Electronic Health Reporter

Guest post by Richard Kimball, Jr., CEO,  HEXL.

In an ideal world, a patient should be able to visit the doctor whenever he has health concerns. However, for many patients, particularly the millions living with lifelong chronic diseases, such as diabetes, heart failure and chronic obstructive pulmonary disease (COPD), meeting this need is a challenge because of several reasons. Key among these are: lack of time and limited access to a nearby health facility. These obstacles, in turn, sometimes create even bigger problems, such as patients’ failure to practice daily routines of disease prevention and management, resulting in worsening of their conditions and triggering the need for emergent care.

Fortunately, a solution is underway. Experts are taking advantage of today’s modern technology—telehealth — and are using it to bring healthcare education and services closer to consumers. Most simply put, telehealthcare provides contact between clinicians and patients who are at some distance from each other, and uses telecommunication-ready tools to “see” each other and undergo clinical examinations even at a distance.

Through telehealth, patients can easily get in touch with their doctors without having to worry about geographical distances. From a residential setting, not only can a simple and known tool like a telephone be used as an audio communications device to connect patients with their clinicians, but an array of monitoring devices, such as blood pressure cuffs, pulse oximetry measurement tools, weight scales, and others, can also be used to transmit current vital sign readings for clinicians’ review. In the same manner, physicians can use today’s information technology to easily access their patients’ electronic health records and monitor their patients’ development outside the walls of their clinics or hospitals.

Truly, telehealthcare and remote monitoring have enabled many healthcare practitioners to help manage the chronic health conditions of their patients, and subsequently, help improve their patients’ quality of life.

Although still a relatively new development, telehealth has resulted in a number of benefits both for the patients and the healthcare industry in general. Through this technology, patients can more readily access health services, especially from the comfort of their homes. Health interventions and disease management can be administered more quickly, thus leading to better outcomes. It also decreases the likelihood of patients being lost to follow-up care.

In addition, remote monitoring is also useful for delivering care to patients who have just been discharged from hospitals and other health facilities. They can also be educated about self-care using this technology, and by using it regularly, helping reduce costs for their family.

The benefits that telehealthcare bring do not end there. Both the consumers and the healthcare industry save a lot of time and money by avoiding hospital readmissions and reducing the patients’ lengths of hospital stays. Patients who suffer from chronic diseases are also reported to get better as clinicians are able to keep a close eye on them even from a distance. How so? Through telehealth contact, clinicians, such as home healthcare nurses can, for instance, provide timely advice on daily needs that are customized to the patients’ routines (for instance, suggesting early morning exercise routines if the patient prefers exercising early in the day, or suggesting other routines practiced at other times a day for other patients).

Thousands of cases of successful telehealth use, particularly with patients living with congestive heart failure, have been collected over the past 20 years.* Timely interventions for the estimated 5 million+ Americans living with this particular chronic disease are absolutely essential. Problems such as a two-pound weight gain over a one-day period must be addressed by prescribing a diuretic and dietary counseling about, for instance, limiting one’s sodium intake to alleviate probable respiratory distress caused but fluid retention affecting a CHF patients lungs.

Here is a case in point of a telehealth intervention with a CHF patient, described by Denise Buxbaum, manager of the Heart Failure Program at Essentia Health, St. Mary’s-Heart & Vascular Center in Duluth, Minnesota.

If they [CHF patients involved with her program] are in trouble [this, typically meaning that a daily weight gain of two pounds or more has been indicated on the patient’s telehealth transmission from his weight scale], we are calling them right then and there for an assessment, checking on their symptoms, their weight, their diet and right away we can go over it with their provider and get back to the patient, usually within an hour, [This “getting back” typically involves nurses’ providing dietary counseling about the upcoming day’s food choices and encouraging the patient to exercise by taking short walks and other such activities.]

This example, one among thousands collected to date, shows that timely interventions triggered by data collected via telehealth monitoring tools can provide excellent means for keeping patients living with chronic diseases well and at home. Telehealth interventions and remote monitoring tools carry great potential as complementary, if not outright alternatives, to traditional face-to-face and scheduled-in-advance healthcare services. Patients can keep themselves more well and do so at home. Ultimately, telehealth can also pave the way towards a promising future not just for particular patients or entire groups living with chronic diseases but for the healthcare industry.

*See one case example at: Ulsery, DJ, Reducing CHF Readmission Using Telehealth [2014], at: http://www.americantelemed.org/about-telemedicine/telemedicine-case-studies/case-study-full-page/reducing-chf-readmission-using-telehealth#.VX6HqP_D_L8

After graduating from Yale with a B.A. in economics, Richard Kimball spent more than two-and-a-half decades advising healthcare organizations on strategy and capital structure and leading and building both early stage and more established businesses.  Rick started at Morgan Stanley and rose to Managing Director. More recently he was Chief Strategy & Growth officer at Accretive Health.  Rick is a Trustee of The Brookings Institution, a Fellow in Stanford University’s Distinguished Careers Institute and a member of the World President’s Organization.  Rick is currently CEO of HEXL, a population health management start up.