Arizona Telemedicine May 2014 - Page 25

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.” 21