Using Telemonitoring for Preventative Diabetes Care in the Western New York Beacon Community
Posted Jul 10 2012 4:04pm
According to the New York State Department of Health , diabetes affects one out of every 12 adult New Yorkers. The number of diabetics in New York State has more than doubled since 1994 and that number could double again by 2050. Western New York, which includes Buffalo and eight counties ranging from urban to suburban and rural, has one of the highest rates of diabetes in the country with approximately 150,000 diabetic patients.
Western New York Beacon Community
The Western New York (WNY) Beacon Community is one of 17 ONC-funded Beacon Communities building and strengthening local health IT infrastructure and testing innovative approaches to make measurable improvements in health and health care, while also reducing costs. The WNY Beacon, made up of HEALTHeLINK, Western New York’s clinical information exchange, and clinical transformation partners Catholic Medical Partners and P2 Collaborative of Western New York, is attempting to move the needle in a positive direction for diabetes care management by focusing on preventative health through early intervention and better care coordination. The WNY Beacon launched a telemonitoring pilot last summer with a focus on high-risk diabetic patients and a goal of reducing preventable emergency room visits and future hospital re-admissions. The innovative piece of this telemonitoring pilot, as compared with others, is that it targets patients who have not recently been hospitalized, while many other similar models focus on patients who have been recently discharged. WNY Beacon is one of four Beacon Communities working with telemonitoring interventions and one of many Beacon Communities working to improve diabetes care.
Approximately 110 patients are currently participating in the WNY Beacon telemonitoring pilot. Mobile devices installed in the patient’s home electronically report vital signs including blood pressure, glucose readings, and weight to health care providers through HEALTHeLINK. The WNY Beacon believes that involving the patient in his or her own care will improve their compliance and accountability for their health. Many participating providers and their patients said that they didn’t understand the impact of weight or specific foods on their diabetes until they began this daily monitoring. With this knowledge readily available, the patients participating in the pilot are able to proactively manage their diabetes.
Telemonitoring Success Stories
Since launching the telemonitoring pilot last summer, the WNY Beacon has a few success stories:
A participating community health center asked to enroll additional patients into the telemonitoring pilot based on the success of its patients to date.
One participating practice realized, through the telemonitoring pilot, the need to better address the nutritional needs of their diabetic patients and hired a nutritionist to provide better education in this area.
Three months after joining the telemonitoring pilot, a 71-year-old diabetic female reduced her glucose/HbA1C levels by approximately 4 percent and was taken off of the medication that she was taking to better manage her diabetes by her primary care physician.
Because of the ease of use and portability of the monitoring equipment, two patients have taken it with them while on vacation so there is no gap in telemonitoring.
Kenneth, age 54, shared how participating in the telemonitoring pilot is helping with his health care:
“Telemonitoring has worked well for me because I know someone is monitoring me daily. If I don’t monitor, I know that the nurse through telemonitoring will call me, which gives me incentive and motivation to do it. In the last few months my A1C has decreased remarkably and has been the best it has been in many, many years. My blood pressure has also decreased from 150’s to 130’s and although slower then I might like, my weight has decreased also. Having nurses from the Visiting Nurses Association and Elmwood Health Center help offer me encouragement, support, and assistance in obtaining supplies and medications. I see all of this as one big puzzle and without all of the pieces it falls apart. I have maintained better blood sugar control, blood pressure control, and weight loss since beginning on telemonitoring.”
Previously, one concern around telemonitoring programs was the information overload on physicians and the impact on their workflow. The WNY Beacon offered a new solution to this issue by working with three home health care agencies—Catholic Health’s McAuley Seton Home Care, Kaleida Health’s Visiting Nurses Association of Western New York, and Advantage Telehealth—to support the telemonitoring services with patient tutorials on how to use the monitoring equipment and provide home interventions such as updates to health assessments, help with treatment, or assistance with the equipment with the patients as needed. Nurses and other health care professionals from these organizations interpret the vital signs and readings daily and report critical health information to the primary care physician. Physicians then have the ability to view data on their diabetic patient and change the course of treatment before larger medical issues could develop, saving the patient both time and money with less frequent doctor visits and preventable trips to the emergency room.
Learn more about the WNY Beacon telemonitoring pilot from Elmwood Health Center, through a patient story .
Other Beacons and Telemonitoring
There are other Beacon Communities working on telemonitoring projects such as San Diego, Indiana, and North Carolina. For example, the San Diego Beacon Community has deployed two remote patient monitoring pilots that have targeted post-discharge chronic heart failure (CHF)/ chronic obstructive pulmonary disease patients with a history of noncompliance, high utilization rates, or poor understanding of their disease. Results for the CHF pilot have demonstrated a positive effect on self-activation levels among patients.