1. health and fitness

T E L E H E A L T H
Remote patient monitoring benefits patients and healthcare system
T
oday, telemedicine is making its
way into patient homes with
Telehomecare, a program of the
non-profit Ontario Telemedicine
Network (OTN).
The largest service of its kind in
Canada, Telehomecare couples remote patient monitoring with health coaching by
telephone. It provides patients with
Chronic Obstructive Pulmonary Disease
(COPD) and Chronic Heart Failure (CHF)
with coaching in self-management and
daily remote monitoring of vital signs.
Patients also respond daily to a few simple questions about how they are feeling. A
specially-trained clinician – a registered
nurse or respiratory therapist – monitors
their signs and symptoms in order to prevent exacerbations that would lead to an
Emergency Department visit or hospital
admission.
“Telehomecare patients feel well-supported and confident as they learn how to
live their best possible life through weekly
health coaching,” says Laurie Poole, RN,
who is vice-president of Telemedicine Solutions at OTN. “And they know that a specially-trained professional is monitoring
their blood pressure, heart rate and
weight,” she says. “They feel reassured,
knowing that their vital signs will alert the
clinician if things are not as they should
be. And they know their doctor will be informed if they need a medication adjustment or a visit to the doctor.”
Patients – who must have been hospitalized within the last year for COPD or
CHF to be eligible for Telehomecare – can
be enrolled in Telehomecare by their family doctor, nurse practitioner or specialist
or enrolled at discharge from hospital or
through a self-referral.
Piloted in 2007, with provincial implementation beginning in 2011, Telehomecare is delivered in Ontario’s Local Health
Integration Network regions by Community Care Access Centres (CCACs), hospitals or Family Health Teams. Seven of Ontario’s 14 LHINs are already participating
with others expected to come on stream in
coming months.
The program is already delivering results that are attracting the attention of
doctors and hospitals across the province.
Telehomecare patient visits to Emergency Departments have been reduced by
more than 37 percent. Hospital admissions
have been reduced by more than 44 percent.
Data from William Osler Health System,
which delivers Telehomecare in the Central
West LHIN, shows that six months after
discharge from the six-month Telehomecare program, inpatient visits from Telehomecare graduates is 70 percent lower
than pre-Telehomecare. Emergency Department visits are reduced by 53 percent.
Toronto Central CCAC, which delivers
Telehomecare in Toronto Central LHIN,
also measured patient satisfaction. Eightyseven percent of patients would definitely
recommend Telehomecare to others and
98 percent said their Telehomecare nurse
understood what is important to them.
“Telemedicine has already become normalized in our hospitals and, now, it is increasingly being normalized in our homes.
Remote patient monitoring means the
doctor is always in – in our computers, on
h t t p : / / w w w. c a n h e a l t h . c o m
our phones and, most importantly, in our
living rooms and kitchens,” says Dr. Ed
Brown, OTN’s CEO.
“The patient doesn’t have to get in her
car to go to healthcare. It comes to her.
This means better health for the patient. It
also means better health for the healthcare
system itself. It means we actually have a
chance to maintain and improve our cherished universal healthcare system in spite
of the rising tide of chronic disease that we
know is just over the horizon.”
Beyond the patient interface, the technology platform is being enhanced so that
Telehomecare data can be integrated with
the CCAC Client Health and Related Information System and physician’s Electronic Medical Records.
And, finally, Telehomecare is likely to be
expanded as a care pathway for other conditions. A diabetes pilot is already underway.
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O C T O B E R 2 0 1 4 C A N A D I A N H E A LT H C A R E T E C H N O L O G Y
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