Telemedicine sends vital information to patients’ health care providers
Each morning, after Madison Arnold wakes up, he turns on a monitor, steps onto a scale to weigh himself and slides on a cuff to take his blood pressure.
He then answers two questions: In the last 24 hours, has he had any trouble breathing, and has he fallen.
The equipment then transmits his vitals and his answers from his Marion home to Cathy Bales’s office in Cedar Rapids, where she reviews his weight and blood pressure and makes adjustments to his medications if necessary.
“We can avoid hospitalization by catching these subtle changes,” said Bales, the telehealth coordinator for home care at UnityPoint Health-St. Luke’s Hospital.
The 90-year-old Arnold, who lives alone, began using the telehealth equipment about 13 months ago. He’s had heart problems since the 1970s, taking countless trips to hospitals in Cedar Rapids, Milwaukee and Louisville.
“There’s a comfort to the patient knowing we monitor them and check on them seven days a week,” Bales said. “It’s also saving them from unnecessary doctors’ visits and visits to the emergency room,” which can cost between $9,000 and $12,000.
Arnold has been in the hospital only once since Bales started monitoring his vitals on a daily basis.
“It was after his 90th birthday,” she said. “Family was in town, and they did lots of celebrating.”
“I’ve avoided several hospital visits,” Arnold said, “because it warns you if something is haywire.”
St. Luke’s has been using its 33 telehealth monitors for about three years, putting them into patients’ homes within a 50-mile radius.
Expanding access
Through various devices in telehealth and telemedicine, Corridor hospitals can reach more people and cover a larger geographical distance, which improves access to care in rural communities or home-bound individuals. Doctors and nurses no longer have get in a car and travel to see patients.
Advances in technology have allowed doctors to conduct patient visits by interactive video, forward digital images to remote specialists, interpret radiology results remotely, offer pharmacy services and monitor patients in their own homes.
In 2012, the University of Iowa and the UI Critical Access Hospital Network received $7.7 million from the Centers for Medicare and Medicaid Services to improve care coordination and communication with practitioners in 10 rural Iowa counties.
The healthcare organizations are using that funding to develop transitional care teams for rural patients with complex illnesses, which includes the use of telemedicine.
Mercy Medical Center also uses the telemoitors, putting the devices in about 85 patients with cardiac problems or diabetes. The hospital just purchased two telemedicine carts, which will allow a physician to remotely diagnose a patient.
Each telemedicine cart, carrying about $25,000 in equipment that is certified by the Federal Drug Administration, consists of a high-definition video monitor, a blue tooth stethoscope, an ear, nose and throat scope and a camera, which all hook up to the screen and stream images and conversations back to the diagnosing doctor.
“The physician can be virtually anywhere,” said Jeff Cash, senior vice president and chief information officer.
Redefining the patient-doctor visit
Dr. Timothy Sagers, medical director for MercyCare, said a nurse can conduct the examination either in a rural critical access hospital or on a mobile unit while a physician oversees the appointment and asks the patient questions — a specialist can even be brought in if needed.
“We’ve just scratched the surface,” Sagers said.
Telehealth can expand care for those in rural areas who need mental health services, have children with diabetes or are in need of other services that require specialists.
“This could be a solution to these problems,” Sagers added.
In this era of concern over patient privacy and Health Insurance Portability and Accountability (HIPAA) compliance, the video feed is run through the hospital’s secure network, the same network that is used to store electronic medical records, so all physician-patient interactions are confidential and secure.
“This will redefine the access and quality of health care,” Mercy’s Cash said. “The interaction, the exam is all the same as if it were happening in person.”
The only limitation is that the primary care physician can’t touch the patient’s sore back or hurting abdomen, he added.
“But most diagnoses are based on a patient’s history,” Cash noted.
Moreover, telehealth technology can save the general population millions of dollars in health care costs.
According to the Great Plains Telehealth Resource and Assistance Center, which has helped health care providers implement telehealth programs in Iowa, Minnesota, Nebraska, North Dakota, South Dakota and Wisconsin, telehealth will reduce the cost of health care in the region by $12.5 million over the next three years.
“As the population ages and the number of people accessing health care expands, we have to ask who will see all of these new patients,” Sagers said. “We have to find solutions that address access and cost.
“This (technology) will redefine the patient office visit.”
Source: thegazette.com