Challenges for Home Health Care Providers: A Needs Assessment

Home health care is the delivery of predominantly medically related services to patients in a home setting rather than in a medical facility. It provides substantial benefits over traditional, hospital-based health care, such as supporting older adults' independence and quality of life, as well as being more cost-effective. This aspect of the health care industry could be enhanced through increased technological supports. When providing health care in a home setting, formal caregivers, such as certified nursing assistants (CNAs), registered nurses (RNs), physical therapists (PTs), and occupational therapists (OTs), are faced with many challenges that impede their ability to perform their jobs. Technological interventions have the potential to alleviate many of these challenges. However, to achieve this potential, new technologies must be created to meet the needs of home health care providers. To date, these providers' specific and most critical needs are not thoroughly understood. This understanding can be gained by conducting a detailed needs assessment that captures the common challenges and difficulties that home health care providers encounter. We conducted a needs assessment comprising three phases: (a) an extensive literature review of research regarding the needs of home health providers, both hospital and home-based (CNAs, RNs, PTs, and OTs); (b) subject matter expert interviews with experienced individuals from home health care; and (c) structured interviews with CNAs. We identified several significant sources of frustration and difficulty faced by CNAs including medical device usage, patient education, family involvement, provider isolation, and barriers to communication. This analysis provides an understanding of the challenges confronting home health care providers that can provide guidance for interventions. Future home health care technology can be developed to specifically target these workers' most urgent needs and allow them to perform their jobs with greater ease. Moreover, RNs, PTs, and OTs can benefit from understanding some of the challenges faced by their teammates in the home health care process.