Technology helps with recovery




HOMEWORK- Agoura  Hills  resident  Linda  Steinman demonstrates how she uses the HomeMed Sentry III in her home. WENDY PIERRO/Acorn Newspapers

HOMEWORK- Agoura Hills resident Linda Steinman demonstrates how she uses the HomeMed Sentry III in her home. WENDY PIERRO/Acorn Newspapers


Linda Steinman felt short of breath one day last December. Within minutes of calling in sick to work, the mother of three asked her teenage son to call an ambulance.

In the hospital, the 54yearold was shocked to learn she had congestive heart failure, pulmonary edema and diabetes. Doctors implanted three stents into Steinman’s arteries and two days later sent the legal assistant home to recover.

Steinman’s experience is typical of the trend to have patients out of the hospital as soon as they are stable and recovering under the care of a healthcare professional at home.

Nurses from Los Robles Homecare Services in Thousand Oaks have checked on Steinman’s progress in her Agoura Hills home every week since she was released from the hospital in January.

But it’s a small machine known as a telemonitor that has earned Los Robles commendation from Lumetra, a nonprofit agency contracted with the federal government to improve home-delivered medical care in California.

“They are one of our best examples,” Lumetra spokesperson Laura Marshall said. “Among the home health agencies we work with and the type of work we do, they’re one of the standouts.”

Home healthcare agencies dispatch medical professionals- doctors, nurses, occupational and speech therapists, social workers, home health aides and the like- to care for people who are recovering at home from surgery or an acute illness.

Patients choose the home healthcare agency they want when being discharged from the hospital, and the service is covered by most insurance companies when ordered by a doctor.

Los Robles Homecare Services, a for-profit company not affiliated with Los Robles Hospital and Medical Center in Thousand Oaks, is one of 600 Medicare-certified home healthcare agencies in California.

Through the Los Robles telemonitoring system, a nurse can monitor a patient’s status throughout the day and take action that could prevent the person from reentering the hospital.

A thermometer, weight scale, blood pressure cuff and a fingertip device that measures blood oxygen level and pulse rate are connected to the telemonitor that sits on Steinman’s dining room table. The collected data is relayed via satellite at least once a day to the Los Robles office, where a nurse looks over the information.

Through the telemonitor, the nurse can send a message to Steinman- asking if her ankles are swollen or if she’s having difficulty breathing, for example. Steinman responds by hitting a “yes” or “no” button.

“I love it because it gives me peace of mind and a sense of security that everything’s okay,” Steinman said. “I don’t worry (being) here any more because I have this.”

Los Robles nurse Carolyn Coleman-Grady said the system is useful for patients recovering from nearly any type of illness or surgery but is particularly helpful for those people taking heart or multiple blood pressure medications.

The machine, however, is not a substitute for a doctor’s or nurse’s care or for the emergency room, Coleman-Grady said. It’s a tool that could prevent a medical problem from escalating to the point where the patient must reenter the hospital, she said.

Less than 22 percent of Los Robles Homecare patients reenter the hospital, compared with California and national averages of 23 percent and 28 percent, respectively.

Lumetra and Los Robles officials give much of the credit for the lower number to the telemonitoring system. Los Robles has 60 telemonitors for its patients and doesn’t charge patients or insurance companies extra for the service, although Los Robles must pay substantial rental fees for the machines.

“We do this because we believe in a higher standard of care,” owner Joan BuckPlassmeyer said.

The move to improve

Medicare wants the more than 8,800 Medicare-certified home healthcare agencies to follow Los Robles’ example and reduce patient readmittance.

More than 1 million Medicare patients are hospitalized a year, and the average hospital stay costs the federal agency more than $8,000. Medicare stands to save millions of dollars when home healthcare agencies reduce patient readmittance by even a percentage point or two.

So Medicare and a group of medical associations and organizations launched the yearlong Home Health Quality Improvement campaign, which ended last month. Los Robles was one of 270 California agencies and 5,585 nationwide that participated in the voluntary program to improve home-delivered medical care.

BuckPlassmeyer, a registered nurse, said usually the best agencies get involved in campaigns like this one because they want to make a difference.

“Many people will not put the money out to improve quality,” she said.

During the campaign, participating agencies shared with each other their success stories and best practices, such as Los Robles’ telemonitors.

Home healthcare agencies that didn’t participate faced no penalties, but they could feel the financial effects later. On Jan. 1, Medicare began testing a payfor-performance program that offers incentive payments to a sample of Medicare-certified home healthcare agencies in California and six other states for maintaining high levels or significantly improving the quality of care. Some officials think the federal agency is headed in the direction of a merit-based pay system for the healthcare industry.

GOOD BUSINESS- Carolyn Coleman-Grady, clinical supervisor with Los Robles Home Care Services Inc., says the HomeMed system is useful for patients recovering from illness or surgery.

GOOD BUSINESS- Carolyn Coleman-Grady, clinical supervisor with Los Robles Home Care Services Inc., says the HomeMed system is useful for patients recovering from illness or surgery.

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