Patients gain from in-home care link

SPECIAL TO THE SENTINEL Shane Clausen, left, a home health nurse, demonstrates the use of the remote home monitoring program on Delta-Montrose Home Health Services Director Herbert Grigat.

Delta County Memorial Hospital now has a new way of using telehealth to provide in-home care for high-risk patients it serves.

The hospital's Delta- Montrose Home Health Services recently became the first Western Slope provider to partner with Health Recovery Solutions on a remote home monitoring system that will increase care for rural patients.

The device is similar to an iPad or tablet with 4G preloaded with software that a nurse brings to a patient's home.

After a 30-to-45-minute training session, the patient or caregiver holds onto the device and can use it to speak with a provider and send along vital information such as heart rate, weight, blood pressure, oxygen levels in the blood and blood viscosity.

"The data is automatically entered into our electronic medical record system," Delta-Montrose Home Health Director Herbert Grigat said.

It can also notify the provider when the patient takes medication so that if the provider doesn't receive notification more than 15 minutes after the patient was supposed to take his or her dose, they can call and remind the patient or caregiver.

The provider can also assign videos loaded on the device for the patient or caregiver to watch about their treatment or symptoms to further education on what the patient is going through.

This differs from many other forms of telehealth, in which a patient drives to a regional clinic and is connected virtually with a doctor who is at another location. Other telehealth sends a provider out to a home with equipment to connect with a doctor virtually.

This new service allows the patient to send the information personally without anyone coming to the home outside of the initial training.

Patients can qualify for the program and receive devices. To qualify, patients need to be high-risk, chronic-care patients. Some possible ailments include chronic obstructive pulmonary disease, congestive heart failure and diabetes. Some post-surgical patients can also qualify. The patient keeps the device as long as needed, and there is no extra cost to be in the program.

The idea is to keep these high-risk patients in their homes for as long as needed without having to travel for so many follow-up appointments. The service area is within a 60-mile radius of the hospital.

While the program is for rural patients, Delta County Memorial Hospital Chief Clinical Officer Jodi Roeber said the qualifications are more about the risk as opposed to where the patient lives in relationship to the hospital.

"I think that it keeps us current with technology and it certainly is a wonderful resource for our at-risk patient population," she said.

Grigat came on board at Delta-Montrose Home Health in October and had consulted with home health for several years. He said he learned of the Health Recovery Solutions program and submitted a proposal. He said the hospital is one of the first agencies in the state to implement the program.

"There's a huge increase in quality of what we provide for patients," Grigat said.

More good news about cholesterol-lowering statin drugs: They might reduce the risk for glaucoma.

Previous studies of the link between statin use and glaucoma have produced conflicting results. Now a large study, published in JAMA Ophthalmology, offers long-term data.

Researchers followed 136,782 health care workers for up to 15 years, tracking statin use and the incidence of glaucoma, the fluid buildup in the eyeball that damages the optic nerve and can lead to blindness.

At regular intervals from 1988 to 2012, participants reported their most recent total serum cholesterol and their current use of any cholesterol-lowering drugs. Over 15 years, there were 886 cases of open-angle glaucoma, the most common type. Every 20-point increase in total cholesterol was associated with a 7% increase risk of glaucoma.

But using statins had a beneficial effect. After adjusting for other factors, five or more years of statin use led to a 21% reduction in the risk.

Jae Kang, an assistant professor of medicine at Brigham and Women's Hospital in Boston, suggested that statins reduce pressure in the eye, help maintain good blood flow and might help protect the optic nerve.

Still, she said, glaucoma treatment or prevention is not by itself a reason to start statins.

"Our study doesn't address whether statins stop the progress of the disease," she said. "That would require a clinical trial."