In 2001, Lake Sunapee Region Visiting Nurse
Association in New London, NH, became the first home health agency in
New Hampshire to implement telemedicine, a program which benefited
nearly 300 individuals in 2005. Small, easy-to-use HomMed units are
installed in patient homes to monitor vital signs and other health
status indicators on a daily basis. With an expansive, rural service
area of more than 1,600 square miles and a shortage of nurses and other
clinical staff, this out of the box solution was envisioned and
pioneered by agency President and CEO Andrea Steel.
“Changing demographics, increasing costs, nursing
shortages, federal initiatives to control Medicare spending, shorter
hospital stays, the need to decrease utilization while improving
outcomes, and the growing importance of patient self management all led
us to implement this program,” Steel said. “Because patients are
monitored seven days a week, we are able to track and trend vital
signs, manage their care and immediately respond to emergency events.
“It allows us to provide information to physicians
in a timely manner for use in treatment plans, and teaches patients to
become actively engaged in managing their own health care and create
long-term lifestyle changes. All of this saves money and improves
outcomes,” said Maureen Strachan, RN, coordinator of the VNA’s
telehealth program.
Using the HomMed units has allowed Lake Sunapee
Region VNA to target its nursing visits when patients need them most
rather than on a somewhat arbitrary pre-set schedule, have a far more
efficient use of resources, and provide a better standard of care.
Finally, the added measure of security for patients and their loved
ones knowing that someone is checking in every day is a critical part
of healing and wellness.
Here are some of the outcomes:
• Reduction in visits per episode from more than 35 in 2000 to less than 15 currently.
• Patient satisfaction consistently at 95 percent or better.
• Last year’s re-hospitalization and emergent care
rates 20 to 30 percent lower than state and national averages.
• Ability to take medications independently consistently meets or exceeds state and national averages.
• Ability to perform activities of daily living consistently meets or exceeds state and national averages.
• Cost per episode among the lowest in the region.
In addition to cost (currently, telemedicine
technology is not a reimbursed expense) perhaps the greatest challenge
for the future utilization of telemedicine is changing the care-giving
culture so this technology becomes a tool that is valued and trusted by
every member of the team.
“Our goals are clear,” Steel said. “We want to
continue to improve quality, manage cost, empower patients with
information, use technology to support clinical judgment, and offer
peace of mind.”
For more information, contact the Lake Sunapee Region Visiting Nurse Association at (603) 562-4077.
