NYC Health and Hospitals Corporation Expands House Calls Telemedicine Program for Diabetics
Nov 06, 2009
New York City Health and Hospitals Corporation (HHC) today announced that its innovative telemedicine program, House Calls, has helped more than 500 New Yorkers with severe diabetes to significantly lower their blood sugar levels, avoiding hospitalizations and trips to the emergency room.
Seventy six percent of the patients enrolled in House Calls for at least six months have significantly decreased their A1C levels, or blood sugar, and of those, 22% reached the recommended goal of an A1C of 7, a healthy level according to healthcare providers. When the patients first started the program A1C levels ranged from more than 9 to as high as 14.
Dozens of diabetic patients who achieved success through HHC’s House Calls will be honored Thursday, November 5th, at 11:30 a.m. at a recognition ceremony at Metropolitan Hospital Center in Manhattan.
“Telemedicine programs are improving health care outcomes while cutting costs,” said HHC President Alan D. Aviles. “This low cost technological intervention is effective and is resulting in remarkably positive patient outcomes for diabetics whose disease was out of control. And it helps us lessen the burden on primary and acute care providers and ensure HHC resources are used most effectively.”
The HHC House Calls program teaches people with diabetes to manage their own treatment and costs about $3,600 a year per patient, less than the cost of a single day in the hospital or an emergency room visit. Patients are given a glucometer that connects to a telephone modem the size of a flip phone that is easily installed in their home. If clinically indicated, a bathroom scale and blood pressure cuff are also connected to the modem to allow for more extensive monitoring.
Diabetics use the equipment provided by the program to measure their blood sugar, weight, and blood pressure and with the push of a button they send the automated readings to the House Calls nurses via the program’s toll free phone line. Readings that are outside acceptable levels trigger automatic alerts and clinicians then work to guide the patient back to controlled levels before a health crisis occurs. House Calls nurses call each patient one or more times a week to discuss readings, design weekly meal plans and develop strategies to control their weight, blood sugar and blood pressure. They receive this one on one, personalized healthcare without leaving the comfort of their home. Normal care for a diabetic patient will average four office visits a year while House Calls provides at least 52 calls or “visits” annually.
“The program is fantastic for patients who are home and can’t get to appointments easily,” said Yvonne V., a House Calls patient. “It’s great to have a relationship with a nurse who cares and talks to you about your health problems and your diabetes control. I recommend it for all diabetics. It’s been a great program for me.”
Telemedicine has spurred a growing interest in home health strategies and more than 200,000 U.S. residents use telemedicine home-monitoring services, according to the American Telemedicine Association. Recent studies suggest telemedicine can reduce costs from office visits and hospitalizations by hundreds of millions of dollars annually and should be a major component of health care reform.
Diabetes is a chronic disease that affects nearly 24 million Americans and is the leading cause of kidney failure, adult blindness and lower extremity amputation and is a major contributor to heart disease and stroke. A1C levels are the best measure of how well diabetic patients are controlling their blood sugar. According to the American Diabetes Association and the CDC every 1 point decrease in A1C reduces the risk of eye, kidney and nerve diseases by over 40%.
“House Calls is proving to be one the best tools we have in addressing the epidemic of diabetes,” said HHC Health and Home Care Executive Director Ann Frisch. “Teaching diabetic self-management to patients is a challenge – but one we are meeting head-on with technology and skilled clinical staff. We offer patients with poorly managed diabetes the necessary preventative, emotional and educational support they need to control their disease.”
The program is available at no cost to the 16,479 diabetics enrolled in MetroPlusHealth, HHC’s insurance plan, if their blood tests indicate poor self management of their disease and are referred by their doctor. MetroPlusHealth’s latest data showed that unplanned doctors’ visits, hospitalizations and emergency room visits by House Calls patients were reduced by 50%, a savings of thousands of dollars per patient.
“Using positive reinforcement, recognition of patient efforts, and small frequent doses of education, the House Calls staff is helping HHC patients effectively manage their disease and gain the knowledge and confidence required to make the necessary behavior changes that result in improving their health,” said Susan Lehrer, RN, director of House Calls.
Recently the NYS Department of Health made it mandatory for Medicaid Managed Care plans to cover telemedicine services such as this for patients who meet specific requirements after a risk assessment. HHC cares for more than 50,000 diabetic patients and hopes eventually to make House Calls available to all eligible diabetics.
Contact: Ian Michaels (HHC) .
The New York City Health and Hospitals Corporation (HHC) is a $6.7 billion integrated healthcare delivery system with its own 420,000 member health plan, MetroPlusHealth, and is the largest municipal healthcare organization in the country. HHC serves 1.4 million New Yorkers every year and more than 475,000 are uninsured. HHC provides medical, mental health and substance abuse services through its 11 acute care hospitals, five skilled nursing facilities, six large diagnostic and treatment centers and more than 70 community based clinics. HHC Health and Home Care also provides in-home services for New Yorkers. HHC was the 2008 recipient of the National Quality Forum and The Joint Commission’s John M. Eisenberg Award for Innovation in Patient Safety and Quality. For more information, visit www.nychhc.org/hhc or find us on facebook.com/NYCHealthSystem or twitter.com/NYCHealthSystem.