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Patients' vital signs checked from comfort of home
By Tracy Wheeler
Beacon Journal
Published on Sunday, Jan 06, 2008
A slow, 30-foot trip from his living room to the bedroom can leave Bill Pritts out of breath.
So just imagine what going to the doctor is like.
The hope, though, is that the 71-year-old Barberton man can avoid trips to the doctor, hospital or emergency room, thanks to a new in-home monitoring system from Visiting Nurse Service.
Each morning starts with a check of his blood pressure, his pulse-oxygen levels, his weight and his blood sugar. The results are automatically sent via phone line to VNS. If any of the readings are out of whack, the monitoring unit will ask a series of simple questions, like, ''Are you having more difficulty breathing?''
A nurse monitoring the vital signs at the home-care agency then calls to follow up.
''The first thing we'll do is call the patient and say, 'What's going on?' '' said Michelle Morse, VNS director for pro
gram development and education. ''We'll ask if they've taken their medication. What's different in their regimen? What's different in their diet? We just had the holidays and maybe they're not following their diet like they should have. Maybe a patient with congestive heart failure ate some ham, so their salt intake went up and their blood pressure went up.
''If they need something, by all means, the next call is to their physician, to order an antibiotic or get a medication change. The idea is that we're able to nip things in the bud, before it gets so bad they have to go to the emergency room.''
VNS bought 25 Philips telemonitoring units in November, thanks to $118,000 in grants from the GAR Foundation, the John S. and James L. Knight Foundation, and the AT&T Accelerator Grant program.
Pritts suggests that anyone who is homebound with a chronic medical condition consider using the monitoring system.
''You've got nothing to lose and everything to gain,'' he said. ''It can be lifesaving.''
Since Pritts was diagnosed with pulmonary fibrosis in February, he has been hospitalized five times.
''His lungs have gotten so bad, when they do an X-ray, all you see is black,'' said his wife, Martha.
Knowing that somebody is watching his situation every day is a relief.
''You can't always get ahold of somebody right away,'' Martha Pritts said. ''With this, there's always somebody there looking at this info all the time. And he can go downhill really fast.''
Dr. Tim Stover, Akron General Medical Center's director of care management, said there are ''definite advantages'' to in-home monitoring, especially for patients who have difficulty getting to the doctor.
It's not unusual for some patients with chronic conditions to find themselves in the emergency room 14 or 15 times a year.
''Sometimes the patients don't need to come to the emergency room,'' he said. ''Very often, it's just not necessary.''
Akron General began using similar technology several years ago for patients with congestive heart failure, finding that return visits to the ER dropped from 85 percent to 13 percent.
At Visiting Nurse Service, the telemonitoring is limited to vital signs and some other data. But Stover said that new technology is on the horizon that would allow a doctor to see a patient via a video link and talk to them via an audio link, all while reviewing EKGs, MRIs and other data.
Less personal contact
Insurers are beginning to cover the cost of the monitoring in some instances, though many times it's not covered. There is also criticism that telemedicine cuts out personal interaction.
''The doctor's fear is that we're not actually putting our hands on the patient,'' Stover said. ''At the end of the day, medicine is a one-on-one phenomenon. It's the connection between the physician and the patient.''
When all you're looking at is a computer feed, he said, ''if we don't ask the right questions about the data coming to us, it doesn't matter what the data is.''
Use of the monitor is free for those selected for the VNS program.
So far, only about half of the 25 units are in place, Morse said, because VNS wants to be sure to find patients who are able to follow directions and willing to comply with daily regimens.
Pritts' daughter, Mary Faith, said no one should be intimidated by the technology.
''It's very simple,'' she said. ''It's just A, B, C. It's cut and dried. If you can use a TV remote, then you can do this.''
Tracy Wheeler can be reached at 330-996-3721 or tawheeler@thebeaconjournal.com.
A slow, 30-foot trip from his living room to the bedroom can leave Bill Pritts out of breath.
So just imagine what going to the doctor is like.
The hope, though, is that the 71-year-old Barberton man can avoid trips to the doctor, hospital or emergency room, thanks to a new in-home monitoring system from Visiting Nurse Service.
Each morning starts with a check of his blood pressure, his pulse-oxygen levels, his weight and his blood sugar. The results are automatically sent via phone line to VNS. If any of the readings are out of whack, the monitoring unit will ask a series of simple questions, like, ''Are you having more difficulty breathing?''
A nurse monitoring the vital signs at the home-care agency then calls to follow up.
''The first thing we'll do is call the patient and say, 'What's going on?' '' said Michelle Morse, VNS director for pro
gram development and education. ''We'll ask if they've taken their medication. What's different in their regimen? What's different in their diet? We just had the holidays and maybe they're not following their diet like they should have. Maybe a patient with congestive heart failure ate some ham, so their salt intake went up and their blood pressure went up.
''If they need something, by all means, the next call is to their physician, to order an antibiotic or get a medication change. The idea is that we're able to nip things in the bud, before it gets so bad they have to go to the emergency room.''
VNS bought 25 Philips telemonitoring units in November, thanks to $118,000 in grants from the GAR Foundation, the John S. and James L. Knight Foundation, and the AT&T Accelerator Grant program.
Pritts suggests that anyone who is homebound with a chronic medical condition consider using the monitoring system.
''You've got nothing to lose and everything to gain,'' he said. ''It can be lifesaving.''
Since Pritts was diagnosed with pulmonary fibrosis in February, he has been hospitalized five times.
''His lungs have gotten so bad, when they do an X-ray, all you see is black,'' said his wife, Martha.
Knowing that somebody is watching his situation every day is a relief.
''You can't always get ahold of somebody right away,'' Martha Pritts said. ''With this, there's always somebody there looking at this info all the time. And he can go downhill really fast.''
Dr. Tim Stover, Akron General Medical Center's director of care management, said there are ''definite advantages'' to in-home monitoring, especially for patients who have difficulty getting to the doctor.
It's not unusual for some patients with chronic conditions to find themselves in the emergency room 14 or 15 times a year.
''Sometimes the patients don't need to come to the emergency room,'' he said. ''Very often, it's just not necessary.''
Akron General began using similar technology several years ago for patients with congestive heart failure, finding that return visits to the ER dropped from 85 percent to 13 percent.
At Visiting Nurse Service, the telemonitoring is limited to vital signs and some other data. But Stover said that new technology is on the horizon that would allow a doctor to see a patient via a video link and talk to them via an audio link, all while reviewing EKGs, MRIs and other data.
Less personal contact
Insurers are beginning to cover the cost of the monitoring in some instances, though many times it's not covered. There is also criticism that telemedicine cuts out personal interaction.
''The doctor's fear is that we're not actually putting our hands on the patient,'' Stover said. ''At the end of the day, medicine is a one-on-one phenomenon. It's the connection between the physician and the patient.''
When all you're looking at is a computer feed, he said, ''if we don't ask the right questions about the data coming to us, it doesn't matter what the data is.''
Use of the monitor is free for those selected for the VNS program.
So far, only about half of the 25 units are in place, Morse said, because VNS wants to be sure to find patients who are able to follow directions and willing to comply with daily regimens.
Pritts' daughter, Mary Faith, said no one should be intimidated by the technology.
''It's very simple,'' she said. ''It's just A, B, C. It's cut and dried. If you can use a TV remote, then you can do this.''
Tracy Wheeler can be reached at 330-996-3721 or tawheeler@thebeaconjournal.com.

