One of the most powerful forces sculpting the warp and woof of the medical industry is CMS – the Center for Medicare and Medicaid Services. Their policies on who gets reimbursed how much for what have a massive effect on the economic incentives for medical facilities. So when CMS decides that they're going to pay less for services offered to someone who was readmitted after a recent visit for the same problem, suddenly the drive to actually solve a problem becomes much stronger.
Moreover, the drive to monitor each patient and make sure that their post-procedure plans are going smoothly is stronger as well. That's why Vidant Health, one of many telemedicine companies that offer remote monitoring services to hospitals and other facilities in North Carolina, offers wireless routers that come with peripherals that include:
• A scale that automatically reads and reports weight, BMI, body water content, and more,
• A fingertip clasp reads and reports blood oxygen and pulse rate,
• An armband that takes and reports blood pressure,
• And several more.
Their products are not cheap to make, but they allow physicians to perform 'maintenance' like adjusting medication dosages and timing or offering counseling for stress, sleep loss, or other common post-procedure problems – all without leaving their office.
What's the upshot? How about a 74% reduction in readmissions for patients with diabetes, congestive heart failure, high blood pressure, and other serious chronic conditions?
Taking Insult from Injury
In another telemedical success story, the University of Pittsburgh Medical Center has, for the past few years, been giving patients who were grievously wounded a cheap digital camera. Each day at first, and every few days as time passes, they take a picture of their wound. That picture is then examined asynchronously by doctors who examine it for signs of infection, misalignment, or other potential problem. If anything seems wrong, they call the patient to talk about what can be done to keep things from getting worse.
Education In Real-Time
Perhaps one of the most unexpected effects of telemedical devices in the home is the opportunity it affords nurses and doctors to educate their patients on the proper use of their health care equipment. For example, Sharp Rees-Stealy Medical Group in San Francisco puts sensors in all of the inhalers they pass out. Each time an inhaler is used, it reports back to the doctor the time used and the duration of the activation.
The result? Patients who forget their primary inhaler and are forced to drop back on their emergency inhaler receive a friendly email from their nurse reminding them that they need to be more conscientious about their primary. More aggressively, patients with a history of missing their primary will start to receive text messages informing them that it's time to put them to use. They report that breathing struggles are greatly reduced with the system in place.
Improvements Can Be Made
Of course, as with any complex system, room for improvements exists. Many medical facilities report that, when first installed, the sheer amount of data the remote monitoring equipment produces is overwhelming. It can take weeks or months to fine-tune the algorithms so that only genuine 'red flag' signals appear on the screens of nurses and practitioners. But even with these minor hiccups, remote monitoring remains one of telemedicine's most unequival success stories.