Criteria for identifying appropriate candidates for Telemedicine follow-up care

Mandatory Requirements for enrollment include:

• The home environment is such that daily care and medical problems can be managed in the home. Access to utilities and safety concerns may be addressed for appropriate installation of equipment.
• The patient and caregiver accept the technology in the home.
• The patient and caregiver demonstrate competency in using and maintaining Telehealth equipment.

The following inclusion criteria may be considered for enrollment:

• The patient has chronic conditions, including but not limited to: congestive heart failure (CHF), chronic obstructive pulmonary disease (COPD), diabetes mellitus (DM), hypertension (HTN), and other conditions where technology and care coordination could improve resource utilization and clinical outcomes.
• The patient receives palliative care services due to a terminal illness.
• The patient has a wound that requires close monitoring.
• The patient requires more than one nursing home visit per week due to severity of illness and need for monitoring, management or education.
• The patient has had two (2) or more hospital admissions or emergency room visits in the preceding fiscal year.
• The patient is enrolled in a Primary Care Clinic with greater than fourteen (14) outpatient visits in the preceding fiscal year.
• The patient has greater than ten (10) active medication prescriptions.
• There are other circumstances through which the use of Telehealth technology may improve quality of life and/or clinical outcomes.

Exclusion criteria: The following exclusion criteria must be considered:

• The patient and/or caregiver are unwilling or unable to give consent.
• The patient and/or caregiver are unwilling or unable to operate Telehealth equipment.
• The patient is uncooperative or combative.
• The patient does not have a compatible phone line and can not reasonably get one.
• The patient has a history of non-compliance or behaviors such as active substance use that might impact on the safety of staff and equipment in the home.
• The patient regularly receives the majority of his/her care from providers outside the VA.