Telemedicine reduces costs and nursing home injuries, study says
HOST INTRO: Every year, residents of nursing homes make two million trips to emergency rooms. Nursing homes can reduce the number of trips to the ER by installing technologies that allow caregivers to keep tabs on an elderly person’s condition at a distance. But those technologies are expensive and it’s not clear who’s going to pay for it. Kate Cox has more. (00:14)
The sixth floor nursing station at New York’s Hebrew Home for the Aged is a busy place. It isn’t always easy for the nurses to tell when a resident is having trouble, because it can be hard to spot the signs…like shifting position in bed.
GREENE: “It could be an indicator of pain or an indicator that the patient is having some respiratory condition.” (00:06)
But they know someone has a problem when they hear this sound – and they know exactly who.
SOT: BEEPS /// bring sound up, fade down. //
GREENE: “Okay, on the screen, if a patient is getting out of bed or if there is an abnormal alert, it lights up to red…” (00:07)
Sandra Greene is a supervising nurse. She’s demonstrating a monitoring system called EarlySense. When patients change positions, sensors in their beds trigger an alert. This is an example of telemedicine. That’s “tele” as in telephone or television – medicine at a distance. The sensors are connected to a giant flat screen at the nurse’s station. A list of patient names and room numbers make it look like an airport departures display. If a patient changes position, it may be an indication that they’re about to fall out of bed or have medical trouble.
GREENE: “And the screen lights up red so that we know it’s an emergency and we need to go to the room. It can be an early save in terms of preventing them from being transferred to the hospital.” (00:12)
Nurses know they can prevent conditions that would otherwise send a patient to the ER. And ER visits are expensive. The Department of Health and Human Services reports Medicare foots the bill for those to the tune of $2.8 billion.
A study by researchers at Dartmouth and Harvard shows that telemedicine of all kinds can reduce the number of trips to the ER. Bridget Gallagher, a geriatric nurse at Jewish Home Lifecare in New York is already using the technology in her nursing home. She says that telemedicine can also help prevent conditions that require hospital stays.
GALLAGHER: “I mean, a congestive heart failure hospital stay, the average spend is $6800. And that might be for a three day stay.” (00:08)
There are also health benefits to keeping the elderly out of the ER.
GALLAGHER: “Emergency rooms, and hospitals, are not good places for older people.” (00:07)
Bridget Gallagher says in ERs the elderly often struggle to advocate for themselves. They fail to alert someone when they’re hungry or need to use the bathroom. The average wait time in a New York City ER tops six hours.
Hebrew Home implemented telemedicine with help from a grant from New York State. They’re also using the technology in people’s homes. Nancy D’Auria, a nurse and telemedicine expert at Hebrew Home says that has a huge upside when it comes to the wellbeing of the elderly.
D’AURIA: “I think we’re all happier if we can stay in our homes and in our communities, where we know the people, the deli down the street, we’ve always gone to the same dry cleaners. Those are the rhythms of our lives. And to be able to preserve that really preserves the quality of our life. So the longer we can keep someone at home, the better.” (00:20)
The savings may come in the long run, but there are big up-front costs involved in buying and installing telemedicine systems. James O’Malley, a statistician at Dartmouth and co-author of the telemedicine study says in order to take advantage of those savings the federal government pay for it. Because Medicare dollars are paying for the care anyway. He and his partner suggest a mechanism that would give nursing homes a set payment to implement the technology in the way they see fit.
O’MALLY: “Just giving the home the freedom to figure out what works best for itself. And incenting them to do the best job they can with that and to provide the best quality that they can so that there’s the least medical treatment needed for their residents.” (00:27)
O’Mally admits that in the current political climate that may not be an entirely realistic hope.
Kate Cox, Columbia Radio News.