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Challenges facing the use of high-tech home care

Challenges of high-tech home careAs primary care organizations and hospitals extend the frontier of high tech health-care delivery into patients’ homes, providers, caregivers, and patients must overcome a host of challenges related to the user-friendliness of equipment and devices.






User-friendliness is a fundamental consideration because it can impinge on a technology’s clinical effectiveness.


Our research into providers’, caregivers’, and patients’ home-based use of intravenous (IV) therapy, oxygen therapy, parenteral nutrition (PN), and peritoneal dialysis (PD) found that these user-friendliness challenges comprise two intersecting sets of concerns:


  • Technical factors, resulting from

    • design

    • functions

    • complexity of use

  • Human factors, resulting from users’ abilities:

    • cognitive

    • physical

    • psychological


Complex technologies Technical factors
In our study we examined four technical factors:


  • Complexity

  • Number of products

  • Renewal of products

  • The home environment


Perhaps not surprisingly, we learned that IV therapy presented the most technical challenges. At the opposite extreme, oxygen therapy was reported as creating the fewest technical challenges. In between, PN and PD were nearly equal on all four counts.


Except for oxygen therapy, therefore, technical complexity poses a significant obstacle to providers (from 35% in the case of oxygen therapy to 80% for IV therapy). The number of different products and the pace at which new products are introduced also present sizeable challenges.


A puzzled patient Human factors

Overall, we found that providers’ concerns were mainly directed at patients. That’s because providers saw patients’ physical, psychological, and cognitive limits as more frequently challenging than those of their caregivers.


Our research uncovered substantial variations among the four technologies in terms of patients’ limits. Here are a couple of examples:


  • IV therapy (physical: 23%; psychological: 30%; cognitive: 26%)


  • Oxygen therapy (physical: 15%; psychological: 26%; cognitive: 15%)



Meanwhile, CSSSs identified caregivers’ limits as most challenging in two areas:


  • PN (physical: 17%; psychological: 20%; cognitive: 16%)

  • PD (physical: 18%; psychological: 18%; cognitive: 11%)



In the context of the widespread and growing use of high-tech home care in Quebec and elsewhere, and in light of our research on the technical and human factors challenging the proper use of such innovations, we offer three recommendations:


  1. A global approach to high-tech home care should be devised. Such an approach would address both the technical and human factors that enhance or detract from a technology’s user-friendliness.



  2. High-quality information and staff training should become cornerstones of primary care organizations’ high-tech home-care delivery.



  3. Funding ought to be increased for staff training and patient education.



Based on : Lehoux, P., R. Pineault, L. Richard, J. St-Arnaud, S. Law, & H. Rosendal. (2003)
Adapted by : Morgan Holmes, Ph.D.



  • Lehoux, P., R. Pineault, L. Richard, J. St-Arnaud, S. Law, & H. Rosendal. (2003). Issues in quality of high-tech home care: Sources of information and staff training in Quebec primary care organizations and relationships with hospitals. International Journal of Health Care Quality Assurance 16.1: 37-46.


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