Remote Monitoring Yields Healthier Patients
Nursing service uses wireless devices to monitor homebound patients and get data to doctors faster, reducing hospitalizations by more than 50%.
As more healthcare providers deploy electronic medical records, they're also looking to tie them into remote monitoring systems used by homebound, chronically ill patients. Now faster access to information generated via remote monitoring devices is reducing medical complications and hospitalizations, and improving quality of care, according to one in-home nursing service that's using those devices.
Bayada, which has 140 offices in 17 states and the United Kingdom, in the last year has rolled out wireless, Internet-connected remote monitoring devices from Idea Life to about 200 U.S. housebound patients with limited mobility and conditions such as chronic obstructive pulmonary disease, hypertension, and congestive heart failure. During that time, hospitalizations of those patients have been reduced by 54%, said Brian Farber, director of telehealth at Bayada.
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The remote monitoring system alerts Bayada's nurses as soon as a medical problem crops up with a patient, letting the nurses respond fast. The system also sends alerts to patients' doctors, allowing them to adjust medication quickly or otherwise intervene.
Without remote monitoring, problems can go unnoticed for several days. Homebound patients with chronic diseases often don't notice or report subtle changes in their conditions to doctors, and those changes aren't discovered until a nurse makes a scheduled visit, which could be days after a problem first develops.
Also, the education that Bayada provides to remotely monitored patients helps, too. For example, patients with congestive heart failure and high blood pressure are made aware of salt intake can worsen their conditions.
Ideal Life provides Bluetooth-enabled monitoring devices, such as wireless body weight digital scales and blood pressure cuffs that let patients take readings daily. The data is sent in real time via the Internet, phone, or cell lines to nurses in Bayada's offices who monitor a dashboard that provides alerts on readings that fall outside acceptable levels specified by patients' doctors. Nurses can also receive alerts on their smartphones or via e-mail.
If a patient with congestive heart failure shows a gain of 3 pounds or more over 24 hours that could indicate a fluid retention, a dangerous condition for someone with that illness. The system sends an alert, and the nurse receiving it might schedule a home visit or notify the patient's physician so medication can be adjusted or other treatment prescribed.
"We work closely with the doctors," Farber said. Bayada's nurses are able to monitor patients whose doctors lack resources and time to do the monitoring themselves, he said. Data can be incorporated into the e-medical record systems that patients' physicians use.
Reducing hospitalizations avoids thousands of dollars in costs. "It costs a minimum of about $10,000 every time someone goes into the hospital," said Farber. And if a trip to the hospital includes a stop in the emergency room, costs go even higher.
One obstacle to widespread use of remote monitoring is that insurers and other healthcare payers generally don't reimburse providers like Bayada for remote monitoring services. However, that's slowly changing, said Jason Goldberg, president and founder of Ideal Life.
Ideal Life recently announced its medical devices were part of a state-funded project in North Carolina to remotely monitor 400 rural Medicaid patients who have heart failure or cardiovascular disease. Some private healthcare companies, including CareMore, a health-maintenance organization in California, are paying for the remote monitoring of patients with chronic diseases, Goldberg said. Increasingly, there are new incentives "to reward for preventative care, rather than just reactive models," Goldberg said.
Remote monitoring is helping Bayada more efficiently schedule and manage its nurses, sending them to visit patients with the most urgent needs, Farber said. So far, the company has invested about $100,000 in the remote monitoring gear, he said.