Wired for better care

    A home-health company says stepped-up monitoring is keeping some of its frailest patients out of the hospital.

    The federal government is looking for ways to prevent “bouncebacks” — and the Medcaid and Medicare programs may soon fine doctors and hospitals that don’t do enough to prevent readmissions.


    Ruth Martynowicz, who leads operations at Mercy Home Health in southeast Pennsylvania, said her company uses wireless monitoring to keep track of clients with congestive heart failure and chronic lung disease.

    Each morning patients step on the scale and slip into a blood pressure cuff to send their vital statistics to a nurse.

    Martynowicz says a blood-pressure spike or even a 2-pound weight gain can trigger a check-in call, depending on the doctor’s standing orders.

    “We can give her medication to get that fluid removed and manage the patient at home, as opposed to waiting until they are in trouble a week later, maybe they’ve gained five or six pounds and they go into failure and show up in the emergency room,” she said.

    For patients with congestive heart failure, rapid weight gain can indicate fluid buildup and be a sign that the heart isn’t pumping efficiently.

    Across the home-health field, rehospitalization rates range from 24 to 29 percent, Martynowicz. She says the hospitalization rate for her telehealth patients is about 18 percent.

    Right now, the public plans and insurance companies she works with do not pay for telehealth monitoring.

    Philadelphia resident Patricia Prelle, 75, was a telehealth patient for several weeks after her diabetes became unmanageable.

    “They keep connected with you all the time. You get up and get weighed, take your blood pressure or pulse, it all goes right to the office. If your sugar’s a little high, there’s someone on the phone to find out why,” Prelle said.

    Clarification: Mercy Home Health offers its telehealth services to some of the agency’s frailest clients. A Mercy representative says, when needed, the service is provided within the overall home care program. There is no discussion of additional cost or payment. 

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