Devices & Technology

Home Electronic Monitoring Preserves Continuity of Care

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By Jennifer Larson, contributor

January 14, 2011 - In today’s challenging health care environment, home care providers and health plans are turning to technology to solve problems--and to achieve better patient outcomes. They're using technology such as electronic home monitoring systems to facilitate and maintain better connections with patients at home.

Linda Sheffield, vice president of Nursefinders, an AMN Healthcare company with a specialty division in home health care services, noted that this type of system allows for quicker interventions, too. If a patient’s information looks worrisome, a nurse can go out and visit the patient and address the situation, rather than waiting for a pre-arranged time.

“With the monitoring, we have real time information, and it provides us with a mechanism to really be able to have our fingers on the patient’s pulse,” she said.
Kathy McCarthy, RN, director of patient services at South Shore Home Health in Oakdale, N.Y., agreed.

“Telehealth benefits long-term patients,” she said, adding, “It’s an excellent teaching tool for making patients more self-aware.”

Providers are using a variety of equipment from companies such as Viterion TeleHealthcare, Cardiocom, Advanced Monitored Caregiving (AMC) and Intel. Most systems are set up to allow nurses to check on their patients’ weight, blood pressure, blood sugar and oxygen saturation without leaving the office. Typically, the biometric information flows from the device over the telephone lines to a Web-based portal that contains the data, although wireless devices are entering the market. The nurse then intervenes appropriately.

Debra Katz, MPH, RD, vice president for strategic accounts for AMC, explained that when a patient is discharged, AMC personnel insure that his home is stocked with medical devices equipped with Bluetooth technology. When the patient uses his blood pressure device or his glucometer, those devices automatically send the measurements in real time to his physician’s computer. The physician can then access the patient’s information, review the data and check for any disturbing trends. The system does not depend on the patient to record or submit any data. The physician does not have to worry whether the data is correct.

“We are building communication bridges between the patients and their care teams," said Katz. 

The Intel Health Guide, a second-generation unit, feeds the data into a decision-support tool that helps nurses spot trends and offers clinician videoconferencing and multimedia patient-education opportunities.

"It's interactive and more comprehensive," explained Julie Cherry, RN, MSN, PHN, director of professional services for Intel Digital Health Group in Santa Clara, Calif.

South Shore Home Health Services offers patients two different home monitoring options. It initially began installing Viterion TeleHealthcare units in patients’ homes more than five years ago as part of a New York State Department of Health telemedicine grant. The agency has since added the Health Anywhere program, in which a home health aide visits patients with a Blackberry smartphone and Bluetooth enabled blood pressure, weight scale and pulse oximetry unit. The device immediately sends the information, transmitting it in real time back to the office.

“Some patients were noncompliant or had difficulty taking their own blood pressure, so the Health Anywhere works better for them, and they like the visit,” McCarthy said.

Amedisys has deployed 2,500 Cardiocom devices into the homes of patients at high risk of hospitalization. The system allows the nurses to ask about how the patients feel in addition to transmitting the biometric data.

“We’re expanding our program this year,” said Kendra Case, RN, MBA, vice president of disease management at home healthcare provider Amedisys of Baton Rouge, La. “We feel it’s been effective.”

GE’s QuietCare system monitors patients’ activity 24 hours a day and serves as an early warning system that lets caregivers know if something is wrong in the home. Small, wireless sensors are placed in key areas of the home and send data through a base station to the QuietCare computer, which analyzes changes in behavior from the baseline data collected during the first seven to 10 days of operation. The call center will alert by e-mail, pager, text or voice the professional caregiver.

“It helps prevent crises and has enhanced the nursing staffs’ response to our residents,” said Zina Quigley, director of marketing at Quaker Gardens Senior Living in Stanton, Calif.

Patients like the new technology, too, McCarthy said, noting that patients can see the cause-and-effect for themselves, such as how the food they consume affects their blood sugar levels.
“It ties into quality care for the patients,” said Case. “It helps them learn to self-manage their condition based on the choices they make.”

And Jim Pursley, general manager of sales and marketing for the Aging Services Division at GE, noted that seniors have been receptive to the GE monitoring because it has no cameras or microphones. They like that the system preserves their privacy.

Pursley noted that independent living and assisted-living facilities, typically, install the GE system to help them detect residents’ emergencies or potential emergencies. But Pursley sees the market expanding to home use for elders trying to age in place.

“Only 8 percent to 12 percent of seniors live in senior housing,” Pursley said. “Bringing technology of this type into the home is where we have to go if we are going to positively impact millions of lives around the globe.”

“A telehealth visit by a clinician is still less expensive than a face-to-face home visit,” Case said. “If we can keep in touch with our patients with telehealth, without adding visits, it’s a very cost effective method of keeping an eye on your patients and keeping them satisfied.”

Overall, a telehealth system that allows home monitoring is more cost-effective and more "person-effective," Sheffield said, and it allows more people to remain in their homes, which is what people want to do.

© 2011. AMN Healthcare, Inc. All Rights Reserved.

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