High tech answer to the lack of nurses

Appeared on New Hampshire Public Radio April 25, 2007. Transcript below:

Natural Sound of Machine. (:02)
Tom Getters had a stroke over a month ago.
His doctor wants to record his blood pressure three times a day.
But instead of driving to the clinic, Getters relies on a device about the size of an alarm clock to make sure his doctor gets the information he needs.
“And this tells you where to put the cuff cause it has the arrows point to your artery. Press the green start button … it’ll tell you to that if you don’t do it … and relax. That’s all there is to it." (Tomcuff :12)
Getters is one of a growing number of patients who are part of the latest trend in home health care, called Telehealth.
Patients no longer have to wait for the daily nurse visit.
They hook themselves up to a machine that takes their vital signs and asks them a series of questions.
The machine then sends that data through the patient’s phone line to the Visiting Nurse Association, or VNA.
A nurse reviews the results and calls the patient or the doctor if the numbers don’t seem right...
Lake Sunapee VNA Clinical Director Scott Fabre said the technology allows chronically ill patients to receive 24 hour monitoring – a service the local VNA can’t provide.
"That data can pick up unfavorable trends before the patient can actually feel those unfavorable trends. The machine may notice that somebody that’s got heart disease, cardiac disease, may have put on four pounds over the last four days." (Scottheart :20)
Such weight gain in a heart patient could mean fluid retention – leading to congestive heart failure and a trip to the hospital if it’s not caught in time.
Janet didn't want us to use her last name.
She's just had hip surgery
She says using this new technology makes her feel more secure.
“It waits for me to get there. I was rushing initially and the first time I did it my blood pressure was quite high and they called me shortly thereafter to find out if anything was wrong, which was a very comforting thing.” (Janet1 :11)
Home monitoring has reduced the number of nurses the VNA needs at a time when nurses are in short supply.
But Andrea Steel, President and CEO of Lake Sunapee VNA, said some patients have found the technology overwhelming–
But then again so did the staff when the VNA first started the program in 2000.
“I think in the beginning some nurses didn’t trust the readings. It’s a little different technology that they had been used to.” (Andrea2 :08)
And since the the system saves what could be unnecessary visits to the doctor or hospital, Steel says it cuts healthcare costs.
“We had a little boy – 11 ½ or 12 – who had a heart transplant and he used one of these units for about a year and he never had any emergent care visits down to Boston during that year because we picked up when his medications needed to be adjusted.” (Andrea4 :20)
The machines run about 35 hundred dollars each, but neither Medicaid nor Medicare cover it.
But Dr. Louis Kazal at the Dartmouth Medical School is working to change that.
Kazal, who also runs the New Hampshire Telehealth Program, is working with legislators to get Medicare coverage for telehealth.
“In fairness to the Medicaid program they have not been asked to because we haven’t had a significant amount of clinical care being delivered via telemedicine in the state. It’s just beginning to, so it take a while for Medicaid to digest the complexities of telemedicine and where it might fit into their budget.” (Kazal :24)
The New Hampshire Telehealth Program says home health monitors have caught on in the Lakes region and southern New Hampshire.
Now some home health care services in the north country are looking into jumping on the bandwagon.
Pretty soon instead of a daily knock on the door from a visiting nurse, this may be the standard sound of home health care…..
Natural Sound 2 (:07)
For NHPR News, I'm Donna Roberson