VITAL SIGNS VIA BROADBAND: - Broadband Illinois

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-32-A. General Benefits of Home-Based Care and MonitoringHome monitoring has tremendous potential for increasing patients’ quality of life. Somebenefits accrue regardless of the patient’s condition or age.For example, one obvious benefit is reduced (or avoided) travel and waiting time.Depending on patients’ and caregivers’ location and condition, travel to clinics or hospitals canrange from a minor annoyance to a serious hardship. One rural telemedicine study estimated thedistance savings from a set of 444 telemedicine visits to be over 27,000 miles, an average of over60 miles for each round trip. 92 Once at the doctor, the appointment time (an average of 20minutes, according to the 2005 National Ambulatory Health Care Survey) may be extended bywaiting for the doctor to be free. 93 If patients are not easily moved, the expense may be muchhigher than the patient’s mileage and time. A 2007 study of the benefits of provider-to-providertelemedicine found that the average cost of transporting a patient from a nursing home to thedoctor’s office was $76, and this cost will rise to the extent fuel prices increase. 94Avoiding delays in care can be equally valuable to treatment. A 2005 survey of adultswith health problems within the last two years (Patients’ Experiences Survey) found that only 47percent of U.S. respondents had been able to get appointments by the next day, and that 23percent of patients either could not get an appointment at all or had to wait at least a week toobtain one. 95Telehomecare with home monitoring is designed for care to be regular orcontinuous, and allows the patient to receive triage (medical assessment of patient condition andneed for further attention) whenever necessary. Some home monitoring systems even have92. Dimmick et al. at 129.93. National Center for Health Statistics, National Ambulatory Health Survey: 2005 Summary 37 (2007).94. See CITL at 45.95. Cathy Schoen, Robin Osborn, Phuong Trang Huynh, Michelle Doty, Kinga Zapert, Jordon Peugh &Karen Davis, Taking The Pulse Of Health Care Systems: Experiences Of Patients With Health Problems In SixCountries, HEALTH AFFAIRS (Web exclusive) W5-509 (2005) [hereafter Patients’ Experiences Survey], available athttp://content.healthaffairs.org/cgi/reprint/hlthaff.w5.509v3?ijkey=10nPOyqgRXKAM&keytype=ref&siteid=healthaff.
-33-condition questionnaires built into the user interface, to overcome patients’ natural reticence toask for help. 96Similarly, telehomecare allows patients to get care outside of typical office hours.According to the Patients’ Experiences Survey, 60 percent of patients seeking care after hoursfound it somewhat or very difficult to get care, and 26 percent of emergency room visits were forcare that could have been provided by a regular doctor if available. 97 Visits to the emergencyroom involve the same travel-related costs and inconveniences as physician visits, and wait timescan be much longer. The Patients’ Experiences Survey reports that 47 percent of patients waitedat least an hour for care and that 12 percent of patients waited over four hours. 98 Moreover,many patients value the sense of security afforded by the ability to reach a care provider(especially when their telemonitoring equipment allows video examinations with attacheddiagnostic equipment). 99Most importantly, home based care and monitoring creates a relationship betweenproviders and patients that is by nature proactive rather than reactive. Although home based careis often only prescribed after heart attacks or other adverse health events, once in place the homemonitoring data enable nurses and physicians to treat exacerbations much sooner than theyotherwise could. In particular, telehomecare with home monitoring reduces both the incidenceand duration of hospitalization for patients with chronic conditions, including COPD andCHF. 100 In one study in the Veterans Administration system the total hospital bed days of care(BDOC) fell by 55 percent. 101 Although I discuss the financial costs of hospitalization later in96. Equipment Manufacturers.97. Patients’ Experiences Survey at W5-519.98. Id.99. Dimmick et al. at 130.100. Cleland et al. at 1661 or Johnston et al. at 44.101. Meyer et al. at 87.
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Page 5 and 6: -3-insurers are capturing many of t
Page 7 and 8: -5-I. OVERVIEWA. The Health Care Op
Page 9 and 10: -7-after the illness has materializ
Page 11 and 12: -9-B. Key Patient Groups Benefiting
Page 13 and 14: -11-intervention or even hospitaliz
Page 15 and 16: -13-eating nutritious diets and sta
Page 17 and 18: -15-change that increases the publi
Page 19 and 20: -17-D. Making the Case for Telemedi
Page 21 and 22: -19-medicine or has suffered a pote
Page 23 and 24: -21-into hospital computers at nigh
Page 25 and 26: -23-Telemedicine would be more effe
Page 27 and 28: -25-have only a 9 percent adoption
Page 29 and 30: -27-For example, all these sensors
Page 31 and 32: -29-strategy has been focused on id
Page 33: -31-Bronx. Telemonitoring is felt t
Page 37 and 38: -35-discharged to a higher level of
Page 39 and 40: -37-health care might also need occ
Page 41 and 42: -39-techniques, telemonitoring keep
Page 43 and 44: -41-TABLE 3: STUDIES MEASURING CHAN
Page 45 and 46: -43-telemedicine promotes outpatien
Page 47 and 48: -45-TABLE 5: POTENTIAL ANNUAL SAVIN
Page 49 and 50: -47-average, the studies above show
Page 51 and 52: -49-Conservatively, I assume that a
Page 53 and 54: -51-technologies have been employed
Page 55 and 56: -53-reduce the need for additional
Page 57 and 58: -55-TABLE 9: ESTIMATED NUMBER OF PA
Page 59 and 60: -57-attention among private insurer
Page 61 and 62: -59-example, an additional 1/25 th
Page 63: -61-GLOSSARY OF TERMSMonitoringAlso

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