According to the Centers for Disease Control and Prevention, rural Americans are more likely than their urban counterparts to die prematurely from the five most common killers: heart disease, cancer, unintentional injury, chronic lower respiratory disease and stroke. Telehealth the use of technology to provide healthcare remotely is an emerging way to combat these trends. And it’s growing in popularity.
West Virginia University researcher Steve Davis is piloting an intervention program that uses tele health to connect rural West Virginians with nurses who can help them manage and even prevent conditions like these. The program will focus on individuals being discharged from long-term care facilities as they transition to life back at home.
Telehealth to help people
“Can telehealth be used to help people who are in some kind of institution; also are getting ready to be discharged to prevent them from being re-institutionalized so that they can live and thrive in their community, near their family?” said Davis, an associate professor of health policy, management and leadership in the School of Public Health. His research team includes Jennifer Mallow from the School of Nursing; so Margaret Jaynes from the School of Medicine, Nathan Pauly and Lindsay Allen from the School of Public Health and Marcus Canaday from the West Virginia Bureau for Medical Services.
“They looked at Medicaid claims data to see what some of the top reasons; hence were for these individuals going back to an emergency department or a hospital,” Davis said. “They designed the program based on what we were seeing.” Each patient will be given a scale; a thermometer and devices to track glucose levels, blood pressure and blood oxygenation. Those at risk of falling will also get a fall monitor. The patients’ medical team will help them set up the equipment and instruct them how and how frequently to use it.
Finding out about a medical problem as soon as it arises may prevent what Davis calls a “cascade” of events that can land someone in long-term care again. For example, if a diabetic patient’s blood sugar rises to a moderately high level, a nurse can call; hence remind the patient to take his or her insulin, and try to prevent future spikes by pinpointing the food that triggered the increase. This way, the patient can get his or her glucose level under control promptly; hence before it reaches a severely high level that necessitates a trip to the emergency room.
Worsening of mental health
In addition, Davis and his team plan to implement semimonthly calls from nurses; hence to keep tabs on patients’ pain and mental health. “If there’s any worsening of mental health; so that can lead to someone being re-institutionalize,” they said. At the end of the pilot program, the researchers will assess its cost-effectiveness base in part on the number of times patients are hospitalize; so readmitted to long-term care facilities and seen at the emergency department or an urgent care clinic. The team expects telehealth to drive these numbers down.
“They know that telehealth does things like reduce healthcare costs and reduce emergency room visits; but it also makes nurses more accessible to patients, and it creates an opportunity for an adequate amount of care with fewer nurses. There’s a massive, nationwide nursing shortage right now,” said Mallow, an associate professor in WVU’s Adult Health Department. “With telehealth, they’re actually able to spend more time with patients time; so that would otherwise be spent traveling or charting or running from one patient to another onsite.”
“Telehealth itself once it’s up and running is pretty easy to use, from an end user perspective; but actually designing and implementing it can be very complicated,” Davis said. “You’ve got competing visions and goals. You’ve got to deal with comorbidities; all of the different types of technologies, a whole range of devices and vendors. Because of that, we believe that telehealth has not reached its widespread potential especially in a rural environment.” What the study reveals can suggest ways to overcome these logistical obstacles and fulfill the promise of telehealth.