4/30/2009
In a new study funded by NIH, educators overwhelmingly embrace
Behavior Imaging technology as a telemedicine tool for more effectively treating children with autism. Dr. Uwe Reischel, M.D., Ph.D, of Boise State University coordinated a study that examined not only the efficacy of "B.I. Capture" (a behavior imaging tool that captures and stores behavioral events via remote control video) in treating students with autism, but also looked at how easy it is for teachers and behavior specialists to use the technology.
"We are finding that autism educators are receptive to using telemedicine and specifically B.I. than we had originally expected," noted Reischl. "This is especially so for participants who not only want to use it for behavior analysis, but who also see it as a useful tool for assessing student skills, giving or receiving consultation, and for training students and staff."
Behavior Imaging was initially developed by the Georgia Institute of Technology and is now marketed by Caring Technologies/TalkAutism in Boise, ID. The system is able to capture on video, a child's behavioral episodes in educational, clinical, and home environments. Behavioral data is captured on video and then the video is used to characterize recognized aspects of behavior to assist in the diagnosis, treatment, and research of autism. The video can be viewed, annotated, and stored online, so that behavioral experts can guide students progress from anywhere in the world.
An earlier phase of the study demonstrated that the technology enabled a 43% reduction in errors when collecting data for the Functional Behavior Assessment program. Now in addition to more effective clinical diagnoses and treatment, behavior imaging can help qualified practitioners save time and money by not always observing autistic behavior in people in person.
"B.I Care" is another platform now used by professionals to diagnose, evaluate, treat, train, and provide remote consultation for autism, TBI, PTSD, and other conditions. The new system B.I. Care will be unveiled and exhibited at the ATA Annual Meeting in Las Vegas and complements B.I Capture.
For more information go to www.bicapture.
(Source: Federal Telemedicine News, April 22, 2009)
Wireless Cardiac telehealth systems are not only advancing care, they're turning into marketing tools that companies can use to sell surgeons on their pacemakers and other implanted cardiac devices (ICDs). The pitch? Home-monitored patients should have fewer health problems, but only those with compatible implants can sign up for each provider's service.
Medtronic dominates the cardiac telehealth market with its CareLink patient network. Launched in 2002, it boasts 350,000 patients in 20 countries, with 12,000 more enrolling each month. But the company's lead may narrow.
St. Jude Medical is now rolling out the latest update of its competing Merlin.net network. The new product should help St. Jude grab 5 to 7.5 percentage points of the global $6.5 billion ICD market over the next five years, projects UBS Securities (UBS) analyst Bruce Nudell.
Marketed as an all-in-one package, St. Jude's Merlin line includes several implanted devices that connect to Merlin.net, an Internet-based repository from which authorized doctors have access to patient information. The third version was approved by the U.S. Food & Drug Administration on Mar. 22.
The new software can combine hundreds of measurements taken from medical devices with other information stored in electronic health record databases such as Microsoft's Health Vault and Google Health to predict changes in a patient's health. St. Jude, based in St. Paul, Minn., says the system also has better doctor alerts and comes in more languages. The network is a free service to those with enabled devices.
St. Jude began selling the network across Western Europe in late April. Though Medtronic's CareLink is already on the market in Europe, St. Jude beat Boston Scientific (BSX). So far, the $4.36 billion company has signed on more than 40,000 patients and 1,200 clinics, with patient enrollment growing 17% month over month and clinic enrollment growing 19%. "St. Jude is continuing to advance toward the cutting edge of technology and should gain the most share in 2009," says Christopher Warren, an analyst at Caris & Co. in New York.
Medtronic, though, doesn't seem too worried about St. Jude's advance. The Minneapolis company had $13.52 billion in 2008 revenue and commands about 45% of the global ICD market, with the other 55% split almost evenly between St. Jude and Boston Scientific. Having Europe well covered, Medtronic plans to introduce CareLink to another 10 countries this year. (It's also free for patients with a Medtronic device.)
Medtronic says its head start and scale give CareLink an edge. Users have provided 4 trillion pieces of health data, enabling Medtronic to write better algorithms to keep watch on patient care. "There's always been someone coming after us, but we have been the leader and will continue to be," says Pat Mackin, Medtronic's senior vice-president of cardiac rhythm disease management.
(Source: Business Week, April 27, 2009
Tunstall Healthcare recently announced the launch of its RTX3371 telehealth monitor - an interactive telehealth device with in-built GSM/GPRS mobile phone technology that collects vital signs wirelessly from a range of external devices such as weight scales and blood pressure cuffs.
In addition, the RTX3371 telehealth monitor's spoken voice functionality allows it to collect subjective patient information from patient questionnaires, and to automatically transmit the data to a clinical backend software application based on an open architecture interface.
According to Anthony Taroni, Director of Sales at Tunstall: "The availability of GSM/GPRS cellular coverage in the USA and the rapid increase in the number of people replacing regular phone lines with wireless and mobile phones has set new standards for home hubs and the way they provide connectivity in order to ensure effective telehealth delivery. This wireless device offers service users the freedom to place the device anywhere in the home independent of phone plugs, increasing user satisfaction and acceptance."
SourceL Tunstall Press Release April 30, 2009
NuPhysicia recently launched their Medicine At Work service, which brings retained physician services to the workplace, using video telemedicine to connect board certified doctors and patients.
Medicine At Work delivers innovative medical instruments, telecommunications equipment, and, through its retained physicians, professional healthcare services directly to employees at their place of work. Using two-way video, the doctor providing services to Medicine At Work conducts examinations in real-time with the assistance of a specially trained on-site paramedic.
Melody Reid, NuPhysicia's Executive Director for Employee Health Services, said, " Industry research shows that on-site care enables employers to control healthcare costs, while giving employees convenient access to medical attention from physicians at work during business hours. Employees visit Medicine At Work clinics at the worksite for doctor visits, prescriptions when needed, one-on-one wellness coaching, and other healthcare needs, without the time away from work and expense normally associated with seeing a doctor."
Dr. Michael Davis, Senior Vice President of NuPhysicia, stated, "Through the physicians associated with this program, Medicine At Work(TM) offers a full-time medical presence in the workplace, blending high technology telemedicine and high touch. The doctors use innovative tools and equipment and secure electronic medical records (EMRs), and develop an old-fashioned doctor-patient relationship with the focus on improving employee health."
A Medicine At Work clinic is cost-effective and space-efficient to outfit, needing only a minimum of 12 X 12 feet of space, an electrical outlet, Internet connection and a door for privacy at the employer site. Medicine At Work provides all furnishings, equipment, clinic staff and medical care services for a fixed monthly cost per employee.
(Source: NuPhysicia Press Release, April 16, 2009)
3/26/2009
Baton Rouge,
Lousiana, recently became the second US City to implement a telemedicine program that allows doctors to treat patients en route to the emergency room, city-parish officials said. Initially, the specially equipped ambulance will communicate only with Our Lady of the Lake Regional Medical Center, but plans call for the program to be expanded to all seven major area hospitals with federal Homeland Security funds, said Chad Guillot, assistant director of Emergency Medical Services.
Our Lady of the Lake was selected for the pilot program because it already uses a hard-wired telemedicine system to monitor intensive-care patients from a central location, he said.
The ambulance in the "BR Med-Connect" program will use the same wireless mesh network that police are using for their new high-tech surveillance system, which includes not only video cameras but shot-spotters that detect the origin of gunshots.
The city-parish program consists of one ambulance equipped with $25,000 worth of equipment.
When linked to another $30,000 in equipment at a hospital, the system will allow doctors not only to see and communicate with EMS patients, and also to monitor data from diagnostic machines.
Guillot said equipment for the ambulance was funded by self-generated funds from the EMS budget. Future plans call for the program to be expanded to include other ambulances, he said.
The only other American city with a similar ambulance program is Tucson, Ariz., Guillot said. But he noted that the technology is widely used overseas in countries with a shortage of physicians and hospitals.
Mayor-President Kip Holden said he first saw a telemedicine ambulance during a 2007 conference in Jerusalem. He was so impressed with the system in Jerusalem that he started work on a Baton Rouge version as soon as he returned home.
Holden noted that the first hour after a heart attack or stroke is critical.
The new telemedicine program will allow physicians to begin treatment as soon as a patient is loaded into an ambulance.
The mayor also noted the new system can help to save accident victims and other trauma cases, especially in cases involving long transports.
Don Evans, city-parish director of Information Services, said the same wireless mesh network that powers the telemedicine program and the law-enforcement surveillance canopy is being expanded to included other city-parish functions that involve data transfers. For instance, it may soon be used by building inspectors and even Animal Control, he said.
(Source: 2TheAdvocate, March 12, 2009)
Stroke patients in
Alaska could soon be treated by doctors thousands of miles away using an Augusta, Georgia based telemedicine system. The REACH Call interactive Web-based system will be installed in five facilities in the Providence Health & Services Alaska system, said REACH Call CEO Sandeep Agate.
The system will be based at the "hub" hospital at Providence Alaska Medical Center in Anchorage, and by mid-April it will fan out to three "spoke" hospitals, which will likely include Bartlett Regional Hospital in Juneau, Mr. Agate said. Eventually there will be seven spoke hospitals across the state, he said.
The interactive system, developed at Medical College of Georgia, includes video and the ability to see crucial test results such as CT scans and allows a neurologist to evaluate a potential stroke patient at a remote hospital where there might be no neurologist on call or no neurologist at all.
The consultation is critical for giving the clot-busting drug tPA in particular to rule out bleeding in the brain.
"A neurologist sitting at home in Anchorage, affiliated with the Providence Alaska Medical Center, which is the hub hospital, could be treating a stroke patient almost 2,000 miles away in Bartlett Regional Hospital in Juneau," Mr. Agate said. "They could see whether transfer is actually needed, or whether tPA has to be given, and possibly save the life of that person."
Without it, the only option in Alaska could be putting that patient on a plane, he said.
"It costs a tremendous amount of money to fly somebody on a fixed-wing aircraft from Alaska to Seattle," Mr. Agate said. "And you could potentially be wasting that money. It could be a mini-stroke or a false positive; it could not be a stroke at all."
With the Alaska addition, REACH Call is now used at 74 facilities in seven states, and the company is in serious talks to add health systems in Texas, Louisiana, Illinois and Ohio, Mr. Agate said.
In Georgia, Medical College of Georgia Hospital serves as a hub for 10 rural spoke hospitals. The system is used at Doctors Hospital and is being implemented in Savannah at St. Joseph's/Candler, with plans for five spoke facilities there. The company is also hoping to persuade the state to back a program that would spread it to hospitals statewide, opening up vast areas where there might be no service for stroke patients.
"So hopefully put every Georgian within 30 miles of a stroke care network," Mr. Agate said.
It is also aiding stroke research at MCG by bringing in rural patients who ordinarily would not be able to access clinical trials. said David Hess, the chairman of the Department of Neurology at MCG and a co-founder of the REACH Call company. It is allowing MCG to rapidly find patients to test the drug minocycline to see if it helps limit damage from strokes.
Future clinical studies could include distant medical centers also, he said. It is a big emphasis by the National Institutes of Health to get clinical studies out into the community, "to try to get out there and get community hospitals and rural patients involved," Dr. Hess said. "We've fortunately been able to do that with the REACH system."
(Source: Augusta Chronicle, March 10, 2009)
St. Luke's-Miners Memorial Hospital in Schuylkill County,
Pennsylvania, now has a telemedicine connection with St. Luke's Center for Diabetes and Endocrinology in Center Valley. The technology allows doctors to examine patients remotely through a desktop videoconferencing system. With 23.6 million people, or 8 percent of the population nationwide diagnosed with diabetes, there is a growing need for endocrinologists, according to The Endocrine Society.
In Pennsylvania a slightly greater proportion, 9 percent of adults, said they have diabetes, according to a survey in 2007 by the Pennsylvania Department of Health. At St. Luke's-Miners Memorial, which has no practicing endocrinologists, telemedicine is now being used to fill the void.
''Many of these patients are elderly or perhaps too ill to drive an hour or more to see an endocrinologist,'' Dr. Bankim Bhatt, an endocrinologist at St. Luke's, said.
Endocrinology, a specialty that also treats patients diagnosed with thyroid conditions and pituitary dysfunction, lends itself well to telemedicine because much of the examination is done by talking to patients and looking at lab reports, Bhatt said.
At his fingertips, Bhatt has access to recent patient lab reports and other medical records, which he can reference during the office visit. He can see his patient on a separate computer screen and ask questions about family history and any new symptoms.
On the other end, in Schuylkill County, nurse practitioner Gretchen Heery serves as Bhatt's eyes and ears, checking vital signs, and examining fingers and toes for signs of poor circulation and eyes for signs of diabetic retinopathy, a complication of diabetes, which can cause blindness.
(Source: Allantown Morning Call, March 25, 2009)
Floyd Memorial Hospital in New Albany,
Indiana is supplying Health Buddy devices to some patients. The push-button telemedicine device plugs into a telephone jack in a patients home and sends their information back to Floyd Memorial Hospital (FMH).
Floyd Perdue, a patient who suffers from a chronic lung disease and congestive heart failure, used to make numerous trips to the hospital or doctor's office for a checkup or to have his vital signs monitored. But ever since installed the Health Buddy device, those trips are no longer necessary.
"If his blood pressure is too high, or too low, it sends an alert to our system," said Michelle Wyatt, a registered nurse who works with FMH Home Health Services. "A nurse will call him right back."
"I know if it's too high or low, the phone is going to ring," Perdue said. "They might tell me to slack off on water or salt. It helps me keep better control of myself."
Wyatt said before, if a patient was tired or out of breath, they may have blamed it on doing too much on that particular day. Now, they will be able to have the Health Buddy check them out immediately and send the information to the hospital.
Perdue is still checked twice a month by his home health nurse, Angela Jones.
Wyatt said the Health Buddy also helps cut down on costs.
"We utilize telemedicine to educate patients, but if insurance only pays for X amount of visits, we use it to minimize visits," she said.
The Health Buddy is part of Home Health Care and Medicare and Medicaid pay 100 percent of the costs. The only stipulations are that the patient is homebound and can only go out if someone else drives, goes to church, doctor's visits or family functions.
(Source: New Albany Tribune, March 23, 2009)
A
Nebraska network aimed at extending health care resources to those in need is getting a federal boost. A $95,000 cut of a $410 billion spending package approved by President Obama earlier this month will benefit the Nebraska Statewide Telehealth Network. It receives the support through the Nebraska Hospital Association Research and Educational Foundation.
The network uses communication technologies to improve patient access to care and to provide patient, professional and community education. The network can connect rural patients to clinicians through videoconferencing, for example, or allow professionals across the state to collaborate.
It also serves as an additional communication source in the event of a public health emergency or disaster.
(Source: Associate Press, March 21, 2009)
3/26/2009
Remote patient monitoring technology enables healthcare providers to treat patients before their conditions becomes more acute, according to a new study from the Spyglass Consulting Group. According to the study, remote monitoring not only saves unnecessary trips to the emergency department but prevents re-admissions to the hospital. An estimated 97 percent of healthcare organizations rely on remote patient monitoring to improve clinical outcomes for critically ill patients, the study says.
Trends in Remote Patient Monitoring 2009 is a follow-up to the Spyglass Consulting Group's 2006 report on the same topic. Spyglass is based in Menlo Park, Calif.
"Early adopters of remote patient monitoring solutions are capitated managed care organizations having fiscal responsibility for their patients across the continuum of care," said Gregg Malkary, managing director of Spyglass. "These organizations include health maintenance organizations, integrated delivery systems, home health agencies, hospices, disease management companies and government agencies like the Department of Veterans Affairs."
Among the key findings are:
Forty-eight percent of healthcare organizations interviewed have funded home telehealth initiatives themselves. A strong return on investment exists for healthcare delivery networks serving as provider and payer, including such organizations as Kaiser Permanente and the Veterans Administration.
Convergence with consumer electronics products enables patients to use devices with which they are already comfortable, including smart phones, personal computers and cable boxes. Prices for remote patient monitoring devices and associated peripherals need to drop from several thousand dollars to less than $500 per unit before healthcare organizations will make further investments to support their patients with other chronic diseases.
Healthcare payers are resistant to providing reimbursement for remote patient monitoring despite evidence of their efficacy by the Veterans Administration, which has deployed more than 35,000 units. Healthcare payer reimbursement is focused on a healthcare delivery model ill-equipped to address the needs of an aging Baby Boomer population with chronic illness. Payers reward healthcare providers for the quantity of the procedures performed rather than the quality of care delivered.
(Source: Health IT News, March 24, 2009
3/26/2009
Veterans with chronic conditions can manage their health and avoid hospitalization by using home telehealth technology provided by the Department of Veterans Affairs (VA) in their homes, according to a recent study. The study found a 25 percent reduction in the average number of days hospitalized and a 19 percent reduction in hospitalizations for patients using home telehealth. The data also show that for some patients the cost of telehealth services in their homes averaged $1,600 a year - much lower than in-home clinician care costs.
"The study showed that home telehealth makes health care more effective because it improves patients'' access to care and is easy to use," said Secretary of Veterans Affairs Dr. James B. Peake. "A real plus is that this approach to care can be sustained because it's so cost-effective and more veteran-centric. Patients in rural areas are increasingly finding that telehealth improves their access to health care and promotes their ongoing relationship with our health care system."
The authors of the study in the current issue of the journal Telemedicine and e-Health are VA national telehealth staff members. The study looked at health outcomes from 17,025 VA home telehealth patients.
VA''s home telehealth program cares for 35,000 patients and is the largest of its kind in the world. Clinicians and managers in health care systems, as well as information technology professionals, have been awaiting the results of the telehealth study, said Dr. Adam Darkins, chief consultant in VA's care coordination program, who led the study.
"The results are not really about the technology, but about how using it helps coordinate the full scope of care our patients need," said Darkins. "It permits us to give the right care in the right place at the right time."
The VA's Under Secretary for Health, Dr. Michael J. Kussman, said the key to the program's success is VA's computerized patient record system. "Data obtained from the home such as blood pressure and blood glucose, along with other patient information in the electronic system, allows our health care teams to anticipate and prevent avoidable problems," he said.
VA health care officials emphasize that home telehealth does not necessarily replace nursing home care or traditional care but can help veterans understand and manage chronic conditions such as diabetes, hypertension and chronic heart failure. Patients'' partnership with the medical team can delay the need for institutional care and maintain independence for an extended time.
(Source: VA Press Release, March 25, 2009)
3/26/2009
The Approaching Telehealth Revolution in Home Care: New Article on the TIE
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2/27/2009
The
Australian state of Queensland has launched a telehealth project in the local government district of Ipswich to improve the efficiency of treatment for patients with chronic disease. The Telehealth Lifestyle Coordination (TLC) project will monitor and manage chronic disease sufferers without the need for patients to leave their homes. If successful, the system could be rolled out nationwide.
The pilot project aims to show that telehealth is a viable alternative – or supplement to –hospital care. Chief Executive Officer of Ipswich Community Aid, Erik Jansink, said that in the long-term future telehealth could become a regular part of Medicare, Australia's health insurance program.
Telehealth enables patients who don't need constant supervision to lead as normal a life as possible, while managing their illness. A small HomeMed unit is installed in a patient's home. The unit instructs the patient to take vital sign readings and ask tailored questions. The vital sign reading is then transmitted over telephone lines to a website where it is checked against pre-set parameters. If any readings exceed pre-set parameters, the data is red-flagged and a healthcare provider alerted.
Queensland Health Minister Stephen Robertson said: "The benefit of telehealth services lies in removing physical and social distances between health professionals and patients without affecting the quality of care provided."
It is expected that about 100 people will be involved in the pilot.
(Source: FutureGov Magazine, February 6, 2009)
India has launched a telemedicine project it says will provide medical education and better health care in
Africa. Launched by Indian Foreign Minister Pranab Mukherjee in Delhi, the project will at first connect 11 African countries with India. The services will include virtual classes for medical staff and online medical consultations.
India is highly conscious of China's involvement in Africa and has announced a number of joint projects. Mukherjee described the project as bridging the digital divide between India and Africa.
Patients in parts of rural Africa will soon be able to seek medical advice from Indian doctors via satellite and fiber-optic link-ups. Nurses will get training and virtual classrooms will help around 10,000 African students annually get specialized degrees from universities.
Online medical consultations will be provided every day for one hour to isolated hospitals. To start with, 11 African countries including Ethiopia, Senegal, Nigeria and Ghana will be connected with India.
By June eight more countries will be covered and eventually the offices of 53 African heads of state will be linked.
(Source: BBC News, February 27, 2009)
The first ever US - Israel TeleHealth Business Exchange was held in Atlanta, Georgia on February 24-25. The conference presented an opportunity for telemedicine companies in
Israel to present their innovations to leading companies in North America, as well as meeting with them to further joint venture R&D, investment, and marketing alliances.
Featured technologies included those used by patients or their families to improve the management of chronic disease in the home, such as patient-centric information systems, remote monitoring, patient education, and patient-provider interaction. Israeli companies invited to participate in the event include MediTouch, Vaica Medical, OrSense, Aerotel, ETView and 2P2D Solutions.
"Israel is one of the world's most dynamic sources for high tech companies with original and cutting edge technologies, particularly in the field of medical devices and information technology," said Rick Litzky, event chairman and President of Medical Director Solutions, LLC. "The challenge is that while many of them have created extremely innovative technologies and services, it is often difficult for them to get noticed by the market here.
The event was organized by the American-Israel Chamber of Commerce, Southeast Region.
(Source: Globes Israel Business News, February 23, 2009)
The
European Commission's Directorate General for Health and Consumers (SANCO) is planning to establish a new platform for eHealth and telemedicine in a bid to increase collaboration with health professionals and patients. The platform was recently announced at the Ministerial Conference on eHealth in Prague.
The aim is to integrate citizens and healthcare providers into the planning process of telemedicine projects. This could potentially increase acceptance among users. "Ultimately, the platform will help us to prepare a set of recommendations on how to involve health professionals and patients in the design, validation and implementation of eHealth," said Artur Furtado of DG SANCO.
Setting up a platform like this was among the proposals specified in the Communication on Telemedicine that was issued by the European Commission's Directorate General Information Society and Media (INFSO) in November 2008. INFSO is currently preparing another publication on telemedicine that will be published later in 2009. It includes European best practice examples from the field of telemedicine.
(Source: HealthTech Wire, February 23, 2009)
A national telehealth bill will soon be introduced to the
Philippine Congress. Representative Joseph Emilio Aguinaldo Abaya , the co-chair of the Congressional Commission on Science and Technology and Engineering (COMSTE), said that he will file a bill to deploy a national telehealth system across the country.
According to Abaya, "this kind of collaboration among those from the ICT and electronics sectors, the health/medical profession, the academe and us in government is what we all need in this very difficult time. We are talking here about the kind of public-private partnership that is sustainable, and which will bring about a new and much better way in delivering health services to the public, especially to the marginalized."
The deployment is a result of the successful pilot of the UP Manila National TeleHealth Center (UPM-NThC) system led by Dr. Alvin Marcelo, which is currently in service between UPM-NThC and its provincial sites in Batanes, Pasay, Marikina, Quezon Province and Capiz, among others. The current UP Manila telehealth system is able to provide basic electronic health record registry via the Community Health Information System (CHITS), audiovisual education to local health workers and professionals through E-learning and video conferencing, and tele-referral and tele-mentoring to Doctors-to-the-Barrios (DTTB) using SMS technology through the Buddyworks Program.
COMSTE Executive Director Gregory Tangonan said that, "Deploying telemedicine and digitized family medical records in the Philippines translates directly into better baranggay medical services and to the improved wellness of our people. State of the art medicine as practiced in our best public and private hospitals can then serve the under-served in our remotest areas, using our broadband networks." Tangonan said that this exciting new thrust will translate into new medical service industries in the Philippines - new low cost medical instruments, medical software services, vastly improved public health information systems and even a medical tourism interface.
(Source: Philippine Information Agency, February 24, 2009)
More than 400 patients suffering from long-term conditions are set to benefit after NHS Lothian announced it was pioneering the largest telehealth system in
Scotland. NHS Lothian is one of the fourteen regions of national health services of Scotland. The personal healthcare system was first piloted in practices in West Lothian, Midlothian and Edinburgh last year and is now being rolled out to patients across Edinburgh and the Lothians.
The state-of-the-art system allows people with chronic conditions to monitor their own health on a daily basis at home, using touch-screen technology to undertake a range of health tests including blood pressure, breathing, weight and blood glucose and oxygen levels. It also provides wireless connections to medical devices such as peak flow meters and weighing scales.
NHS Lothian has been working closely with the Intel Corporation and Tunstall Healthcare Group to deliver the innovative technology into patients' homes as part of the drive, which is being funded by NHS Lothian and the Scottish Government.
Dr Charles Winstanley, chairman of NHS Lothian, said: "I am delighted that we are now in a position to bring this advanced technology to so many patients. This is another fine example of innovation in healthcare in Lothian."
And Scottish health secretary, Nicola Sturgeon, added: "Using technology in innovative ways like this can transform people's lives. This touch-screen technology will save hundreds of people from making repeated trips into hospital, making a huge difference to their quality of life.
"I am very excited by the potential for telehealth to bring care as close to home as possible and,in this case, into people's own homes. By harnessing all that new technologies can offer us we can also make care quicker and safer and invest in a 21st-century health service to be proud of."
In this rollout around 400 patients will receive training on the system and its success will be measured as part of a randomized controlled trial by the University of Edinburgh.
Dr Brian McKinstry, an NHS Lothian GP working in Blackburn and lead clinician in the pilot study, said: "This initiative offers excellent benefits to patients by allowing them more control of their condition. It allows the patient to carry out self-monitoring while still being supervised by a clinician. This ensures the safe management of the patient, provides added reassurance and more frequent patient, clinician contact. The telehealth system provides early monitoring of the patient's condition, thereby preventing the condition worsening and reducing the need for unplanned hospital admissions."
Similar-sized trials in other countries have shown the system can reduce hospital admissions by around 30%.
(Source: Healthcare Equipment and Supplies Magazine, February 27, 2009)
2/27/2009
At 9 o'clock each morning, Ann Schoenbeck is run through an array of medical tests that track her weight, blood pressure, heart rate and other vital signs. She then answers several questions about her health. She does all this by herself in the living room of her
Wisconsin apartment.
The results of the tests and the answers to the questions are sent to Aurora Health Care, where a registered nurse checks for any signs that Schoenbeck's recovery from heart surgery is faltering.
"If there is something they don't like," Schoenbeck said, "they will call."
Schoenbeck, 91, is among the patients of Aurora Visiting Nurse Association of Wisconsin who are benefiting from telehealth - technology that monitors patients remotely.
ThedaCare, a health care system in Fox Valley, WI, uses the technology. Wheaton Franciscan Healthcare recently began using it. And the Department of Veterans Affairs has the most extensive telehealth program in the country.
The Veterans Administration is using telehealth to monitor patients with chronic diseases. It saves money whenever it prevents a patient from visiting an emergency department or being hospitalized. That's partly why VA has moved quickly to adopt the technology.
A recently published study of 17,025 patients in the VA's telehealth program found a 25% reduction in the average number of days hospitalized and a 19% reduction in hospitalizations.
"We see that here," said Jody Hersh, a registered nurse who, with Don Weir, a social worker, oversees the VA's telehealth program for home care in the Milwaukee region.
The VA uses telehealth to monitor about 125 patients with congestive heart failure and diabetes in the region. It also remotely monitors nine behavioral health patients using a form of the technology that includes video.
When Hersh sees a reading outside the norm, such as a diabetic patient with high blood sugar, she can contact a doctor to check whether the patient's medication needs to be changed or if the patient should see a doctor.
Patients also know they will get a call if something is amiss.
Richard Fetter, 83, who has a history of heart problems, can attest to that.
"I've turned in some odd numbers by mistake and gotten a phone call pretty quick," he said.
Each morning, Fetter weighs himself, takes his blood pressure sitting and standing and then answers some general questions, including whether he has taken his medication. The routine ends with a surprise question not related to his health.
"What's the capital of Uganda or something like that," said Fetter, who has a doctorate in electrical engineering.
Fetter keeps his daily stats on his calendar. And that's another of telehealth's benefits.
"It helps them monitor their own health and watch for warning signs," said Penny Schumann, cardiovascular coordinator and patient care coordinator for ThedaCare At Home.
"We knew we could not see every patient every day," Schumann said.
About 60 of ThedaCare At Home's 220 patients on any given day will have remote monitors. They include respiratory patients, such as those with emphysema, and patients with diabetes or high blood pressure.
All this comes at a cost. Schumann estimates that ThedaCare At Home spends more than $100,000 a year on staffing for its telehealth program.
And the monitors and other equipment typically cost more than $5,000.
Health care systems such as ThedaCare and Aurora recoup some of that investment by being able to schedule fewer home visits for some patients. But, for now, the key incentive is to provide better care.
The Aurora Visiting Nurse Association first began using remote monitors in 2001. Now all of its congestive heart failure patients, who are at a high risk for rehospitalization, are monitored remotely, said Joann Paulsen, a home care manager who oversees telehealth for the home health care agency.
Schoenbeck, the West Allis resident, is among the grateful patients.
"Sometimes it's a nuisance because you have to be right there," Schoenbeck said. "But they are watching."
(Source: Milwaukee Journal Sentinel, February 1, 2009‎)
A telemedicine facility set up at St. Joseph Hospital in Eureka,
California has been operating for about six years now, letting nationally recognized experts from the University of California at Davis sit in on local sexual assault exams. A study released in the medical journal "Pediatrics" last month found that telemedicine facilities, like Eureka's, greatly improve the quality of sexual assault examinations.
Cassie Burgess, Humboldt County's Sexual Assault Response Team coordinator, recently explained that Eureka's telemedicine facility allows doctors from UC Davis to telephonically sit in on consultations, offering suggestions and support for local providers and an instant second opinion.
"That's amazing in and of itself," Burgess said, adding that utilizing telemedicine is like having some of the nation's sexual assault experts in the room with her during an exam.
Burgess said one of the positives of Eureka's telemedicine facility is that it takes child sexual assault victims out of the emergency room, where they sometimes had to wait for hours to be seen, and into a more comfortable environment. Burgess said it also empowers the local care providers to know they have experts looking over their shoulders.
A recently released study, entitled "Using Telemedicine to Improve the Care Delivered to Sexually Abused Children in Rural, Underserved Hospitals," found that about half of the care providers in rural communities that used telemedicine changed their examination and evidence-collection techniques at the suggestion of a consulting expert.
"Telemedicine is not only a tool for consultation, it's also a tool for teaching rural providers how to examine children and better test for evidence," said Kristen Rogers, one of the study's authors and a professor of pediatrics at UC Davis Medical Center.
The study looked at the effectiveness of consultations performed at two rural Northern California clinics linked via telemedicine to experts with UC Davis' Children's Hospital Child and Adolescent Abuse Resource Evaluation Center.
UC Davis provided each of the study sites with videoconferencing equipment and coloscopes -- lighted magnifying instruments used to examine the vagina and the cervix. An expert in Sacramento then uses the equipment to "sit in" on consultations, providing guidance on all aspects of the examinations by viewing the local care provider, the patient in the exam room and the images captured by the coloscope.
The study included 42 sexual assault cases, and found that 47 percent of the consultations resulted in changed interview methods and that nine, or more than 20 percent, resulted in better evidence collection.
Asked how telemedicine could make such a large difference, Rogers turned to an example. She recalled a case where a child claimed to have been raped, but went through almost an entire telemedicine exam and doctors couldn't find any physical evidence.
"It was hard to find evidence, but one of the things that she had said during the exam is that (the assailant) kept whispering in her ear throughout the rape," Rogers recalled. "We were able to say (to the local provider), 'Why don't you swab the child's ear?' Lo and behold, they got DNA evidence off that."
California District Attorney Paul Gallegos said the use of telemedicine locally has been a great asset to his office, as it provides the examinations with immediate peer review and makes their findings carry much more weight in court.
"Peer review augments any potential challenges to the SART conclusions so they are less subject to attack," Gallegos said. "When it's done, it improves the SART exam, which means it improves the case ... it means it has increased reliability for us, for the court and for those members of the community that serve on the jury."
Gallegos said the results simply speak for themselves.
"About every time we've used (evidence from telemedicine examinations) we've got a conviction," he said.
(Source: EurekaTimes-Standard, February 23, 2009)
Thanks to some high-tech equipment, patients at SMITH/Northview Hospital, in Valdosta,
Georgia now have access to a multitude of specialists SMITH/Northview recently introduced its telemedicine program. The program uses advanced video and computer technology to link patients and doctors who could be miles apart. Georgia's Telemedicine network is the largest statewide network in the country.
Insurance and Safety Fire Commissioner John Oxendine has fought long and hard to implement telemedicine throughout the state. He wants those living in rural areas to have access the healthcare they need.
"People don't want to drive to Atlanta, so they'll put it off and put it off and they're not good about keeping their regular appointments because Atlanta is so far away. This is easy," says Oxendine.
Commissioner Oxendine has also made sure that telemedicine will remain affordable. "He helped pass legislation that enabled insurance companies to give the same reimbursement payment for an office visit for Telemedicine as it would in the actual doctor's office," explains the hospital's Assistant Administrator, Chuck Roberts.
telemedicine will provide not only more service, but in may cases, better quality service. Oxendine adds, "The doctor's tell me that the audio of the heart and lungs is better through the machines than they can get in an examining room."
The benefits will extend beyond those in rural areas. Representative Jack Kingston explains, "It's also a technology that will help our Moody Airmen. When they're in Afghanistan, they can have access in the field to specialty doctors."
(Source: WALB 10 News, February 9, 2009)
Yancey and Mitchell Counties in
North Carolina may soon be able to provide better pediatric care with the implementation of a school-based telemedicine network. Dr. Steve North, a family physician at the Bakersville Community Medical Clinic, is exploring using the advanced videoconferencing technology to expand school-based health centers that provide health care, mental health and other services to more schools in the two rural counties where accessing health care can be difficult.
The project is being run by the Graham Children's Health Services of Toe River and is being funded through The Kate B. Reynolds Charitable Trust, the American Academy of Pediatrics and the Community Foundation of Western North Carolina.
"It's about providing improved coverage for acute issues and better management of chronic issues," said North, who is exploring the idea through a North Carolina Foundation for Advanced Health Programs fellowship. "The overall hope is that by improving kids' health we will in turn improve their attendance at school and their academic performance."
School-based health centers at the two middle schools in Yancey County have been providing health care, mental health and nutrition counseling for the past 15 years, said Paulina Etzold, director of the health centers.
She said the clinics are a huge benefit to the rural area, where access to health care and other services is limited and transportation difficulties compound the problem.
In 2007, Yancey County had 7 physicians per 10,000 people and Mitchell County had 17.6 physicians per 10,000 people, compared with 20.9 physicians per 10,000 people statewide, according to data from the UNC Sheps Center for Health Services Research.
"It really impacts on the health care for children who can't access health care," Etzold said of the school-based clinics.
While the school-based clinics help increase access to health care, North said they are not an option for some smaller schools in even more remote parts of the region.
"While it's a great idea, it isn't financially viable to a school of 60 kids," he said. "The question is: how can we use a centralized nurse practitioner to provide services these kids need, and telemedicine is a potential way to do that."
Under North's model, the existing school-based health centers in Yancey County would serve as hubs as would a new clinic at a school in Mitchell County.
Specialized Internet-based videoconferencing technology outfitted with cameras and scopes would enable nurse practitioners or doctors at these hubs to communicate and examine children at the other, more remote schools in the counties. Psychologists at East Tennessee State University would also provide mental health counseling as part of the network.
North expects the project to be up and running some time this year with full implementation of the program over the next two-three years.
"In addition there is also the potential to do nutrition counseling and education and also to do teledentistry," he said. "If we could provide those services you could really have a functioning school-based health center at a little, tiny school."
North's idea of a school-based telemedicine network is unique, said Jodi Polaha, an assistant professor of psychology at ETSU. She said while telemedicine is being used in some areas of the country it is usually based in a medical center or university, not in a community.
She said having the technology based in the school will make it easier for meetings to be set up with everyone involved in a child's life including parents, teachers and health care practitioners. She said this could help resolve issues quickly or be useful in dealing with complex problems like obesity.
Polaha said if successful, North's school-based telemedicine network could form the basis for similar networks in other areas of the country.
"There are so many other rural areas where this would be an awesome model but no one has seen a rural area pull something like this together," she said.
(Source: Asheville Citizen-Times, February 17, 2009)
A telemedicine program in
Iowa, the Newborn Monitoring Initiative, is being spearheaded by Gunderson Lutheran Health System and the Gunderson Clinic in Decorah. The system is being developed for accessibility to all healthcare providers in the region.
The initiative has received a financial boost through $95,000 in funding secured by Iowa Congressman Tom Latham and approved by the U.S. House of Representatives Wednesday afternoon. Latham, a long-time supporter of the initiative, secured the funds through his work as a member of the U.S. House Appropriations Committee.
"This system will grow to be an important tool for use by health care providers in rural communities to ensure the highest quality of care for both mother and child after delivery," Congressman Latham said.
The telemedicine system will allow local physicians to send real-time data from rural clinics to Gundersen Lutheran Medical Center specialists to facilitate consultations, improve coordination of care, and give women and babies in rural regions access to specialists. Additionally, physicians can remotely monitor hospitalized patients while continuing to see clinic patients throughout the day.
The goal of the Newborn Monitoring Initiative is to enhance community-based care. The system allows patients to receive the best care possible in their own communities, eliminating travel expense.
(Source: U.S. Rep. Latham Press Release, February 27, 2009)
2/27/2009
Home Telehealth holds the potential of both improving care and saving money by reducing hospitalizations, visits to emergency departments and home health visits. It also could create a small industry.
Honeywell HomMed is among the companies that stands to benefit from the adoption of telehealth. The company, founded in 1999 and bought by Honeywell International Inc. in 2004, was among the pioneers in telehealth. It now has about 60,000 systems placed with customers.
Its monitors can remotely be programmed to ask 52 questions in 13 languages. They include general questions, such as whether a patient is feeling better today, as well as specific questions, such as whether a patient is experiencing swelling in his or her legs.
Honeywell HomMed, with revenue of roughly $25 million a year, is a minuscule business for its parent company, which has revenue of $36 billion a year. But the company expects telehealth to touch every part of the health care system within five years.
Several of the world's largest electronic companies - Philips Electronics, Robert Bosch North America, Panasonic Corp. - have bought or started telehealth companies. Intel Corp. recently entered the market.
A slew of small companies also hope to profit.
"It's definitely a growth market," said Paul Keckley, executive director of the Deloitte Center for Health Solutions. Customers include small home health care companies, national chains and health care systems. That's one of the challenges facing Honeywell HomMed and its competitors.
"It's a totally fragmented market," said Mike Benjamin, president of Honeywell HomMed. The biggest obstacle to wider use of the technology, however, is that Medicare and most commercial health plans don't pay for the service.
That gives home health care agencies little incentive to invest in the technology. If a remote monitor prevents a patient from being hospitalized, Medicare or a health plan saves money, but the home health care agency doesn't share in those savings.
(Source: Milwaukee Journal Sentinel, February 1, 2009‎)
A Utah man is working on a
voice-activated telemedicine system. Currently in contract with the Telemedicine and Advanced Technology Research Center, Dave Kadlec spends most days in a small office at Utah State University's Innovation Campus creating voice commands and writing computer code. The official name of the voice-activation process is the Augmented Instructional System.
"Say some poor guy got lost from his platoon with a wounded buddy," Kadlec says. "He can ask this program, 'What can I do?'" According to Kadlec, the computer could then send the soldier medical information about helping the wounded person.
Instead of being connected to the Internet, Kadlec says the government project he is working on has created a different type of interface. Basically, it means the technology does not have to be connected to the Internet to work. Not being connected to the Internet also means there is less fear of viruses and hackers messing with the system.
Being a hands-free device means helpful information can get to a soldier quicker than if the soldier had to write down a command, send it electronically or through radio signals, and wait for a written response. Now, the response comes in voice form.
"I want it to be able to say, 'Patient, 18 years old, 150 pounds, blown off right leg' and have it come back with proper procedure for that," Kadlec says.
The device may only require a wireless microphone and earpiece (to create the hands-free effect) to be hooked to a uniform. Kadlec is currently in phase two of the three-phase process.
Ray DeVito, director of USU's Technology Commercialization Office, says he first learned about Kadlec's product when Kadlec was an undergraduate student. DeVito says he and others saw the potential for commercialization so they tried to help Kadlec find some means to move the product forward. Since Kadlec's graduation, DeVito says he tries to keep in touch and offer advice when he can.
DeVito's son is an army medic and has been deployed to Iraq twice. When his son heard about the technology, DeVito says his son saw good possibilities for practical use.
"He knows what it is to sit there and to have easy access to information so he could see a lot of potential for training and for medics constantly going into the army," DeVito says.
For Kadlec, writing this kind of software seems strange today considering he didn't even know how to turn on a computer a few years ago. After hurting his back after working as a landscaper for 20 years, the 50-year-old decided to take a beginning computer class at Bridgerland Applied Technology College. Later, during a USU class, Kadlec created his initial voice-activated computer program for a school project. After showing it to the department head, Kadlec says things started rolling.
"He said, 'I want to help you with this,' and so I made an appointment with the USU research foundation office," Kadlec says.
Eventually, Kadlec wrote proposals to different organizations asking for grants. Halfway through Kadlec's doctorate program, a military grant for his voice-activated technology came through.
Initially, Kadlec thought his technology would be an education tool.
"The hardest thing has been keeping it simple," he says. "Most teaching tools are overly complicated."
Once he started working with the Telemedicine and Advanced Technology Research Center, however, his view shifted. Kadlec realized his technology could help the army in a more direct way, and possibly save soldiers' lives.
"The invention is just making pieces of software work together in a way they've never worked together," he says.
(Source: Logan Herald Journal, February 25, 2009)
AMD Global Telemedicine recently announced that with its recent shipment to France, AMD equipment is now installed in 74 countries. With the addition of the new site in France, AMD customer sites now total more than 5,200 worldwide.
Dan McCafferty, Vice President of Global Sales and Corporate Development at AMD Global Telemedicine stated, "Our recent success is a great accomplishment for AMD and proves how quickly telemedicine in general is growing. I firmly believe if you combine the new reimbursement laws, the telemedicine funding in the 2009 Stimulus Bill with AMD's new technology, telemedicine is on the rise. This is a very exciting time for AMD Global Telemedicine."
(Source: AMD Telemedicine Press Release, February 27, 2009)
PDS Health recently announced that it received a contract for the use of their proprietary hardware and online software to study telemedicine on certain types of patients in a major hospital system.
The study uses MDmonitor for analyzing the data submitted by the Telehealth monitor that is placed in each patient's home. The system does not require that the patient has a computer, so it's convenient and inexpensive. The study will continue until May 2009 clinical research study.
For this clinical study a Blood pressure monitor will be used, possibly together with a glucose monitor at a later stage. MDmonitor lets patient data be accessed online and keeps information updated, either by care giver's staff, the patient, or the patient's other health professionals. MDMonitor keeps medical data update, analyzes information and can remind patients to take medications.
(Source: PDS Health Press Release, Feb 25, 2009)
Honeywell HomMed recently announced that Terry Duesterhoeft has assumed the role of president of Honeywell HomMed, an industry leader in telehealth and remote patient monitoring, in addition to his current role of vice president of sales and marketing.
Since joining Honeywell HomMed in October 2006, Duesterhoeft has led marketing, product development and sales and has been the driving force in developing Honeywell HomMed's expanded vision and growth strategy. Prior to Honeywell HomMed, he held leadership roles in venture-backed startups, including co-founder and chief marketing officer of XStor Medical Systems in Mountain View, Calif., and vice president of strategic marketing at ZONARE Medical Systems. He also held several marketing and product development executive roles at GE Medical Systems, including global marketing manager with the ultrasound business during its exponential growth to a $1B business.
(Source: Honeywell HomMed Press Release, February 26, 2009)
2/27/2009
Remote, home-based physiological monitoring of patients with congestive heart failure can save thousands of dollars per patient per year through fewer hospitalizations, according to a new report. The report authors estimate savings of $3,703 per patient per year for those with remote monitoring and disease management programs, and $5,034 for those with remote monitoring and standard care. Consequently, the technology has the potential to save $4.7 billion to $6.4 billion a year.
The New England Healthcare Institute, a Cambridge, Mass.-based independent research firm, has updated a report on remote physiological monitoring it published in 2004. The new data estimates an annual cost of $2,052 per patient for the monitoring technology. Add disease management software to the mix, and that price would go up to $2,802.
The return would come from a 60% reduction in hospital readmissions for patients that have standard care and remote monitoring, and a 50% cut in readmissions for patients that participate in a disease management program along with the monitoring, the report authors estimate.
The full report, entitled the
Research Update: Remote Physiological Monitoring is available for free download
here.
(Source: Health Data Management, January 28, 2009)
1/28/2009
Expanding a medical video network in
Tennessee will allow small-town doctors who treat pregnant women to consult electronically with obstetrics specialists in Knoxville and Chattanooga when there are serious problems.
The telemedicine project will serve women at 11 rural sites: Winchester, Tullahoma, McMinnville, Cookeville, Livingston, Crossville, Jellico, Morristown, Newport, Sevierville and Athens.
Perinatologists from Regional Obstetrical Consultants will link with the patients through high-speed, secure Internet connections, specialized computer video equipment and digital medical devices.
The project, funded with a $1.8 million grant from Blue Cross Blue Shield of Tennessee Health Foundation, expands the work of the nonprofit Community Health Network Inc. The network has been operating in Tennessee for about three years and has become a national model, CEO Keith Williams said. Its existing 55 sites will also be used for the perinatal cases and last year served more than 1,200 rural patients statewide, mostly linking them to specialty diabetic and eye care.
In November, Tennessee received an "F" on a Premature Birth Report Card released by the March of Dimes. The report shows Tennessee's pre-term birth rate is 14.7 per 1,000 live births, compared to the national rate of 12.7. The federal government wants to reduce the rate to 7.6 percent by 2010.
Network spokeswoman Andrea White said the new perinatal telemedicine initiative is modeled after an Arkansas program that has also helped reduce spending on medical care. She said the video initiative should eventually expand into other areas of medical care.
Dr. David Adair, CEO of Regional Obstetrical Consultants, said the video hookups in Tullahoma and Newport will be operating by mid-February. The other nine will be added over the next 12 to 18 months.
He said the telemedicine project will reduce medical costs and patients "appreciate not having to drive."
"People are not afraid of telehealth," Adair said.
Adair also said the network and obstetrical specialists will work with TennCare, the state's expanded Medicaid program, to make it available to those enrollees.
(Source: Associated Press, January 27, 2009)
In its end-of-year report to the state legislature on the effects of telemedicine in
Texas Medicaid, the Texas Health and Human Services Commission (HHSC) found that only a small number of physicians utilized telemedicine services. This finding, however, said HHSC in the report, could be due to the way providers report the use of telemedicine services.
"HHSC continues to encourage the use of telemedicine to increase access to care in medically underserved areas of the state," continued the report which said the Commission is also making changes to improve the use of telemedicine services. "These changes will increase the types of medical services that may be reimbursed through telemedicine, expand allowable patient-site presenters, remove limitations on distant-site providers, add reimbursement of a facility fee payable to the patient site, and add local health departments as an additional location where patients may receive telemedicine services. In conjunction with these changes," continued the report, "HHSC is also increasing its ability to track telemedicine utilization and distinguish between patient and distant sites, thereby increasing the ability to further analyze the use of telemedicine in Texas Medicaid."
(Source: Government Technologies, January 5. 2008)
Diabetic students in Watertown,
New York will spend less time traveling to the Joslin Diabetes Center in Syracuse. The South Jefferson Central School District and Lowville Academy and Central School are part of the center's pilot project to demonstrate the feasibility of telemedicine care for diabetic children in kindergarten through 12th grade, according to nurse practitioner Kathleen A. Bratt, a certified diabetes educator with the Joslin Center.
"We just got them up and running in October, so it's still fresh," she said. "We talk to each other live on the computer."
Mrs. Bratt said each of the school districts' buildings is equipped with a computer and webcam so someone from the center, the student and the school nurse can communicate and share results of the student's blood glucose tests.
School nurses can download student data, so everyone reviews the information together. The meter results will tell someone from the diabetes center if a student's treatment should be adjusted.
"The meetings are fairly brief � 10 to 15 minutes," Mrs. Bratt said. "We set it up month to month. We work around a student's schedule."
So far, the study found improvements were made in diabetic children's lab tests and emotional function, Mrs. Bratt said. Urgent diabetic calls have been reduced significantly, she said.
The Joslin Diabetes Center would like to expand the program into other north country school districts. A similar project was started in Onondaga County, Mrs. Bratt said.
Lowville Superintendent Kenneth J. McAuliffe said he was contacted by the diabetes center to join the pilot program because the school had the technical ability to have the on-site virtual clinic.
"It was a pilot without an end," he said. "It didn't have a year attached to it, but it was going to be a trial to help our children and parents avoid the long travel across the Tug Hill."
Cheryl L. Kelly, registered nurse with the school, said Lowville connects with the diabetes center each month, working with two of its nurse practitioners.
Seven students are a part of the program, she said.
"We're still working out the bugs with the technology," she said. "We're supposed to be able to download readings from their glucose meters into our computer, but we haven't been able to share our readings with them," Mrs. Kelly said.
She said the school district is working with the diabetes center to work out the technological snags.
South Jefferson has not had any problems with the program yet, according to Alice M. Curtis, registered nurse and nurse coordinator for the district.
"I think it's really good because they're able to adjust the insulin and answer any questions students or nurses have," she said. "I think it's really going to help keep our students under better control."
The district's four school buildings have a setup for the program. About five Type 1 diabetic students use the program.
Mrs. Curtis said the direct contact among the diabetes center, school, children and parents helps keep everyone better informed.
Although she said no contract was signed with the diabetes center, the program will continue for at least one year.
(Source: Watertown Daily News, January 22, 2009)
Patients in Lihu'e,
Hawaii, can now take an active role in managing their health without having to leave their homes, said Dardanelle Ka'auwai, director of St. Francis Home Health Care Services.
Telemonitors are ideal for patients who are able to use the monitor themselves, or have a family member help them, and allow nurses of St. Francis Home Health Care Services-Kaua'i to keep in daily contact with their patients, health officials said.
A monitor is set up at a patient's home and information and vital statistics are transmitted to the offices of St. Francis Home Health Care Services-Kaua'i. This information is received at a computer terminal there and monitored by a nurse on a daily basis. A nurse checks the monitor between 8 and 9 a.m., Ka'auwai said. The time was established following dialog between the St. Francis Home Health Care Service patient base and discussions with the nurses.
"Through the telehealth program, we can see on a daily basis who is complying and who doesn't," Ka'auwai said. "If a nurse checking the monitor notices something out of the norm, a phone call to the patient follows for further investigation."
Kaua'i is the first island to provide this service that was made possible through a $60,000 grant from the Antone and Edene Vidinha Trust. There are plans to initiate this service on O'ahu starting this quarter, a release from St. Francis states.
Telemonitors check patients' vital signs such as weight, blood pressure, blood sugar level, pulse oximetry and oxygen in the blood. It can also be programmed to remind patients to take their medications.
This information is sent through phone lines to the home care office for nurses to review. If the patient's medical condition is changing, the nurse can then provide immediate attention and follow-up with the patient rather than wait until the next scheduled visit.
Data can also be sent to the patient's physician, Ka'auwai said, and the physician can be notified to determine whether the patient's care plan needs adjustment.
The equipment is removed once the patient no long requires home health services.
Currently, Ka'auwai said St. Francis Home Health Care Services-Kaua'i services about 100 patients a month on average with nurses visiting between 600 to 1,000 patients at their homes.
"Home health nurses generally visit their patients two or three times a week to monitor and assess their patients' medical condition," Ka'auwai said. "Telehealth monitoring allows the nurses to ... spot any significant trends in their medical condition."
Patients recovering from surgery or who have chronic medical conditions are ideal candidates for telehealth due to the high incidence of re-hospitalization and the high incidence of emergency room visits, Ka'auwai said.
"We envision telehealth monitoring to help reduce unnecessary trips to the ER, or the need for recurrent hospitalizations because the symptoms of potential problems are intervened before they become too serious," Ka'auwai said. "Telehealth monitors allow patients to take an active role in regaining their health and we believe this will have an impact in obtaining positive patient outcomes."
The Antone and Edene Vidinha Charitable Trust was established by Kaua'i's late Mayor Antone "Kona" Vidinha and his wife Edene to assist nonprofit organizations that provide services to the people of Kaua'i. The trust provides grants for educational scholarships to colleges or universities in the state of Hawai'i, churches on the island of Kaua'i, health organizations and hospitals that benefit Kaua'i residents.
The trust Distribution Committee continues to follow the instructions of the trust by providing funding to support St. Francis Home Care Services-Kaua'i with telehealth monitors that will benefit and enhance the quality of life of the people on Kaua'i.
(Source: Lihue Garden Island, January 16, 2009)
Whitney M. Young Jr. Health Services, an Albany,
New York based nonprofit health center has received a $2.7 million grant from the state Department of Health to use text messaging to manage patients with diabetes. It will use the funds to hire up to 10 new case managers and other workers and to contract with Cerner Corp., a Kansas City, Mo.-based health care information technology firm.
Dr. Kallanna Manjunath, chief medical officer for Whitney M. Young, said the center will first identify 275 area Medicaid patients with diabetes and other chronic illnesses to take part in the three-year pilot. The program will expand upon the center's "high-touch, high-tech medical home" approach to care, which combines personal service and support, from both Whitney Young staff and other medical providers in the area, with electronic medical records to better manage and track each case. The patients will be given free cell phones so the center can text them with reminders about their care routines and appointments. In order to keep the phones, they must meet their obligations.
"Unless patients take charge of their own care, we won't see results," Manjunath said. "They can't be passive any longer."
The center's hope is that by better managing the care of patients with chronic illness, it will improve outcome, reduce hospitalizations and lower costs.
This was also the state's goal in providing the grant. Whitney M. Young was one of six health care providers in the state to receive a grant, and the only one locally. Statewide, the grants totaled $7.1 million.
State Health Commissioner Dr. Richard Daines said three-quarters of the state's $46 billion Medicaid budget is spent on 20 percent of its patients, who often have multiple chronic conditions such as heart disease, diabetes, and high blood pressure. Many also have histories of mental illness or are addicted to drugs or alcohol.
"We must help them manage their care, despite its medical complexity, to improve their health and save taxpayer dollars," Daines said.
The centers that succeed in meeting these goals will be eligible to participate in additional funding from a $6 million incentive pool.
(Source: Albany Business Review, January 7, 2009)
Many older adults want to remain active and independent for as long as possible. Seniors want to age in their own homes and avoid moving to institutions or nursing homes.
University of Missouri researchers are using sensors, computers and communication systems, along with supportive health care services to monitor the health of older adults who are living at home.
According to the researchers, motion sensor networks installed in seniors' homes can detect changes in behavior and physical activity, including walking and sleeping patterns. Early identification of these changes can prompt health care interventions that can delay or prevent serious health events.
As part of the "aging in place" research at MU, integrated sensor networks were installed in apartments of residents at TigerPlace, a retirement community that helps senior residents stay healthy and active to avoid hospitalization and relocation. MU researchers collected data from motion and bed sensors that continuously logged information for more than two years. The researchers identified patterns in the sensor data that can provide clues to predict adverse health events, including falls, emergency room visits and hospitalizations.
"The 'aging in place' concept allows older adults to remain in the environment of their choice and receive supportive health services as needed. With this type of care, most people wouldn't need to relocate to a nursing home," said Marilyn Rantz, professor in the MU Sinclair School of Nursing. "Monitoring sensor patterns is an effective and discreet way to ensure the health and privacy of older adults."
In recent evaluations, the sensor networks detected changes in residents' conditions that were not recognized by traditional health care assessments. MU researchers are perfecting the technology infrastructure at TigerPlace as a model, so these technologies and supportive health care services can be made available to seniors throughout the country.
"Our goal is to generate automatic alerts that notify caregivers of changes in residents' conditions that would allow them to intervene and prevent adverse health events," Rantz said. "Additional work is underway to establish these health alerts, improve the reliability and accuracy of the sensor network, implement a video sensor network, and refine a Web-based interface to make it even more user friendly and meaningful to health care providers."
Tiger II, a 22-unit addition to TigerPlace, opened on Jan. 1. TigerPlace community residents receive health and wellness services through TigerCare, a service of the Sinclair School of Nursing. Residents receive care and services when they need them and where they want them - in the privacy of their apartments.
Through its university affiliation, residents can participate in a number of educational, cultural and research projects both on site and on campus that are conducted by the College of Engineering, School of Nursing, Health Professions, and Medicine at MU.
The study, "Using Technology to Enhance Aging in Place," was presented at the 2008 International Conference on Smart homes and health Telematics. It was funded by a grant from the U.S. Administration on Aging and the National Science Foundation ITR grant.
(Source: Science Daily, January 6, 2009)
