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Telemedicine remote health care monitors patients in their homes
[February 07, 2006]

Telemedicine remote health care monitors patients in their homes

(Post-Star, The (Glen Falls, NY) (KRT) Via Thomson Dialog NewsEdge) Feb. 7--Louella Spears finds comfort in the computerized voice that awakens her at 8:30 each morning.

A homebound diabetic who suffers from congestive heart failure, Spears knows someone is keeping tabs on her health every time the synthetic female voice announces: "Good morning. It is now time to record your vital signs."

The mechanical greeting comes from Spears' Telemedicine machine, one of 31 dispensed to homebound patients by Warren County Health Services since November.

The machines monitor patients' vital signs from home, red-flagging health problems before they manifest into costly doctor or hospital visits and, in turn, aiming to save patients money, county health services officials said. The devices also cut down on the number of times home-care nurses visit patients.

Before Spears agreed to participate in November, she'd already visited the hospital five times in six months. Since using the Telemedicine machine, she has successfully avoided the hospital for the past two months. She has also cut down on doctor visits, since her primary physician receives a snapshot of Spears' condition daily from the machine read-outs.

Maureen Linehan, Spears' home-care nurse, no longer visits Spears as often, thanks to the machines. Before, Linehan visited Spears at least once each week at a Medicaid-reimbursed rate of $125 per visit. Now, she only has to show up once every other week when Spears' health condition is stable, Linehan said.

Since November, the Telemedicine program has cut the number of hospital visits for participating patients by nearly 75 percent, said Sharon Schaldone, director of Warren County Health Services' home care division.

Forms of Telemedicine have existed for decades, the earliest and most recognizable versions developed by NASA in the 1960s to monitor from Earth the vital signs of astronauts in space.

This form of remote health care is gaining more attention nationally as a way to cut health care costs, while at the same time allowing patients to stay at home, where they'd rather be.

The device, about the size of an alarm clock, is hooked into the phone line at the patient's home. It is then equipped with attachments that record weight, heart rate, blood pressure and oxygen levels, among other possible measurements.

The machine is also programmed with a series of "yes" or "no" questions tailored to the patient's specific health condition. Answering "yes" to any question always prompts a phone call or visit from a home care nurse.

The federal distance learning and Telemedicine grant program is set to receive $25 million through the president's 2006 budget -- the same as in 2005.

Warren, Washington and Essex counties recently received a combined federal grant through the U.S. Food and Drug Administration of $140,000 for their respective Telemedicine or Telehealth programs.

Washington County's Office for the Aging, which purchased 10 Telehealth units last May, will use its portion of the federal money to jump-start the program this year, said home care Director Ann Reynolds. The county intends to use the machines, which have video-conferencing capabilities, for congestive heart failure and chronic obstructive pulmonary disease patients, then branch them out for use with mentally ill patients in need of remote counseling, Reynolds said.

Warren County is one of three in the state so far to receive funding through the state Department of Health's Telemedicine Demonstration Program. Warren County's award of $108,600 fully funds the purchase of an additional 31 machines at no cost to participating patients. The initial $100,000 cost of the program and the first 31 machines came from the county Health Services budget, Director Patricia Auer said.

Warren County Health Services is in the process of making contracts with private insurance companies to be reimbursed for the cost of the machines. Negotiations with insurance provider Senior Blue are almost complete, Schaldone said. Medicare and Medicaid are also mulling the prospect of reimbursing public health agencies for the machines, she said.

As in Washington County, Warren County's program is tailored exclusively for homebound patients who suffer from either congestive heart failure or chronic obstructive pulmonary disease. Plans are in the works to expand the program's offerings to patients with other chronic diseases, said Schaldone.

Getting accurate daily measurements of her weight and blood pressure motivates Spears to make better nutrition choices. Spears, 67, has lost 20 pounds, controlled her blood sugar and even cut back on some medication since following the Telemedicine program.

But sometimes, it's tough to face the reality of how even a little diet cheat can affect her body.

Spears' weight increased a bit Friday -- likely because she treated herself to a Sausage McMuffin at McDonald's the day before.

Linehan said the machine's daily readings show regular results of choices the patient has made over the previous 24 hours, helping patients pinpoint foods they shouldn't eat or activities they shouldn't do.

"We know when they cheat," Linehan said, smiling.

For Spears, the plain-as-day readouts of her vital signs give her reassurance every day that she is healthy -- and that someone will help her if she's not.

"I have more peace of mind," Spears said. "It's good to know everything's OK."

Many patients would rather keep the machine when it comes time to finally wean them off the Telemedicine program after they show significant improvement, Linehan said.

"They know if we're not here every day we can still check on them," she said. "People don't like to see it go. It's like their lifeline."

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