Remote monitoring of Nova Scotia heart patients
From Canadian Healthcare Technology, October 2010 issue
The 113-year-old Victorian Order of Nurses is finding new ways to solve the problems of the 21st century. In particular, it is embracing innovative technologies like telehealth to provide care to the steadily growing ranks of the sick and infirm in Canada.
Registered Nurse Cindy Hintsman, the senior director of business development for VON Canada in Ottawa, earlier this year wrapped up a RPM chronic disease management project called Stay@Home with VON.
It was conducted in partnership with the Nova Scotia Department of Health and the regional Gainsborough Antigonish Strait Health Authority (GASHA).
The Stay@Home with VON project was done remotely with at-home chronic obstructive pulmonary disease (COPD) and congestive heart failure (CHF) patients over a standard 12-week visitation cycle and a further 12-week follow-up cycle.
Under VON director Hintsman, project staff measured outcomes against those usually achieved by traditional nursing visits.
The results were striking:
- 84 percent of the patients had clinical outcomes improve or remain stable;
- emergency and other hospital visits declined by an average of eight days compared with a traditional home visit cycle;
- average hospital costs decreased by over $7,500 per patient.
Very encouraging results for an ambitious project that was meant to accomplish a lot in one fell swoop.
As Hintsman details: We wanted to look at innovative ways that would address the needs of patients living at home in the GASHA community.
More specifically we wanted to see if we could: make savings for the overall healthcare system by keeping people in their homes for longer periods; reduce the strain on hospital emergency departments; make better use of ALC (alternate level of care) beds versus acute care beds; maximize the use of our scarce human resources in healthcare by using remote monitoring technology; improve productivity and care by finding out issues with patients proactively rather than reactively; and finally reduce the huge strain chronic disease patients put on the healthcare system by using technology-aided self management techniques.
Partnering with Hintsman and the VON in the project were Honeywell HomeMed, which helped with systems for patient and project management, along with Procura, the maker of home visitation record-keeping software and a health-care systems integrator.
Technically the project was not difficult, says Warren Brown, president of the Victoria-based Procura.
“We were already working with the VON and have done over 200 installations of the HomeMed product. I think the bigger challenge came on the human side.”
And maybe you guessed it, already. Those human challenges were mostly physicians.
We put a lot of effort into recruiting and getting buy-in from physicians, says Hintsman. We even had nurse practitioners and other people from the local healthcare committee going out and knocking on their doors.
Patients were also an important part of the equation.
Among the key outcomes of the Stay@ Home with VON project were high ratings and confidence in RPM technology, enabling patients to self-manage their own conditions.
