Home Medication Management by Videophone: Translation from Pilot Project to Integrated Service

Abstract

The implementation of a telehomecare medication management service, by a community health and care organisation, is described from pilot project to ongoing service. Nurses undertake virtual visits using videophones to guide and monitor medication administration for home-based clients with cognitive impairment, or for those receiving directly observed therapy for tuberculosis. Changes in nursing roles, the development of new clinical protocols and procedures, and a new method of providing flexible, high bandwidth connectivity to the home were developed. Clients reported the telehealth service to be convenient, reassuring, and less intrusive than face-to-face contact, and found the videophones easy to operate. The nursing service found the telehealth service was safe, reliable, cost-effective, and that clients improved their health status. The translation to service integration was accomplished by dedicated resourcing, staff education, addressing staff concerns, the development of a telehealth unit, and a clinical–technical partnership. The critical organizational success factors were the engagement of clinicians, clear development of new professional roles, a continuing change management strategy, and leadership.