July 08, 2005
Telemedicine In Treating Chronic Illnesses
A project with two large health centers in Oregon and Washington will give 2,000 patients Internet-connected equipment to collect vital signs that nurses and doctors can monitor remotely. Centers for Medicare and Medicaid Services will be evaluating an early intervention program and learn where it works best, with a new home-health-monitoring telemedicine project that will launch in January 2006.
The patients chosen by the centers for the project are under care for conditions such as congestive heart failure, chronic obstructive pulmonary disease, or diabetes.
The hope is that with earlier intervention for chronically ill patients experiencing health problems, serious complications and expensive trips to the hospital can be avoided. A goal for each of the two medical groups is to cut by 5% the total Medicare costs for the patients assigned to them. Often, patients don't realize they're having symptoms that indicate an impending, but preventable, health crisis until they actually get very sick,
The Technology
For the project, the patients will use home-monitoring devices, such as glucose tests or blood-pressure cuffs, to collect readings. The readings are collected by "Health Buddy," which is an appliance from vendor Health Hero Networks that provides an interface between the patient's home and the care provider. Depending upon the device, readings can be either electronically collected and transmitted to Health Hero, or keyed in to Health Hero by the patient.
Health Hero includes monitoring technologies, clinical databases, Web-based decision-support tools, health-management programs, and content-development tools. The home-health-monitoring medical devices that hook up to the Health Buddy, such as blood glucose testing devices, are available in many pharmacies and other retailers.
Those devices feed data into the Health Buddy, which plugs into a home phone line and dials-up to send data and information about patient symptoms to a secure remote database. The Health Buddy serves as a "home hub for health."
Individualized health information and programs also can be downloaded to the Health Buddy.
Health Buddy features four large keys that automatically get labeled electronically, based on text questions the patient is asked to answer about his or her symptoms and behavior.
The Health Buddy screen can display several lines of text, and is programmed to ask specific questions based on the individual patient's responses. So, for instance, if a blood-pressure reading is high for a heart patient, the Health Buddy could ask a series of questions to help determine the cause, such as whether the patient recently has eaten foods with high sodium content.
The data is sent to remote clinical information databases. At the provider's end, authorized doctors and nurses can access the data via the Internet. Decision-support tools are provided to review a patient's status to detect problems earlier. The system also gives health-care providers a list of patients having symptoms or other problems, and can rank the list based on the severity or type of problems, so that nurses or doctors can intervene by calling the patient or changing treatment.
The system also can be programmed to provide emergency alerts to nurses or doctors, so that ambulances can be called in serious situations. The goal of the three-year project -- called "Advancing Chronic Care Through E-Health Networks And Technologies" project, or Accent -- is to determine whether a project involving 2,000 patients is beneficial and can be scaled to a much larger population.
Posted by rsk at July 8, 2005 07:39 AM