Telehealth Aims To Decrease Hospitalization, Home Visits

March 27, 2007
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With many of its patients in remote rural areas, Hackley Visiting Nurse Service and Hospice found its caregivers were spending a larger percentage of work hours traveling to patients’ homes than actually administering care.

To visit a patient in Hesperia, for instance, a caregiver from the Muskegon-based operation will drive an hour, visit the patient for an hour, and then spend another hour on the return trip. Naturally, president and CEO Nancy McCarthy explained, this means the company is able to care for fewer patients. “We make fewer visits because of the excessive travel,” she said. “But more importantly, it’s harder to quickly deliver care to people who are that much of a distance away.”

For patients with certain chronic illnesses, a serious decline can happen quickly. If a patient with congestive heart failure begins gaining weight — a sign of fluid gain — on Monday, an ER visit might be required by the time a caregiver arrives on Thursday.

Through a $160,000 grant from the U.S. Department of Agriculture, Hackley is launching a telemedicine program to address these issues.

Over the next year, Hackley will roll out diagnostic monitors in the homes of up to 45 patients with chronic illnesses such as diabetes, congestive heart failure and obstructive lung disease. Depending on the condition, the patient will hook up to the automated diagnostic machine daily or several times a day. A screen asks the patient several health-related questions, then walks him or her through the use of devices that measure pulse, blood pressure, weight, breathing and other factors. The data is transmitted via the Internet to the caregiver, who takes appropriate action.

According to Continua Health Alliance, the rise of chronic conditions and the rapid aging of the population is shifting medical care from traditional institutional settings to the home. Telemedicine should help alleviate the burden of home health care providers.

Porter Hills Home Health Care launched a telemedicine program in 2005. “It’s a national goal to decrease hospitalization and ER visits, and this has helped us do that,” said Teresa Toland, executive director of Porter Hills Home Health Care. The patient and caregiver work to determine how often and when the readings should be taken. At the appropriate time, the monitor emits an alarm to signify a reading is necessary. The only limitation Porter Hills has found is that patients must be cognitive and have good enough vision to read the screen.

“They do have to have a desire to use it,” Toland said. “We ask everyone to try it, but not everyone trusts it.”

A recent report by the New Millennium Research Council suggests that older Americans’ will resist telemedicine because of a generational distrust of technology and a fear of losing longstanding relationships with their doctors. McCarthy anticipates similar concerns as Hackley rolls out the program.

“People are afraid they’re just going to be talking to a machine and they’ll never see a nurse again,” she said. “That’s not what is going to happen.”

The McClees Clinic at Hackley Hospital has been using telemedicine for several years. The HIV/AIDs clinic serves most West Michigan and has had difficulty delivering service to outlying areas, as far north as Traverse City. In 2004, it rolled out a telemedicine program linking Lakeshore Hospital in Oceana County, Baldwin Family Health Care in Lake County and the Muskegon-based clinic. The clinic had long used the technology to treat patients housed in the Michigan Department of Corrections, where telemedicine is widely adopted.     HQX

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