As approved by the IEEE-USA Board of Directors
November 2004

IEEE-USA urges Congress and policy-makers, in both the public and the private sector, to take the actions needed to expand uses for electronic devices, assistive and monitoring software, and home health communication technologies to provide home health care to those in need. Further, we support developing guidelines for reimbursement of these technologies -- both for developers and users.

IEEE-USA believes that using electronic technologies to assist and monitor elderly, disabled, and chronically ill individuals in the home can improve quality of life, improve health outcomes, and help control health care costs.

Accordingly, IEEE-USA supports:

• Public and private sector research on the effectiveness, cost-efficiency, and potential return on investment for each class of home care technology; and research on how such technological innovations can best be integrated into a comprehensive package for home health care.
• Tax incentives to stimulate research, development and deployment of home care technologies.
• U.S. Department of Health and Human Services’ Centers for Medicare and Medicaid Services action to streamline and expedite exemption, clearance and approval processes for home care technologies. Reimbursement should not be limited to U.S. Food and Drug Administration approved devices.
• Medicare and other health insurance carrier action to provide reimbursement for home care technologies that meet specified qualifications (see background).

This statement was developed by IEEE-USA’s Medical Technology Policy Committee and represents the considered judgment of a group of U.S. IEEE members with expertise in the subject field. IEEE-USA is an organizational unit of IEEE. It was created in 1973 to advance the public good and promote the careers and public-policy interests of the more than 225,000 technology professionals who are U.S. members of the IEEE. The IEEE is the world’s largest technical professional society. For more information, go to http://www.ieeeusa.org.

BACKGROUND

Increasing health care costs and an aging population are placing significant strains upon the U.S. health care system. Small pilot studies have shown that meeting seniors’ needs for independence and autonomy, coupled with expanded use of home health technologies, mitigate against the circumstances above, and provide improved health outcomes. Difficulty with reimbursement policies, governmental approval processes, and absence of efficient deployment strategies has hampered adopting such technologies.

These technologies can reduce or eliminate the need for personal services in the home and can also improve treatment in hospitals and nursing care facilities.

Guidelines For Reimbursement Are Needed For:

• Monitoring and assistance for ambulation, toileting, and other activities of daily living, for individuals who would otherwise require institutional placement because of inability to perform these activities.
   
• Emergency call devices.
   
• Managing a disability (for example: catheter care for a quadriplegic, or care for a severely disabled child).
   
• Managing a major chronic illness.
   
• Relief of pain and other distressing symptoms.
   
• Technologies that enable the patient or caregiver to attend school, work, or otherwise participate in activities outside the home. These activities should be covered by health insurance for persons who are not otherwise homebound.
   
• Personal home care services, systems and devices that might be more expensive than institutional care. These elements should be considered for coverage when:
   
  • Such services and devices make it possible to pursue better health outcomes on a long-term basis than would be possible with institutional placement.
     
  • Such services and devices make possible economic productivity by patient or caregiver that would not be possible with institutionalization.
     
• Managing a major chronic illness, including [standards-based] applications to support remote monitoring, patient-provider communications, and an online, patient-accessible health record. Such services and devices make a much better quality of life possible for patient or caregiver than would be possible with institutionalization.