More than 5 million people in the U.S. suffer from congestie heart failure (CHF), according to the Centers for
Disease Control and Prevention (CDC). The annual cost is estimated at more than $32 billion in health care services,
medications, and lost earnings, the CDC says. Northern Arizona Healthcare’s “Care Beyond Walls and Wires” can
improve CHF patients’ health and reduce health care costs.
W
oody Smith and his daughter, Rita
Yazzie, used to drive as often as
twice a month from their home on the
Navajo Reservation to Flagstaff Medical
Center, nearly two hours away. Mr. Smith
is living with congestive heart failure, with
symptoms so severe he required frequent
hospitalizations.
But Mr. Smith can now get along for several
months without having to be admitted to
the hospital. His remarkable turnaround
has resulted from an innovative program
called Care Beyond Walls and Wires, a
telemedicine-enabled home-monitoring
program that has shown it can significantly
improve the health of most patients living
with congestive heart failure.
The program also is reducing emergency
room visits and hospital admissions and
readmissions, and decreasing the length of
stay for those who still require hospital care.
“It’s phenomenal,” says Gigi Sorenson, a
registered nurse and telehealth director
for Flagstaff-based Northern Arizona
Healthcare, which operates Care Beyond
Walls and Wires in collaboration with
Flagstaff Medical Center and Verde Valley
Medical Center in Cottonwood.
Ms. Yazzie says Care Beyond Walls and
Wires “is the best thing ever for me, and the
best thing for my dad.” He has required only
two hospital readmissions since enrolling in
the program more than a year ago.
And at 90, Mr. Smith has been able to return
to his favorite activity: riding his horse.
Care Beyond Walls and Wires provides
patients with a backpack containing the
equipment they need to check their blood
pressure, measure their oxygen level, and
check their weight daily; the latter because
patients with CHF can gain and drop weight
suddenly. The data are automatically
transferred to a smart phone that transmits
the information to Northern Arizona
Healthcare’s care coordination office, which
provides the smart phone, monitoring
equipment and backpack to every patient
enrolled in Care Beyond Walls and Wires.
The San Diego telecommunications
company Qualcomm was chosen to lead
the project, with Maryland-based Zephyr
Technology and Verizon providing software,
smart phones and remote-monitoring
hardware.
Some of the program’s patients have no
electricity at home, so they also are given
solar chargers.
Northern Arizona Healthcare agreed to
conduct a pilot project involving 50 patients.
The 16-month project got under way in
December 2011.
“We have found that, number one, the tools
and the technology are considered really
cool. Grandkids love all the equipment, and
help their grandparents understand it,” Ms.
Sorenson says. “But it’s the relationships
that we have been able to develop with
these patients that matter most.
“Care Beyond Walls and
Wires is the best thing
ever for me, and the best
thing for my dad.”
“You could take part in the study if you lived
in Flagstaff but had no family support,” Ms.
Sorenson says. “Or you could live in Supai
(at the bottom of the Grand Canyon) or on
a mesa on the reservation. Our patients
were Native American, Hispanic, and white,
ranging in age from 31 to early 90s.”
Qualcomm funded the Care Beyond Walls
and Wires pilot study. When it ended on
April 1, 2013, Northern Arizona Healthcare
took on the costs of continuing the program.
Rita Yazzie
The monitoring kits cost around $650,
including the backpack, Ms. Sorenson says,
and there are monthly cell phone charges.
“They know someone is watching out for
them, and they will not even have to initiate
a call if something needs attention. If a
care coordinator sees a patient’s weight
go up three pounds overnight, they will call
the patient and ask, ‘How are you feeling
today?’”
“But it’s very much worth the investment,”
she says. Not only are patients benefiting,
but a new Medicare rule penalizes hospitals
if patients with certain conditions, including
congestive heart failure, are readmitted
within 30 days of being discharged.
From Flagstaff Medical Center’s
perspective, the idea for Care Beyond Walls
and Wires originated with the National
Institutes of Health Office of Public and
Private Partnerships, which was looking
for better ways to monitor patients with
CHF who live in rural areas. The goal was
to provide better care while keeping the
patients out of the hospital, thus reducing
health-care costs.
“And we have tremendous patient
satisfaction. Patients like the feeling that
they have more control over their health,”
Ms. Sorenson says. “We couldn’t have
asked for anything more. It’s a global win.”
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