Good Samaritan tracks patient vital signs via home monitors, satellite

BOULDER — Laura Townsend had recorded abnormally low blood pressure three days in a row.

That’s when Jean Jackson, the telehealth coordinator for Good Samaritan Home Care in Boulder, received a red alert on a monitor about Townsend’s condition from the HomMed Health Monitoring System.

With the system, home-care patients like Townsend, who lives in Fort Collins, have a telemonitor placed in their homes that they use to take their own vitals each day. The results are transmitted by satellite to Good Samaritan, where Jackson, the “queen of the machines,” looks over the vitals of each of Good Samaritan’s 35 home-care patients who use the monitors.

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If a vital sign comes back abnormal for a patient, Jackson’s central station monitor signals a red alert. She or one of the other registered nurses at Good Samaritan can then call the patient to see how he or she is feeling, make sure the patient has taken all his medications and, in cases like Townsend’s, send a nurse to check on the patient.

Janet Puglisi, the director of home care for Good Samaritan in Boulder, said the system made by HomMed LLC in Brookfield, Wis., has helped cut costs while increasing efficiency. She said Good Samaritan leases to own the monitors, paying $150 per month per monitor, and that HomMed provides the central station, as well as technical support, upgrades and marketing. If paid for up front, Puglisi said the package would cost Good Samaritan $7,500 per monitor.

She said Good Samaritan has been able to increase its client base by 30 percent without having to hire any more nurses in the face of a nursing shortage.

That increase in clientele has helped the nonprofit organization see its revenues approach $2 million this year, an increase from $1.2 million in 2002.

HomMed also provides a kiosk at Good Samaritan where onsite senior living clients and employees can track their vital signs. The kiosk can store data for 150 people. Puglisi said it has helped reduce Good Samaritan’s insurance risk pool costs for its employees.

She said the system also cuts down on “windshield time,” time spent driving from home to home, for nurses since patients require fewer scheduled visits by a nurse for checkups.

Good Samaritan is the only home-care company in Boulder using the HomMed telemonitors. Puglisi said Good Samaritan has the exclusive rights to use them in Boulder, Weld and Larimer counties as long as it uses a minimum of 30 HomMed monitors in that area.

If another area home-care company were to use the HomMed system, it would have to buy the monitors through Good Samaritan. Puglisi did not say what the cost would be but said she would likely only allow another company to use the monitors if it were filling a community need that Good Samaritan could not.

“As long as I can hire people to fill that need, I want to keep it in my own business,” she said.

Monica Baer, a spokeswoman for HomMed, said two other Colorado companies, Best Care in Englewood and Wellness Way in Denver, are using the HomMed system.

Good Samaritan seems to be on the forefront in using such devices. Neither Heartland Home Health Care and Hospice in Lafayette nor Boulder Community HomeCare use telemonitoring devices.

Rich Sheehan, director of public relations for Boulder Community, said, “We’re still in the process of evaluating these systems. We’re looking into lots of options and trying to understand which ones are really worthwhile.”

While other companies, such as American TeleCare Inc. in Eden Prairie, Minn., make devices similar to the HomMed system, Puglisi said HomMed was the “only one that fit the bill” as far as Good Samaritan was concerned.

Puglisi thinks that telemonitoring systems will be essential in order to compete in the next five years in the low-margin home-care industry, especially with a nurse shortage.

“Efficiencies don’t have to be inhuman,” she said. “It leads to better-quality nurse visits because data is collected before the visit.”

For Townsend, who has a kidney disease that claimed one of her kidneys last December, her nurse could not have come at a better time. After visiting with Townsend, her nurse suggested she call her doctor, who insisted that Townsend check into the hospital. Her nurse agreed.

“I went reluctantly, but I went,” Townsend said.

When she arrived at the hospital, doctors discovered that Townsend was severely dehydrated and malnourished. “It was a lifesaver for me, as far as I’m concerned,” Townsend said.

That early detection is the largest benefit of the telemonitoring system, Jackson said.

“We can pick up subtle complications before the problems show up,” she said. “It extends the nurse to seven days a week rather than two days a week.”

Puglisi said there are many things that play into overall benefit of the system.

“Now we have trended data, and nurses have more time to think about the patient’s condition,” she said. Puglisi said doctors also find the trended data helpful because they can see what has been happening over a period of time and make adjustments to medication dosages, schedule a visit with a patient or send a patient to the emergency room.

“Patients participate in their own care, which is always good,´ said Howie Wolf, a Broomfield physician familiar with the system. “If the data is reliably collected and recorded, it can be of great help.”

Often, Puglisi said, there is a “white-coat effect” when patients visit the doctor or have a nurse visit their homes that can make a patient nervous to the point of altering results of blood pressure testing or heart rate. This effect can mask a problem or make it appear that something is problematic that is really normal.

Taking his own vital signs in his own home each day, a process that takes about three minutes, can make a patient more relaxed and more likely to get true readings, said Puglisi.

Plus, different attachments can be added to customize the monitor for a patient. Normally, the system checks things such as a patient’s heart rate, blood pressure, weight and oxygen absorption.

Depending on what type of information Good Samaritan needs from a patient, an EKG or spirometer can be added. A finger prick can also be added to check a patient’s blood sugar levels, and a digital camera can be added to monitor wounds. There are also 46 different questions a nurse can choose to have the monitor ask a patient about her condition.

Good Samaritan includes the monitors free of charge for its Medicare patients who have a referral from a doctor for home care. Puglisi said some of the clients just want to use the monitors for their own and for their families’ peace of mind.

For private use, Puglisi said Good Samaritan charges $300 per month plus the cost of nurse visits.