Alycia De Lucio, RN, is meeting with a patient with congestive heart failure,
checking the woman’s vital signs and assessing her health status.
But De Lucio, a nurse with
St. Joseph Home Health, is nowhere near her patient’s home. She and the patient have scheduled
video conferencing appointments using an iPad and Bluetooth-connected
medical equipment. The patient has taken her own vital signs and the results
pop up on De Lucio’s computer for review during the nursing video
The patient, at high risk of hospital readmission, is participating in
a televideo pilot program through Home Health. Her vital signs are monitored
daily and if something is out of range – perhaps her blood pressure
gets too high or her heart starts beating quickly – De Lucio knows
right away. De Lucio does televideo assessments with her patients several
times a week in conjunction with the Home Health nurse visits.
The televideo program is part of Home Health’s efforts to keep patients
from going back into the hospital. A larger program, home remote monitoring,
doesn’t include the video component but provides people who have
been recently discharged from the hospital reassurance in the weeks after
they return home. Home Health nurses are currently monitoring more than
130 patients this way, assessing them remotely over the phone.
De Lucio, who is the supervisor of the home remote monitoring and televideo
programs, gets 50 to 80 alerts a day that a patient’s vital signs
are out of range. She checks into them and calls the patient if she thinks
there’s reason for concern. The program allows clinicians to see
patients earlier and prevent future medical emergencies.
De Lucio also empowers patients to manage their own health by making sure
they understand their medications and health conditions and reinforcing
the importance of eating right and exercising. She has developed bonds
with her patients.
“The patients and families feel secure in knowing our nurses are
watching them closely,” De Lucio said of home remote monitoring.
“We get to know them and form relationships.”
Bradley Borsari, MD, an internal medicine physician at
St. Jude Heritage Medical Group in Fullerton, has referred many patients to the home remote monitoring program.
“We’ve long known that some patients are at a greater risk
of hospital readmission; some research shows that up to one-third of heart
failure patients are readmitted to the hospital within 30 days of discharge,”
Dr. Borsari said. “That’s tough for them and for their families.
We also know that closer monitoring of these patients can make a difference.
A follow-up call within three days of discharge can dramatically improve
outcomes. Remote monitoring helps patients with their emotional and psychological
health as well as their physical health.”
While home remote monitoring is now focused on cardiac and COPD patients,
the goal is to expand the program to all patients, said Linda Glomp, executive
director of St. Joseph Home Health.
Glomp said her department’s research shows that patients who are
monitored remotely have a lower rate of readmission when compared to a
similar population of patients.
Home remote monitoring may be saving lives as well as reducing readmissions.
When a nurse called on a Saturday to check on a patient who’d had
a heart attack, he said his stomach was upset and he felt clammy. The
nurse told the patient to go to the emergency department immediately to
rule out another heart attack. The man was having a medical crisis. He
had two stents inserted and was home two days later. The nurse’s
call saved the man from another heart attack. He’s now doing well.
“I believe in this,” Glomp said. “This program helps
patients to better understand their disease, to better manage their symptoms
and to stay well and at home.”
For more information about St. Joseph Home Health, please click
here. For more information about Dr. Borsari, please click