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Rx for Rural Health Part 3: Home health provides 'eyes and ears of the doctor'

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Rx for Rural Health: Technology driving telemedicine explosion

Robert Inglis/The Daily Item This screen with two cameras, a microphone, and more attached allows doctors to get an up close look at patients while not being in the room at Evangelical Community Hospitals TeleStroke program.

Hospital leaders see growing roles for home nursing and other home health professionals in the overall delivery of health care.

“Home health is becoming ever more important,” UPMC Somerset President Andrew Rush said. “Patients don’t stay in the hospital long, but they do require some ongoing care.”

In rural areas of Somerset County, the hospital’s home health teams can use remote monitoring to connect patients directly with their primary care physicians and assist with virtual wellness visits, Rush said.

A demonstration program through Chan Soon-Shiong Medical Center at Windber takes the telemedicine approach one step further to create a home hospital environment with 24-hour telemonitoring.

“When a patient can be cared for at home, that is really the best for the patient and the family,” said Dr. David Csikos, Windber’s chief medical officer. “Elderly patients may deteriorate mentally in a hospital setting."

Telemedicine is a valuable addition to the home health toolbox, but the president of UPMC Home Healthcare says the program’s health care professionals have always played a similar role.

“We are the eyes and ears of the doctor when we are there,” Paula Thomas said, “because if there is something that needs changed we can call the doctor.”

The home health professionals can go beyond the vital signs, she added.

“They build a relationship,” Thomas said. “Those relations are so important because when they trust you, they share. Then we can do the best job for them.”

Even with their own home monitoring equipment, patients benefit from having support from a home nurse, said Lori Nelson, director of health care services for Interim Healthcare of Johnstown, which provides home health and hospice services in 17 western Pennsylvania counties, along with 11 counties in West Virginia.

“In a televisit with the patient and the doctor, they want the home nurse to be there,” Nelson said.

While many rural areas don’t have access to broadband internet for telehealth monitoring, Thomas said home nurses are getting creative to overcome the obstacle. They often use their smartphones to text photos and vital signs to the doctors from areas with weak service. Some carry two phones, each with a different cell carrier, to keep patients connected.

Like many areas of health care, home nursing faces challenges in rural areas. A study published in the American Journal of Managed Care showed patients in rural areas were more likely to be discharged from hospitals into nursing homes than to home health, even if their conditions were appropriate for either care level.

A shortage of nurses and other health care professionals is amplified in the home health industry.

Nelson says it makes good financial sense to improve access to home health in rural areas and encourage patients to consider the option.

“It really helps keep patients out of the hospital,” she said. “That’s what we do in home health. We can do the stuff they do in the hospital — minus a few things. There are a lot of resources.”

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