Report: Effective home health hinges on human factors
Although home-based healthcare can lower costs and boost patient satisfaction, it also brings care and caregivers into environments that weren’t designed to support healthcare, warned a recent report from the National Research Council titled “Healthcare Comes Home: The Human Factors.”
“Among the most critical factors that need to be addressed are the human-systems interactions, also known as human factors. If the demands of providing or self-administering healthcare exceed a person’s capabilities, then the safety, efficacy and efficiency of that care will suffer,” stated the report.
The NRC Committee on the Role of Human Factors in Home Health Care made 11 recommendations for improving healthcare in the home environment by addressing human factors, according to the report. The recommendations include:
1. The U.S. Food & Drug Administration (FDA) and the Office of the National Coordinator for Health Information Technology (ONC) should collaborate to regulate, certify and monitor healthcare applications and systems that integrate medical devices and health IT.
2. The ONC, in collaboration with the National Institute of Standards and Technology and the Agency for Healthcare Research and Quality (AHRQ), should establish guidelines and standards, based on existing accessibility and usability guidelines, for content, accessibility, functionality and usability of consumer health IT related to home-based care.
3. The FDA should promote development of new standards based on the most recent human factors research for instructional materials for medical devices designed for home use. The FDA should also streamline its approval processes to facilitate and encourage regular improvements of these materials by manufacturers, the report stated.
4. The FDA should improve its adverse event reporting systems to be easier to use; to collect data that are more useful for identifying the root causes of events related to interactions with the device operator; and to develop and promote a more convenient way for lay users as well as professionals to report problems with medical devices.
5. Professional practice and advocacy groups should develop certification, credentialing and/or training standards to prepare formal caregivers to provide care in the home; develop appropriate informational and training materials for informal caregivers; and provide guidance for all caregivers to work effectively with other people involved.
6. Federal agencies, including the U.S. Department of Health and Human Services (HHS), the Centers for Medicare & Medicaid Services (CMS) and the U.S. Department of Housing and Urban Development (HUD), should collaborate to facilitate adequate and appropriate access to health- and safety-related home modifications, especially for those who cannot afford them.
7. Federal agencies, such as HUD, the U.S. Department of Veterans Affairs (VA) and the Federal Housing Administration, should take a lead role, along with states and local municipalities, to develop strategies that promote and facilitate increased housing accessibility and universal design in all segments of the market. This might include tax and other financial incentives, local zoning ordinances, model building codes, new products and designs, and related policies that are developed as appropriate with standards-setting organizations.
8. The AHRQ should support human factors-based research on the identified barriers to coordination of healthcare services delivered in the home, and support user-centered development and evaluation of programs that may overcome these barriers.
9. The FDA, in collaboration with device manufacturers, should establish a medical device database for physicians and other providers, including pharmacists, to use when selecting appropriate devices to prescribe or recommend for people receiving or self-administering healthcare in the home.
10. Federal health agencies should coordinate data collection efforts to capture comprehensive information on elements relevant to healthcare in the home. These surveys should collect data on the sociodemographic and health characteristics of individuals receiving care in the home; sociodemographic attributes of caregivers and the nature of the care they provide; and the attributes of the residential settings in which the care recipients live.
11. The AHRQ should collaborate, as necessary, with agencies such as National Institute for Disability and Rehabilitation Research, the VA, the National Science Foundation, the Department of Defense and CMS to support development of assessment tools customized for home-based care and the operator capabilities required.
“Among the most critical factors that need to be addressed are the human-systems interactions, also known as human factors. If the demands of providing or self-administering healthcare exceed a person’s capabilities, then the safety, efficacy and efficiency of that care will suffer,” stated the report.
The NRC Committee on the Role of Human Factors in Home Health Care made 11 recommendations for improving healthcare in the home environment by addressing human factors, according to the report. The recommendations include:
1. The U.S. Food & Drug Administration (FDA) and the Office of the National Coordinator for Health Information Technology (ONC) should collaborate to regulate, certify and monitor healthcare applications and systems that integrate medical devices and health IT.
2. The ONC, in collaboration with the National Institute of Standards and Technology and the Agency for Healthcare Research and Quality (AHRQ), should establish guidelines and standards, based on existing accessibility and usability guidelines, for content, accessibility, functionality and usability of consumer health IT related to home-based care.
3. The FDA should promote development of new standards based on the most recent human factors research for instructional materials for medical devices designed for home use. The FDA should also streamline its approval processes to facilitate and encourage regular improvements of these materials by manufacturers, the report stated.
4. The FDA should improve its adverse event reporting systems to be easier to use; to collect data that are more useful for identifying the root causes of events related to interactions with the device operator; and to develop and promote a more convenient way for lay users as well as professionals to report problems with medical devices.
5. Professional practice and advocacy groups should develop certification, credentialing and/or training standards to prepare formal caregivers to provide care in the home; develop appropriate informational and training materials for informal caregivers; and provide guidance for all caregivers to work effectively with other people involved.
6. Federal agencies, including the U.S. Department of Health and Human Services (HHS), the Centers for Medicare & Medicaid Services (CMS) and the U.S. Department of Housing and Urban Development (HUD), should collaborate to facilitate adequate and appropriate access to health- and safety-related home modifications, especially for those who cannot afford them.
7. Federal agencies, such as HUD, the U.S. Department of Veterans Affairs (VA) and the Federal Housing Administration, should take a lead role, along with states and local municipalities, to develop strategies that promote and facilitate increased housing accessibility and universal design in all segments of the market. This might include tax and other financial incentives, local zoning ordinances, model building codes, new products and designs, and related policies that are developed as appropriate with standards-setting organizations.
8. The AHRQ should support human factors-based research on the identified barriers to coordination of healthcare services delivered in the home, and support user-centered development and evaluation of programs that may overcome these barriers.
9. The FDA, in collaboration with device manufacturers, should establish a medical device database for physicians and other providers, including pharmacists, to use when selecting appropriate devices to prescribe or recommend for people receiving or self-administering healthcare in the home.
10. Federal health agencies should coordinate data collection efforts to capture comprehensive information on elements relevant to healthcare in the home. These surveys should collect data on the sociodemographic and health characteristics of individuals receiving care in the home; sociodemographic attributes of caregivers and the nature of the care they provide; and the attributes of the residential settings in which the care recipients live.
11. The AHRQ should collaborate, as necessary, with agencies such as National Institute for Disability and Rehabilitation Research, the VA, the National Science Foundation, the Department of Defense and CMS to support development of assessment tools customized for home-based care and the operator capabilities required.