Arthur Bernard Tyson, 70, is a stroke survivor with diabetes living in rural eastern North Carolina. He woke one morning feeling “healthy and normal” except for a nosebleed. He was headed to his job as a foreman at a nitrogen company when he received an urgent call from a nurse.
After a previous hospitalization for congestive heart failure, Tyson enrolled in remote patient monitoring for daily testing of his weight, oxygen level, pulse and blood pressure. The day of his nosebleed, the nurse told him his heart rate had dropped and his blood pressure had escalated. Tyson was, in fact, experiencing a complete heart blockage. “My nurse was able to identify a significant change in my condition that I was unaware of and I received prompt medical attention, which spared my life,” Tyson said.
The Center for Connected Health Policy in Sacramento, California describes ‘telehealth’ as a wide range of diagnosis and management, education and other related fields of healthcare that are delivered via technology rather than ‘in person.’ The growing field has a variety of applications, from helping to diagnose, treat and monitor patients with chronic conditions to solving the challenge of access for underserved patients who might struggle to get to a doctor’s office.
“Today, a child in rural Texas can be treated by a specialist without traveling to the specialist’s office. A new mother can get advice from her child’s pediatrician late into the night from her home. And a rural emergency department can get a consult from a specialist in an urban setting on how to treat a patient with a stroke,” said Alexander Vo, Ph.D., vice president of telemedicine and health services technology at the University of Texas Medical Branch in Galveston, Texas.
With the nation’s growing aging population and rise in chronic conditions such as diabetes, hypertension and cardiovascular disease, telehealth solutions are enabling healthcare providers to monitor patients while the patient stays at home. Telehealth programs allow for early patient interventions, more informed provider decisionmaking and patient management, greater patient self-care and reduced risk of hospital readmissions and ER visits. Tyson is an example of a patient who has experienced better quality of life since enrolling in a remote patient monitoring program. “I have been able to spend more quality time with my family instead of spending time in the hospital,” Tyson said.
Congress has turned its eye toward strengthening the coverage and use of telehealth to help patients like Tyson. Legislators have introduced bills that call for expanding federal telecommunications programs and the removal of Medicare restrictions to telehealth. Such initiatives and continued use of telehealth programs by providers are shaping how healthcare will be funded and delivered in the future.
There’s also statistical proof. Arizona-based Banner Health, which operates in seven states, is partnering with Philips to pilot an at-home telehealth program for patients with multiple chronic conditions. The Intensive Ambulatory Care (IAC) pilot program, part of the overall telehealth program at Banner, focuses on the most complex and highest-cost patients—the top five percent of patients who account for 50 percent of health care spend. The IAC program, first launched in 2013, aims to improve patient outcomes and care team efficiency, and prevent IAC patients from entering the acute care environment, where costs are significantly higher.
As part of the pilot, Philips and Banner assessed the six-month outcomes of 135 patients and recently announced successful results, with reduced costs of care by 27 percent, reduced acute and long-term care costs by 32 percent and reduced hospitalizations by 45 percent.
“Telehealth has helped us move beyond the limitations of geography, access to specialists and constraints on time,” said Hargobind Khurana, M.D., senior medical director of health management at Banner Health. “Telehealth, at its best, improves the physician/healthcare provider experience and not only the measurable, quality of care patients receive, but the care experience as a whole.”
Telehealth, an outgrowth of clinical demand and innovations in digital technology, isn’t just for rural, underserved or senior populations—it also promises to become a regular serving on the larger menu of healthcare services. Consumer technologies like wearables have the power to encourage healthier behaviors. From fitness bands that monitor movement to patches that monitor cholesterol levels and heart rate to cloud-based patient data storage, mobile health technology and telehealth will play an increasingly important role in the practice and delivery of healthcare in the years and decades ahead.
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