Technology bringing medical care home

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Mabel Henninger knitted on her living room couch as her husband of 69 years sat nearby in a recliner having his heart and lungs monitored by a Geisinger physician.

The physician, Dr. Anthony Wylie, was in his Pittston office more than 60 miles away while the consultation with Glenn Henninger took place through a laptop computer.

It’s a scenario playing out across the nation as a growing number of medical professionals are using telemedicine to evaluate, treat and even diagnose patients through communication technology.

From 2015 to 2017, telemedicine visits increased 261 percent, according to a Harvard-led study based on a large U.S. commercial health plan database. The study was partially funded by the National Institutes of Health and published in the Journal of the American Medical Association in 2018.

Henninger was enrolled in the Geisinger at Home program following his 2018 heart attack. After his release from the Danville hospital, a team of nurses and health aides came to his Paxinos home to provide him care, including a monthly visit via the internet, similar to Skype, with a physician who is able to monitor his heart, lungs and overall physical health.

“I’m very thankful for the program. It saves us a lot of trips to Geisinger,” said Henninger, 90, who added that his wife also likes the convenience of home medical visits and high-quality, virtual care.

“Do you see what she’s doing?” he said, as Mabel Henninger focused on her knitting while nurse aide Keri Harne held a stethoscope to Henninger’s chest and electronically conveyed the information to Wylie through the Internet.

The Centers for Disease Control calls telehealth services “a promising public health tool” because of its potential to expand access to medically underserved areas and save billions of dollars.

Its use has grown rapidly in U.S. hospitals, with 61.2 percent employing remote patient monitoring in 2017 compared to 43.1 percent in 2015, the American Hospital Association said.

Wylie said the technology that allows both physician and patient to see one another despite the distance provides “peace of mind” for both and reduces the number of emergency room visits.

Harne carries several instruments on each home visit, including a mobile x-ray and device that can scan the body and deliver a high-quality picture via the Internet to a consulting physician.

Henninger said he especially appreciates the blood tests that can be done remotely, saving him many trips to the hospital.

“The fact that we have these devices (to remotely monitor health) plays a large role in the assessment of patients. They allow us to get to more people who otherwise may end up in the emergency department,” said Wylie.

The Geisinger at Home program serves 4,000 Geisinger Gold members with certain health needs and has helped reduce hospital admissions by 48 percent and emergency room visits by 43 percent, said David Fletcher, associate vice president for telehealth.

The average cost of telemedicine visits is $79, according to a study conducted by Rand Corporation, a California-based nonprofit think tank.

It’s estimated that every emergency room visit avoided as a result of remote medical care saves between $309 and $1,500. For primary care visits, the savings range from $19 to $120 per visit, according to the American Journal of Emergency Medicine.

Many of the patients treated via telemedicine would be traveling or having to be transported by ambulance to hospital settings, shooting up the costs for both patient and provider.

And it’s not just younger patients who have embraced the use of technology in managing their health, he said.

“It’s a common misconception that millennials use it more. Surveys show there is not been any difference in age,” Fletcher said. “Regardless of age, it’s crucial to set up a program that is easy for all to use.”

Geisinger uses telemedicine in an array of specialties, including neurology and behavioral health, areas that rural hospitals often have difficulty in recruiting experts.

Most of the telemedicine services provided by the health care system are used in a hospital or clinic setting which requires patients to travel locally but gives them access to medical experts via the internet that they would not usually have, Fletcher said.

“Many of our clinics are in smaller towns where there isn’t enough volume” to employ a specialist, he said. With telemedicine, the patient is able to receive the care of an expert who may be hundreds of miles away allowing them the benefit of a specialist without having to travel outside their communities.

Evangelical Community Hospital in Lewisburg has employed TeleStroke and TelePsych services for stroke victims and patients with mental health issues for several years and has a partnership with Lehigh Valley Hospital to provide online consultations with its burn experts.

Registered nurse Cindy Anderson said the services offer a quick way to provide high-quality care of specialists that otherwise wouldn’t be available in the rural hospital, saving patients time, money and worry. More than 200 stroke victims seek treatment at Evangelical each year, she said.

“If 911 gets a call from someone with stroke symptoms, we’ll have a team waiting at the door and a specialist (on a screen) who will be able to make treatment decisions,” Anderson said. “With a stroke, time is so important.”

For people struggling with mental health problems, timely treatment is also vital and the telepsychiatry service has reduced the wait time for patients from two to four days down to one to four hours, said Johnette Bennage, director of emergency services.

“The population of patients needing this is rising and we don’t have enough specialists in the area,” she said.

Both Bennage and Anderson entered the medical field in 1992 and couldn’t imagine the ways technology has expanded the reach of health care.

Not only does it lower cost, patient transports and hospital visits, “It helps decrease a lot of anxiety,” said Bennage.

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