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Home Health Care Answers the Call

Telehealth helps nurses monitor at-home patients 24-7

By Claire Charlton Photo by Alexandra Hichel

Nurses know that patients who are educated about their diseases and conditions recover more quickly, live more comfortably, and even sidestep dangerous complications. A growing area in patient care is telehealth, which melds technology with a human touch. One example: The Visiting Nurse Association of Southeast Michigan (VNA) is using TeleHomecare - remote monitoring technology in the home setting - to help patients become more actively involved in managing their diseases, with great results.

On a regular basis in their own homes, patients enter details on their medication, weight, blood pressure and other information into a TeleHomecare "health buddy" electronic device. The data is transmitted to a remote computer at the VNA. Nurses monitor patients from their offices, and when they receive a risk alert or discover a change in a patient's health, they follow up with a call or visit..

More than just a cost-efficient way to care for many patients at once, the system provides surprising patient benefits, says registered nurse Jill Pahl, VNA TeleHomecare program manager

"TeleHomecare allows patients to connect the dots between their lifestyle and behavior and their own wellness," says Pahl. "It actually empowers them and gives them the desire to do well."

Patients appreciate the constant care, too, Pahl says. "One patient said, 'I never knew that somebody cared so much.' They know we want them to have success in their disease management, and they enjoy gettinAt any given time, the VNA of Southeast Michigan typically has more than 100 patients over the age of 65 using TeleHomecare to manage chronic conditions such as heart failure, diabetes, high blood pressure and chronic obstructive pulmonary disease.

The program was put into use in 2002 at a cost of more than $1 million. In 2006, TeleHomecare helped reduce hospitalizations by 16.6% compared to the national benchmark, according to Outcome Concept Systems, a home health industry information company.

B"Instead of just getting a snapshot of how a patient is doing during a visit, I now have the ability to see how they respond to medication when it is peaking and when they are symptomatic," says Pahl. "The whole goal is better disease management, and I see technology becoming more and more instrumental in helping us take care of our patients."

Many technologies can be incorporated into the teleheath spectrum. At the University of Michigan Health System, nurses digitally photograph images of homebound patients' pressure wounds and send the information to plastic surgeons, who assess the wounds for treatment.

Sparrow Home Care in Lansing is implementing a system for heart failure patients to report weight, blood pressure and other vitals to remote nurses through wireless technology

Trinity Health is piloting an electronic health records system at Mercy Primary Care Center in Detroit and Mercy Place in Pontiac. Similar to VNA's TeleHomecare, Trinity patients use telemonitoring devices to transmit health information throughout the day to a monitoring care manager for patients with chronic conditions.