| Vital signs
TeleHealth system enables patients to be monitored at home
Marian Rizzo - StarBanner At one time, Helen "Ruth"Craft was losing weight so quickly, it frightened
her family. Diagnosed with familial visceral myopathy, a rare disease that can
affect a person's digestion, Craft went down to 60 pounds within one year. A
mere 4-feet, 11-inches tall, Craft was so weak she could hardly get out of bed.
"She was going to starve to death, I think,"her daughter, Carol Craft, said. "She
was eating - not a lot - but she was not digesting it. For awhile, she was in
bed all the time."
At 76 years of age, Ruth also has asthma and high blood pressure.
Over the last couple years, she spent a lot of time in doctors'
offices and sometimes
ended
up in the emergency room at the hospital. Then, her home nursing service,
Palliative Home Care, installed a home monitoring system at her
bedside.
The Home TeleHealth System monitor records Ruth's weight, blood
oxygen levels and blood pressure and transmits the data to a central
nurse's station. The
daily recordings indicate when Ruth needs to go on her home oxygen supply.
And, copies of the data are passed to her doctor.
"Before, I always had to worry about should she go to the doctor? Should she go
to the emergency room? Things like that,"Carol said. "It takes the
pressure off. When I check it, I know what she needs. I don't have to guess whether
she needs oxygen or if her blood pressure is high or low."
Using the data, Ruth's doctor put her on a feeding tube. The
readings show that her weight is fairly stable and the tube feedings
are working, Carol said.
Now 67 pounds, Craft sits on the edge of her bed swinging her
legs, while her 11-year-old great-granddaughter, Cameron, takes
her blood pressure and taps
the monitor screen, sending the data to the central station, where daily
readings also come in from other patients.
"It's the next best thing to being there,"said Laurie Bennett, a registered
nurse and clinical supervisor who oversees the central receiver.
"We listen to lung sounds, check all the vitals,"Bennett said. "When
the nurses aren't out there to see the patients, I can see them."
A member of Hospice of Marion County's Healthcare Alliance, Palliative
Home Care has placed monitors in several patients' homes. It's
the first private
home health
care agency in Central Florida to use the monitors, said Lori Johnson, a
registered nurse and vice president of sales and marketing for
American TeleCare Inc.,
an Eden Prairie, Minn., firm that developed the TeleHealth home monitoring
system.
Numerous health care facilities throughout the country use them, Johnson
said. Most units cost less than $5,000 each, depending on accessories
ordered, she
said.
Palliative Home Care purchased six 8-inch touch screen monitors,
like the one in Ruth Craft's home, and two larger versions that
have audio/video functions.
The larger unit has a 12-inch screen and several attachments, including a
stethoscope and a hand-held camera that allows the nurse to do
a visual assessment of the
patient without ever leaving the office. Both versions connect to the patient's
telephone line for transmission of data.
The devise stays on 24-hours a day. A brief musical interlude
alerts the patient when it's time to take a reading. The unit also
reminds patients to take their
medicine, and it keeps a log of doctor's appointments.
While the unit takes some of the guesswork out of home health
care, Dr. Paul Urban, medical director of the cardiac catheterization
lab at Ocala Regional
Medical Center, said such monitoring might not always be necessary. And,
it could give a patient a false sense of security, Urban said.
Patients who have had open-heart surgery rarely need to be monitored
after their operation, Urban said. And, people who have pacemakers
already have a
built-in
transtelephonic monitoring system that can be checked over the telephone,
he said.
"I think there's a question of what do you do with all this information and how
can that better help take care of the patient?"Urban said. "The heart
rhythm thing, I think, has a huge potential. But, suppose somebody has malignant
rhythms? Who's responsible for getting this person into the system? And promptly?"
The physician is in charge of the patient's care, said Mary Kiefert,
chief executive officer of Palliative Home Care. Monitors are placed
in patients'
homes only
through a doctor's written order, she said.
Dr. Bhayani Ketheeswaran at Magnolia Family Care has prescribed
the home unit for at least one patient whose blood readings fluctuated
slightly. Ketheeswaran
said the daily reports helped her regulate her patient's blood pressure and
blood sugar.
"I can't get the patient, every day, here,"she said. "They send me
results. For certain people it is (fine). But, I have not many patients on that.
It's not for everyone. It's only for certain people, not for unstable patients
who need closer monitoring."
Although readings at Palliative Home Care are restricted to the
normal workday, Monday through Friday, eventually the service could
be expanded into evenings
and weekends, Mary Kiefert said. As far as cost is concerned, Kiefert said
about 85 percent of Palliative Home Care's patients are under the Medicare
program,
which pays a lump sum for 60 days. The monitoring system is included in the
facility's operating budget, she said.
"I think going from the hospital, where you have all those monitors and all that
security, to going into a home environment, where you don't have any of that
technology, that this is a good intermediate step to bring you back to your normal
daily routine,"Kiefert said. "Instead of the nurse visiting their
house two or three times a week, we can visit them every day. We still have the
nurse go out, but it's a way of providing a higher level of care." For information about the TeleHealth monitor, access www.americantelecare.com.
For information about Palliative Home Care, call (352) 873-0475.
Marian Rizzo can be reached at marianrizzo@aol.com or (352) 624-0868.
Article published Jan 13, 2004 |
