New telemedicine program pairs comfort of home with heart care

Doctors started referring the first of 50 patients with congestive heart failure to a new pilot program at St. Vincent Home Care Telemedicine program this month, said Pamela Whitten, a Purdue professor of health communication and Regenstrief faculty scholar. Congestive heart failure is a chronic condition in which the heart muscles weaken because of a heart attack or untreated high blood pressure.

"Patients living with congestive heart failure are often in and out of the hospital for treatment, and that is problematic for people who live far away, as well as inconvenient for patients who are already in physical discomfort," Whitten said. "The comforts of home can be quite reassuring for someone who is ill. Telemedicine services, such as home monitoring, allow people to receive medical care away from the hospital."

Telemedicine is a more efficient method of health-care delivery that uses communication technologies to bring providers and patients together in real time, Whitten said.

"We are extremely grateful for this partnership, which will allow us to better serve our patients suffering from congestive heart failure," said Dr. Jon Rahman, chief medical officer at St. Vincent Health. "Studies have found that 30 percent to 47 percent of patients who require hospitalization for heart failure are back in the hospital again within six months. With the proper rehabilitation, home support and monitoring, patients are less likely to return to the hospital, therefore, maintaining a better quality of life."

A patient's blood pressure, heart activity, weight and other vital statistics can be assessed through in-home monitoring equipment using a traditional phone line. St. Vincent provides the equipment, which resembles a fax machine, to measure vitals and communicate with health-care providers at predetermined times. Because of this technology, nursing response times to condition changes are improved, emergency department visits reduced, and weekly interactions with patients and their health providers are increased, Whitten said.

"Home monitoring improves the amount of information available to those providing care to home-bound patients, helping physicians catch problems before they advance to more serious levels," said Whitten, who also will collect and analyze the data to assess future home monitoring telemedicine services.

The program will be administered by St. Vincent Indianapolis Home Care and the new Heart Failure Clinic at St. Vincent Indianapolis Hospital. The St. Vincent Home Care Telemedicine program is supported by a $50,000 grant from St. Vincent Indianapolis Foundation and a $50,000 grant from the Regenstrief Center for Healthcare Engineering. Regenstrief's funds are from the center's strategic partners, Ascension Health and St. Vincent Health.

The money will pay for the program's equipment, administration and evaluation. Patients' insurance will still cover their health care. Rahman said he hopes the program can increase its patient load from the initial 50 participants.

Telemedicine is currently being used in a variety of ways across the St. Vincent Health system, Rahman said.

"In fact, St. Vincent has been one of the leaders in Indiana to introduce telemedicine in two forms: distance learning and distance medicine," he said. "Distance-learning programs support physicians and clinical support staff in rural, isolated, medically underserved locations."

Distance medicine includes physician-to-patient visits via videoconferencing technology, specifically tele-psychiatry. For example, a psychiatrist at the Anderson Center at Saint John's examines children and adolescent patients at St. Vincent Mercy Hospital in Elwood via a remote connection.

"This meets a dramatic, unmet community need in this northern Elwood market," Rahman said. More information about these programs are available online. For more information about the St. Vincent Home Care Telemedicine, call toll-free to (877) 287-4663.

Telemedicine services, often using primarily real-time videoconferencing, have been around since the 1960s, but their use exploded in the late 1990s thanks to digital technologies, Whitten said.

Whitten has studied, evaluated and launched telemedicine projects in rural hospitals, school nurses' offices in inner-city elementary schools, patients' homes, community mental health centers and jail settings in Kansas and Michigan. She organized a conference in 2005 to create a working group to address obstacles to telemedicine in Indiana. The group released its final report in March that suggested Indiana's technological infrastructure needs to be improved so telemedicine can be implemented statewide.

At the Regenstrief Center for Healthcare Engineering in Discovery Park, Purdue experts are applying the principles of technology, engineering, supply chain management and more. Initial areas of research have included improving the safety and efficiency of patient care; providing more efficient deployment of physicians, nurses and other health-care personnel; and better coordinating inpatient and outpatient treatment.

Writer: Amy Patterson Neubert, (765) 494-9723, apatterson@purdue.edu

Sources: Pamela Whitten, (765) 494-3313, pwhitten@purdue.edu

Jennifer Northern, communications consultant at St. Vincent Health, (317) 415-6176, JSNorthe@stvincent.org

Purdue News Service: (765) 494-2096; purduenews@purdue.edu

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