Telehealth Perception & Use Among Home Health Care Agencies: A Pilot Survey

Background: Telehealth technology is an innovative and cost-effective system of geriatric care for chronic illness and comorbid depression using internet, mobile, and monitoring devices. Despite the rapid growth of Telehealth and its support for health screening and treatment, the home health care (HHC) sector has been slow to adopt for patient care. Little data exists on how telehealth is used by HHC for depression care and how it is perceived among staff, a key stakeholder in the process of adopting telehealth (Whitten & Mackert, 2005). Thus, this pilot study aimed to understand how HHC agencies: (a) perceive telehealth service delivery, (b) utilize Telehealth for chronic illness and depression care, and (c) can predict intention to use or continue to use telehealth in care delivery.

Methods: Between June and July 2014, participant agencies completed an online survey informed by the Unified Theory of Acceptance and Use of Technology (UTAUT) model. Seventy-three HHC directors and 13 staff nurses (N=86) from the Pennsylvania Homecare Association member agencies participated. Participants were female (80%) and Caucasian (96.5%). Their mean age was 53.6. On average, they had 18 years of experience in homecare profession and 5.6 years of experience in providing telehealth. Descriptive statistics were calculated for all survey items. Cronbach’s alphas were estimated to check internal consistency of items. Spearman Rho correlations were calculated to determine the associations among 1) HHC agency characteristics, 2) participant characteristics, and 3) intention to use or continue to use telehealth. Multivariate analysis of variance (ANOVA) was conducted to examine the relations among variables.

Results: Among HHC agencies that reported using telehealth, telephone (45%) and monitoring devices (32%) were the most utilized telehealth technologies. Only 10% of agencies used web-based technologies and 3% utilized video-conferencing. Telehealth services included monitoring of health status (85%), chronic illness management (46.2%), and caregiver health education (53.8%). Telehealth was used the least for depression counseling (7.7%). Overall, a majority of participants perceived telehealth as useful (80%) and easy to administer (77%). However, telehealth was perceived more positively for chronic illness care (90.7%) than for depression care (53%) services. A majority (74%) perceived themselves as having the knowledge necessary to use telehealth for chronically ill patients while only 32% did for depressed patients.

Implications: Results suggest that once adopted, telehealth is used by HHC agencies in providing a wide range of services for chronically ill patients and their caregivers. Further education is needed to support telehealth use for depression care. Future studies may consider exploring other potential barriers and facilitators to telehealth adoption and use in home health.