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Memorial Hermann nurses help patients use Virtual Care Check health-monitoring system

Patients with chronic illnesses find the tablet-based system can help them achieve better health at home

Friday May 2, 2014
Janice Takeda, RN
Janice Takeda, RN
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Kimberly Berg, RN
For many patients being treated for chronic illness by healthcare providers at Memorial Hermann Health System in Houston, the path to better health — and a better quality of life — starts with a high-tech
house call.

Patients who use Memorial Hermann’s new Virtual Care Check health-monitoring system are able to record and track their vital signs and other measurements at home using tablet-based technology that transmits data wirelessly to Memorial Hermann nurses and other care providers. The patients are equipped, at no cost, with a 10-inch Samsung tablet computer as well as a blood-pressure device, a pulse oximeter and a weight scale during an initial home visit by a Memorial Hermann nurse. The nurse demonstrates both how to log in to Virtual Care Check to enter and send personal data and how to reach a nurse quickly with any healthcare questions.

The overarching goal of the Virtual Care Check system is to help patients better manage their conditions and stay out of the hospital. It means a more healthful, more normal quality of life for the patients, and, ideally, cost savings for Memorial Hermann — keeping patients healthier at home helps the health system avoid Medicare’s 30-day readmission penalties. The Virtual Care Check system is in use with Memorial Hermann patients who have recently had a heart attack or who have pneumonia, chronic obstructive pulmonary disease and/or congestive heart failure, although there are plans to expand its deployment to patients with other chronic conditions.

Nurses and other clinicians at Memorial Hermann receive patients’ Virtual Care Check data in real time, so that if a patient records a spike in blood pressure or blood glucose or reports increased swelling in the ankles, for example, a nurse can follow up with a phone call immediately — and perhaps help the patient avoid an emergency trip to the hospital.

“It enables us to act almost as a crisis emergency team,” said Janice Takeda, RN, BSN, director of specialty programs, hospice, pharmacy and infusion at Memorial Hermann.

“We try to get ahead of problems,” said Kimberly Berg, RN, clinical manager of remote patient monitoring. The Virtual Care Check system, developed last year by Memorial Hermann in partnership with technology provider Vivify Health, lets nurses on the front lines of patient care identify chronically ill patients’ acute problems, trending problems and potential problems. An abnormally high reading might signal that a patient has run out of a medication or skipped a dose, prompting a phone call from a nurse; missed data submissions could suggest that the patient or a caregiver is becoming overwhelmed with care management — spurring a discussion with a social worker about whether in-home assistance might be needed.

On the patient’s side, the Virtual Care Check system is password-protected, and patients need to sign off on any data recorded before it can be submitted. This adds a layer of peace of mind for patients, Berg and Takeda said. And rather than considering the technology and the monitoring demands a burden, many patients are more than happy to show off their new technology to friends and family, they said.

How well is Virtual Care Check working? The system is still new, but Takeda said initial results suggest that 30-day readmission rates for most cardiac patients declined from 7.3% to 5% after home health monitoring was implemented. “We know we’re getting results (and delivering) a better customer-service experience,” Takeda said.

Patient comfort at home helps them retain information

Glenda Sharp, RN, home health coordinator at Memorial Hermann Southwest Hospital in Houston, knows that a hospital isn’t a patients’ ideal setting for knowledge retention. The combination of an unfamiliar environment, the frightening circumstances that might have landed patients in the hospital, and the continual inpatient distractions of everything from medication administration to the beeping of electronic monitors can make it difficult for patients and their caregivers to understand and retain critical information.

Getting patients to understand the whys and hows of Memorial Hermann’s Virtual Care Check system is more easily done when in a comfortable setting. “It feels safe (at home),” Sharp said. “That’s where all the learning and retention comes in.” Having a nurse explain, inside the patient’s residence, why it’s crucial to track vital signs daily and take medications exactly as directed — and showing the patient how this can be done quickly and easily using virtual health-monitoring technology — can increase patient comprehension and follow-through.


Home Healthcare Coordinator Glenda Sharp, RN, shows patient John Abbott on how to use the Virtual Care Check device at Memorial Hermann Southwest Hospital before he was discharged home.
(Photo courtesy of John Lynch, Memorial Hermann)
Is Virtual Care Check too Big Brother?

Given the always-in-touch nature of the Virtual Care Check technology, some might wonder whether patients have reservations about using the system. Is it all too Big Brother-like, or too technologically overwhelming, for patients not accustomed to such regular personal health monitoring and real-time intervention from healthcare providers?

Not at all, Memorial Hermann RNs Kimberly Berg and Janice Takeda said. Almost 150 patients (ages 43 to 97) have used the Virtual Care Check system, Takeda said, and not even a handful have expressed discomfort with it.

“For the vast majority, it’s not too intrusive,” she said. “It’s supportive in an unobtrusive way. There’s comfort in someone seeing them every day.” And from a technology perspective, Berg said, the system poses less of a challenge for older patients than many might believe.

“They’re familiar with things like BP monitors and blood oximeters, so the only new tech for them is the tablet,” which is “pretty simplistic,” she said. The tablets were tested for ease of use in low-vision and colorblind patients as well, Takeda said.


Christine LaFave Grace is a freelance writer. Post a comment below or email editorSouth@nurse.com.