Under the Affordable Care Act, Connecticut’s hospitals must reduce re-admissions that happen within 30 days of patient discharge. The focus is on those with heart, pulmonary and other chronic conditions. How can we accomplish this for chronically ill patients who receive home-based health care? By supporting advanced in-home telemonitoring services under our state’s private insurance plans, Medicare and Medicaid programs.
Telemonitoring equipment helps us remotely assess the complex changes associated with a patient’s condition. In combination with in-home nursing care and health education, telemonitoring gives the home health care team early warning that allows them to treat patients before their conditions deteriorate.
Two telemonitoring bills are currently moving through Connecticut’s legislature. House Bill 5445 would allow Medicaid coverage of home telemonitoring services. Senate Bill 202 would require health insurer coverage of medical advice, diagnosis, care or treatment provided through telemedicine.
Does telemonitoring really work? It recently saved the life of one of VNA Healthcare’s clients. Home health nurses, used to speaking with the homebound patient suffering from hypertension, had come to know her normal ‘baseline’ voice. One morning, the patient’s nurse checked the patient’s telemonitor and noticed that her blood pressure had dropped dramatically. The nurse also noted that the patient sounded weak, speaking in a soft voice.
A care supervisor called the patient’s daughter, who went to her mother’s home to assess the situation. Meanwhile, the nurse called the patient’s doctor, who advised the home health care team to temporarily halt the patient’s blood pressure medications. After the patient’s daughter reported that her mother was having bouts of diarrhea and was experiencing confusion, the patient was taken to the emergency department, where she was re–hydrated and released.
After she returned from the ED, the agency’s visiting and telemonitor nurses kept tabs on the patient through in-person visits and telemonitor checks. In consultation with her physician, they adapted dosing of her blood pressure medications, which helped normalize the patient’s blood pressure, preventing additional emergency care visits and hospitalizations.
In-home visits, daily telemonitoring, physician consultations and family involvement enhanced the care this patient was able to receive at home. What’s more, continuous monitoring of her vital signs helped the patient better manage her daily health routine.
Does telemonitoring really save money? In 2013, telemonitoring services provided to VNA Healthcare patients saved the organization 690 home visits. That translates into approximately $70,000 in Medicare and Medicaid dollars that can be utilized to treat additional patients.
Telemonitoring offers patients with chronic conditions the attention, treatment, education and self-management techniques that are keeping them out of the hospital. It’s effective and efficient. It’s saving money and improving lives. And it should be available to any Connecticut resident.
Tracy Wodatch is vice president of clinical and regulatory services at the Connecticut Association for Healthcare at Home