SCAN
NCH
September 2011

Remote Monitoring to Prevent Avoidable Heart Failure Readmissions

Following a stay at Northwest Community Hospital (NCH), heart failure (HF) patients recovering at home will soon report their vital signs remotely to NCH clinicians. The Hospital's new Telehealth Program, set to launch in October, will allow NCH to keep a closer eye on HF patients with the intent to reduce potentially avoidable re-hospitalizations.

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NCH will use a telehealth device (pictured above) to remotely monitor heart failure patients in the home. The device includes a scale, pulse oximeter and blood pressure cuff.

"The primary objective of the Telehealth Program is to prevent hospital readmissions, and an important element of that will be education," says Judie Truelsen, RN, BSN, director of NCH Home Care. "We want patients to know more about their disease process, and that information will hopefully lead to modifications in their behavior and improve self-care practices."

When the program is rolled out in October, home-bound HF patients (with or without NCH Home Care services), who meet pre-defined physical and cognitive criteria, will have the opportunity to incorporate telehealth into their post-hospital care plan at no additional cost. Upon notifying the patient's doctor, an NCH Home Care team member will arrange an in-home visit to install the virtual care monitoring device, complete with a scale, pulse oximeter and blood pressure cuff.

For approximately two months, patients will use the telehealth device to self-report vitals and upload qualitative data regarding their condition. Each morning, patient information will be securely transmitted to a dedicated NCH Home Care nurse who will carefully evaluate each patient's status, vitals and feedback. The details of the report will also shed light on the patient's adherence to the orders prescribed by the doctor.

Karolee Fill, RN, APN, who coordinates care for HF patients at NCH, explains that a process will be in place to facilitate early interventions should the patient deviate from the care plan. "We will have parameters in place that the telemonitoring nurse will ensure patients achieve on a daily basis," she says. "In the event these measures are not met, the nurse will intervene as needed by contacting the patient, or relaying the information to the NCH cardiac team and the patient's doctor."

Over the course of many weeks using the telehealth monitor, the expectation is that patients will adopt healthy behaviors that ultimately change their lifestyle – reducing their risk of a serious HF episode that lands them in the hospital. Data collected from the telehealth device will also serve as a supplemental tool for physicians as they construct and manage a medical care plan for their patients.

"The Telehealth Program is not intended to replace the one-to-one contact of a doctor or Home Care nurse," says Truelsen. She explains that the monitor is a great overlay to reinforce patient education regarding their disease process, and the importance of proper diet choices, correct medication use and exercise.

Both Truelsen and Fill are optimistic that the use of virtual monitoring technologies will make a difference in the lives of HF patients in the northwest suburbs. "As we move forward and evaluate our processes, our goal is to open up the Telehealth Program to more HF patients and, eventually, to other high-risk patient populations," adds Fill.