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LEARN ABOUT IFT AND HOME TELEHEALTHCARE
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Success Stories Appearing in Home Teleheathcare: Proces, Policy, and Procedures, the latest release from Information Tomorrow. Success
stories in Home Telehealth:
Selected Reports ¯Congestive
Heart Failure (CHF)
¯ Cardoza, C.L., Mello Glaskell, S.
(2002). “Determining the value of home telemonitoring for CHF
patients,” The Remington Report 10
(5); 16;17-20. The authors describe using telehealth at the Visiting Nurse Association of Southeastern Massachusetts for 187 completed patient episodes of home care, and focus on a particularly difficult case of a co-morbid CHF patient with renal failure among other problems. Increased telecontacts (not additional conventional visits) were the norm during periods of the patient’s instability. As a result of generating patient success, as proven with this case, the authors say that their agency has established acceptance of telehealth use by physicians and staff. D’Andrea, B, et al. (1998).
“Transforming high tech into high touch cardiac care.” Continuing
Care, May: 36-41; and Roglieri, JL et al. (1997). Disease management
interventions to improve outcomes in congestive heart failure.”
The American J of Managed Care 3 (12) 1831-1839. Both of these articles report on a
long-term home care telehealth project at NYLCare of New York that
achieved 100% reduction in hospitalizations of the CHF patient
participants. As D’Andrea (a nurse) notes, the project has involved
regular telephone calls from nurses to elderly patients, in which patients
reportedly felt a sense of “caring” by practitioners who called (D’Andrea,
1998). This more frequent contact effectively raised the rates of patient
compliancy. Lewis, P. (2002). “Telehealth technology: empowering
staff buy-in.” The Remington Report 10 (2): 14-16. Representatives from 3 home care agencies across the
country who have achieved success in home telehealth were interviewed
(representing AnMed Home Care Services, Anderson, SC; VNA of Houston,
Houston, TX; and St. Luke’s-Shawnee Mission Home Care, Kansas City, MO).
All three interviewees report on successful use of home telehealth primarily with CHF patients. Patient
satisfaction is high: one interviewee says: “Most patients feel
they’re getting great care [as in more care], yet they’re
getting fewer visits” (p. 16). Wehrman, P, Simmons-Bennett, D. (2002). “Hi-tech &
hi-touch: combining state-of-the-art technology with the state-of-the-art
home healthcare.” The Remington Report 10 (2): 28-31. The authors report on a successful program at the VNA of Houston, in collaboration with the Methodist DeBakey Heart Center. On particular case illustrates success in teaching patient self management: The CHF patient on home monitoring “has even become so in tune with her body and the monitor that she has called her physician herself to report weight gains and gotten orders to adjust the diuretics before we could contact her!” (p.30). ¯Diabetes ¯ Glucose
Telemonitoring
Marrero, DG, et. al.
(1995). “Using telecommunications technology to manage children with
diabetes: the Computer-Linked Outpatient Clinic (CLOC) study.” The
Diabetes Educator 21 (4): 313-319. Marrero and his team
report on 53 pediatric insulin-dependent diabetic patients who self
monitored their daily glucose readings at home and transmitted them to a
clinical center, and compared the outcomes with 53 other patients with the
same diagnosis who were monitored in a clinical setting. A significant
decrease in nursing time was noted with the tele-contacted group.
Among the at-home patients and their caregivers, there was also an
increased feeling of nursing support because of the more frequent contact
(the total time, however, being less than that spent with patients who
were followed in the clinic). Diabetes Education Johnson, A., Gorman, M.,
Lewis, C., Baker, F., Coulehan, N., Rader, J. Interactive
videoconferencing improves nutrition intervention in a rural populations. Journal
of the American Dietetic Association 2001; 101 (2): 173-174 Patients located in a very rural area of upstate New York were assisted by telemedicine effectively and reported liking it, too. In this case, nutritional counseling via video was provided to help diabetics manage their disease better. As the authors note: Nutritional counseling for rural populations “may be perceived by patients as important but not valued sufficiently to warrant traveling a distance to access it.” In other words, when it was made convenient via telemedical tools, it was accepted and used. ¯ Pediatric Interventions ¯ General teleinterventions Melzer, SM, and SR Poole (1999) Computerized
pediatric telephone triage
and advice programs at children’s hospitals: operating and financial
characteristics. Archives of Pediatric and Adolescent Medicine
153 (8): 858-863. The authors discuss the costs of running a
computerized pediatric telephone triage and advice program. Although it
lost money, it has been perceived to be a valuable mechanism for marketing
and increased patient satisfaction. Pediatric asthmaKinsella, A.
(May/June 1998) “Managing the inner city” Home Healthcare
Dealer: 75-76. A successful pilot project in downtown Detroit undertaken in collaboration with community health services, Amelia Earhart Middle School, and various departments at the University of Michigan Ann Arbor is reported on. Adolescents were introduced to means for managing their asthma by in their classroom and homes where they tracked peak flow readings and tracked results as well as used a computerized system to track and graph findings from regular environmental assessments of their homes and schoolrooms. ¯
Wound Care and Management
¯ Mulhearn,
P. (2002). “Wound management via telemedicine results in successful
financial and clinical outcomes. Remington Report 10 (2); 32;
34-37. Reports on a wound care program at the Visiting Nurse Services of the Northwest (Seattle, WA) that was designed to meet goals of raising wound healing rates by 50% or more; as well as meeting the goal of enhancing staff knowledge, skills, and confidence about wound management. Three users of telewoundcare,
Patty Mulhearn, Visiting Nurse Services of the Northwest (Seattle,
WA); Susan Freeman, Alacare Home Health and Hospice, Birmingham, AL; and
Radi Ann Porter, Catholic
Community Services Home Health Bisbee, AZ, report on their successes in
the Keynote Interview segment of the web page: “Telewoundcare:
Moving beyond conventional managing and toward tele-healing,” Home
Telehealth Community of Care Web page, April 2002 installment, available
at: http://www.informationfortomorrow.com/telewoundcare.htm |
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