­ers, in­clud­ing AT&T, Car­di­nal Health, In­tel and Wal-Mart, to pro­mote health and well­ness. Dos­sia uses a Web-based tech­nol­ogy plat­form that hosts a per­sonal health-record sys­tem and of­fers health-re­lated game and in­cen­tive pro­grams as well as in­for­ma­tion “to sup­port well­ness and health­care de­ci­sion-mak­ing,” ac­cord­ing to a re­cent Dos­sia news re­lease.

For hyper­ten­sive pa­tients, for ex­am­ple, Critel­lis said, there’s de­ci­sion-mak­ing value in be­ing able to track swings in blood pres­sure

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