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Technology has brought myriad enhancements to the health-care industry in recent years. It’s just that very few of them have reached the home-health field.
That sector has remained decidedly low-tech: Dedicated nurses visit disabled, recovering or chronically ill patients in their homes, assessing their health needs and assisting them with every-day tasks. But a new in-home monitoring system deployed by VNS Home Health Services in Narragansett has the potential to fundamentally change the industry, according to the agency’s president and chief executive officer, George Laban.
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”I’ve been in the home-care industry for 18 years, and we have been waiting for some help from high-tech,” Laban said. “I think there is a realization that telemonitoring is the future of home care.”
The system, which VNS Home Health has been using at 25 of its patients’ homes since August, enables patients to take their own vital signs, with the results sent directly back to the agency via digital wireless technology or traditional phone lines. The staff gets daily clinical information on patients’ – rather than only when nurses visit – enabling clinicians to regularly track health changes.
”It doesn’t result in fewer home visits, but it allows us to keep in touch with patients far more frequently, so we can see who’s having problems right away,” Laban said.
Milwaukee, Wis.-based HomMed LLC provides the monitor system, which includes a small scale along with a device about the size of an alarm clock. It is activated automatically each day, with a voice telling the patient that it’s time to take his or her vital signs.
The monitor guides the patient through a series of steps that records heart rate, blood pressure, oxygen saturation, weight and temperature, using standard peripherals on the machine, such as an arm band to measure blood pressure. The process takes about three minutes.
It also can measure blood-sugar levels, lung functions and blood clotting, although VNS hasn’t added those features yet.
Each system is individually programmed for patients – all of whom have some form of cardiac or respiratory condition such as congestive heart failure or hypertension – according to parameters set by their physicians. If one of the vital signs fall outside of the parameters, a red warning message pops up on the PC monitor back at the agency.
For example, if a patient’s blood pressure is way up, the RN will be notified in time to contact the patient or send a nurse to the home. In one case, the monitor detected a woman in the early stages of a stroke, Laban said, and she was quickly taken to the hospital.
But the system is not necessarily intended for emergencies. Rather, it lets nurses schedule their day around patient needs. If, for example, the monitor detects problems for a patient who isn’t scheduled for a visit until the next day, appointments can be flip-flopped.
“The bottom line is it gives nurses the information they need to make better decisions,” Laban said.
A three-month peer review of the HomMed system last year showed that it significantly reduced hospitalizations and emergency room visits, according to Congestive Heart Failure magazine.
Another benefit: Patients are more conscious of their own health status and how diet, activity and other factors can affect vital signs.
“We’ve found that patients who use the HomMed system are more compliant with their health-care plans since they know they’re being checked up on every day,” said Dale Reis, clinical director of VNS Home Health Services.
Laban said he has seen other telemonitoring devices, but most are “cumbersome, intrusive and expensive.” He said the agency’s staff likes the HomMed system because it’s easy to use and relatively inexpensive. VNS leases the system from HomMed for $5 a day per patient. The cost includes the home device as well as HomMed’s PC and software at the agency’s office.
It’s an extra expense, and it doesn’t necessarily cut costs, because nurses still visit patients’ homes as often as they would otherwise. But ultimately the system is a tool to provide better care, Laban said, and he thinks it will become standard in the industry in coming years.
“Vital signs are essential to providing quality care,” Laban said. “We have to know how a patient is doing. I think this will become more and more of a norm in our industry.”
