QUESTIONS TO POSE TO HOME TELEHEALTH VENDORS
By Michael Edwards, Northeast Telehealth Resource Center, and
Mia Millefoglie, HomeHealth Visiting Nurses, Saco, ME, Feb. 2009
A version of this tool was developed for participants at a vendor fair held in Portland, ME, in April 2007, at which six vendors provided demonstrations and presentations to clinical and administrative staff of three home health agencies. The NETRC helped HomeHealth Visiting Nurses, Inc., coordinate the event and the pre-RFP process for structured surveys and interviews of the vendors representatives interested in a contracted sale to the agency.
A. General issues for vendors to address in written prospectus:
1. Background information on company/number of employees/operating budget/financial performance
2. Product description and functionality of home monitoring products and servers
3. Production description and functionality of peripheral devices
4. Description of technology, its interfaces, access points, and compatibility with other systems.
5. Summarize strengths and any limitations of your current operating system
6. Capabilities for reconfiguring patent units from the head office
7. Describe system of customer support with implementation and training
8. Describe service contract, unit replacement options, repair service, warranties
9. Provide information on unit pricing, typical volume discounts, and fees for selected products
10. Describe policies for trials of equipment prior to purchase and relevant conditions for such an option
11. Provide a case description of a home health agency that has purchased from you
B. Client usability issues—for written or verbal queries:
1. What features of the telehealth unit placed in the patient’s home are considered user-friendly?
2. Does the unit have touch-screen controls?
3. For units that collect client status input from queries and/or deliver self-management education:
a) When the patient answers the questions, does it move from screen to screen without patient intervention?
b) After the last question is answered does it automatically send the information to the Central Station without patient intervention?
c) Is the question also in audio, not just written on the screen?
d) Is teaching in audio and not just written on the screen?
e) Are the patient handouts for educational telehealth transmissions for low literacy and visually impaired clients?
f) Are there alarms that can be used as reminders, such as to do telehealth session or a medication reminder?
C. Staff usability issues—for written or verbal queries:
1. How is the telehealth unit nurse-friendly?
2. Describe the size and weight of the in home telehealth unit
3. Is the telehealth unit easy to set up? --Describe
4. Is the daily telehealth process easy to teach? --Describe
5. Do patients with vital signs, weight and question outside the preset parameters view as an alarm?
6. Do patients with alarms sort to the viewing screen first with the alarms indicated?
7. How does your system notify the Central Station if a client has not transmitted the telehealth information by a designated time?
8. What data does the telehealth system collect and store?
9. Is there an option for units to be used for interactive video visits?
10. If the patient is using their thermometer or glucometer, can the patient add the results to the patient screen before transmitting to the Central Station?
D. Patient query and education component:
1. What diagnosis groups are served through targeted questions on health status and behaviors? CHF, COPD, hypertension, diabetes, depression?
2. How does the product address challenges for some disabled clients in completing the questions or health education modules?
3. Can the questions from the different diagnosis groups be mixed for clients with co-morbidities?
4. Can new questions be added easily to the standard set?
5. Can the vital signs, questions, and nurses notes be printed together within a specific date range?
6. Can the information be printed to offices at a distance from the Central Station?
E. Linkage to central server:
1. What are the options for hosting of the client monitoring database—server at agency, vendor, or third party organization
2. Is client health information transmitted via a Web based system or by a dial-up link?
3. If the latter, is pulse dial an option?
4. For Internet links, what telecommunications options are available? Dial-up POTS, DSL, cable, broadband wireless?
5. What solutions for security and privacy of patient health information are implemented?
6. If the Central Station disconnects from the server during transmission, is there a recovery process to reduce data loss?
7. Is there any option for the patient information to be transmitted in real time?
8. Is there a nurse reporting option for patient data by client assignment groups?
9. Does clicking on the patient name take you directly to the client’s information?
F. Tech support:
1. Do you have a telephone Help Desk?
2. What hours and days is the Help Desk available for telephone calls?
3. What is your policy for repair of the telehealth units or the Central Station?
4. How does the customer obtain new updates? Is there a cost?
G. Additional questions:
1. Can you identify some hidden costs for your system?
2. Does the customer have a choice to lease or buy?
3. Do you have a trade-in policy for older units? Describe?
4. Does your telehealth system have the ability to interface with laptops? What company models?
5. Does the telehealth information transmit across POTS lines?
6. Is your telehealth equipment wireless?
7. How do you assure your equipment is accurate not just at purchase but ongoing?
8. Do you have an electronic signature for nurse’s notes?
H. References to include:
1. Past customer contact who can discuss vendor customer service response to problems and ability to make changes to meet the customer needs
2. Agency customer contacts who have used the equipment at least one year and would discuss strengths and weakness of the patient unit, nurse central station, and web server software software for telemonitoring.
I. Vendor Checklist Tool
--Home Telehealth Vendor Checklist, MedQIC/Home Care Association of New York State (’05)
This tool provides for ratings on a five-point scale on a broad range of features and capabilities. Although equal weighting of each item is a limitation, and many items that reflect presence or absence of a feature are difficult to rate, the list is very useful as a systematic catalog of product characteristics to garner from vendors and to facilitate comparisons between products
Features--Software
§ Ease of Use
§ Training Time Needed; cost /charge
§ Upgrade fees
§ Reporting capabilities and fees if applicable
§ Ability and ease of transmitting data as needed
§ Ease of incorporating/integrating into existing systems—does information flow into patient’s chart?
§ Programmability for patient education
§ Web-based: Yes No
§ Cost of proprietary software?
§ Languages
§ Patient Portal?
§ Medication Management/Reminders
Features--Equipment
§ Type of Technology: Video; Non-Video; TV;
§ PC-based; phone-based; cell phone; other
§ FDA clearance: Hardware; Software; Peripherals
§ ISO Certified/HL7 Interoperability?
§ Size/weight
§ Back up battery and/or operational batteries: Yes No -- # and type
§ Installation Time/Ease—does company offer installation/deinstallation? Fee?
§ Cleaning time/ease?
§ Equipment reliability—replacement/warranties?
§ Patient’s/caregivers ease of use
§ Modem: Internal External
§ How many peripheral devices can function at one time? # of serial ports_______
§ Vendor offers equipment maintenance protocols and service intervals
§ Video quality; if applicable
§ Digital picture capability; ease of use and upload
§ Ease of connection for visit, if applicable
§ Reporting time: Real time; Store and forward; Other
§ Transmission carrier: POTS; Broadband; Fiber Optic; Other
§ Flexibility: Ease of “stepping up” or “stepping down” monitoring
Peripherals -- Quality
§ Stethoscope; Blood Pressure; Thermometer; Scale; Glucometer
§ Pulse Oximeter; PT/INR; Zoe Fluid Monitor; Spirometer
§ Medication Management
§ Wireless?
Vendors
§ Flexibility/service/accountability
§ Hidden Costs?
§ Lease, rent, purchase?
§ Minimum units?
§ Pilot/demo period?
§ Monitoring service offered? Charge?
§ Equipment obsolescence?
Program Design—Product Suitable for?:
§ CHF; CAD; COPD; Diabetes
§ Wound Care; Asthma; Mental Health
§ HIV/AIDS; OMR/DD; Post Surgical
§ Long Term Monitoring; Speech Therapy
§ Limited English Proficiency (LEP)
§ Patients with low health literacy
§ Medication Management
§ Other