WASHINGTON, Jan. 31 (UPI) -- A New York home health agency is using an "electronic nurse" to supplement regular nursing visits to the homes of some patients to monitor their vital signs.
The Montefiore Medical Center's Home Health Agency, which serves nearly 2 million outpatients annually in the Bronx and Westchester County, is using a hi-tech interactive disease management system for patients with congestive heart failure. The system eventually will also be available for diabetics.
The patients use monitoring devices that relay their vital signs and transmit the data through the phone line to Montefiore, where it is analyzed by the home health nursing staff.
"Our very preliminary results for the patients with congestive heart failure -- we began with 30 patients and now we are up to 60 in the study -- has been that only one has been hospitalized, compared to the norm of 25 percent," Dr. Sandra Selikson, medical director of the Montefiore Home Health Agency, told United Press International.
"It's very cost-effective -- the devices are reasonable to rent, and any time you avoid going to the hospital is a cost saving as well as better for the patient."
Each morning the patient uses an electronic scale that measures changes in weight. A peak flow meter checks lung capacity, a glucometer measures blood-sugar levels, blood pressure is monitored for hypertension and a pulse oximeter reads oxygen levels in the blood. This key information determines interventions needed for patients with asthma and chronic obstructive pulmonary disease.
"The point is to catch problems early and treat them," said Selikson. "We always want to keep patients out of the hospital. For example, if there is a weight change of 5 pounds in a week, this is a key indicator of worsening heart failure. If there is a big change, then perhaps a nurse should visit the home that day or the patient should see the doctor.
"Telemedicine also gives doctors more data to work with. They can compare data for a month, three months or a year as opposed to seeing a patient four or six times a year," Selikson said. "Right now in the study we are getting the data via fax each day, but our goal is to be able to access the patient data by computer."
New York state is funding studies on telemedicine to determine the ideal target populations. Remote home monitoring could provide significant savings and an increased quality of life for patients with congestive failure and diabetes, according to Jonathan D. Linkous, executive director of the American Telemedicine Association.
Home monitoring programs for the elderly are particularly cost-effective and can provide patient monitoring for $30 or $50 per day, depending on the kind of monitoring device. A typical hospitalization of one week for congestive heart failure costs about $820 per day.
"Unfortunately, while telemedicine is better for the patient and the savings can be significant for the healthcare provider, there isn't much incentive for an individual doctor to adopt the new system," Linkous said.
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