Select patients, equipment carefully for telehealth
Select patients, equipment carefully for telehealth
Versatile monitors and cameras increase effectiveness
One of the most prevalent components of most disease management programs is telehealth. Not only does the technology improve staff efficiency, quality of ongoing monitoring of patients, and patient compliance, but it also gives clinicians additional information to help them help their patients.
At North Shore Long Island Jewish Hospital Home Care Network, telehealth was introduced as a part of the disease management program early in the program. It is not, however, used for all patients, says Kathleen Pecinka, RN, BSN, telehealth manager for the agency.
The North Shore agency automatically assigns all patients with heart failure, even if it is not the primary diagnosis, to the disease management protocol, says Pecinka. "This means that nurses know to watch for subtle symptoms or risks, such as infections, that might cause an exacerbation," she says. By knowing to use the care plans, notes, and tools designed specifically for heart failure patients, nurses can reduce the risk of missing signs that might prevent a hospitalization or visit to the emergency department, she explains.
Not all patients meet the criteria for telehealth, explains Pecinka. "Patients must have Medicare as their primary insurance and have a diagnosis related to cardiopulmonary disease, chronic obstructive pulmonary disease, emphysema, or newly diagnosed diabetes," she says. "At this time, managed care doesn't recognize telehealth as a covered service, but we are able to cover our costs when the patient has Medicare," she says. Other requirements for telehealth service are a clean home in which the equipment can be safely placed and a working telephone line or broadband connection, she adds. "The phone line can be tricky, but we've become very creative with filters and other phone line solutions," she says.
The patient also must be able to safely sit in front of the monitor and interact with the equipment and the nurse, says Pecinka. "This doesn't automatically rule out dementia patients, because if they have a caregiver that can interact, we can still monitor the patient," she says.
Although staff members expected some hesitance when introducing patients to telehealth, Pecinka says that the difficulty they encounter is not what they expected. "Patients who might be hesitant at first are often the patients that don't want to give up the monitor when they are discharged from home health!"
One of the most prevalent components of most disease management programs is telehealth. Not only does the technology improve staff efficiency, quality of ongoing monitoring of patients, and patient compliance, but it also gives clinicians additional information to help them help their patients.Subscribe Now for Access
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