For Immediate Release

Veterans Administration doctors use Viterion Telehealthcare to monitor veterans by telephone.

By Brian Bowling, Pittsburgh Tribune Review

- January 15, 2009: Doctors at the Veterans Administration use Viterion Telehealthcare to monitor veterans.

Daily phone calls help U.S. Army veteran Leroy Miles stay out of the emergency room.

Usually, the calls are between a machine in his home and a computer server in Houston operated by Viterion TeleHealthcare which provides his twice-daily blood pressure and sugar readings to a registered nurse at the Department of Veterans Affairs' Pittsburgh Healthcare System.

Occasionally, that prompts another phone call from the nurse to Miles, 74, of Wilkinsburg.

"If my sugar is running too low or my blood pressure is not right, they call you right back," he said. "It keeps me on track."

A recent study of 17,025 patients enrolled in the VA's home telehealth service found that daily monitoring has reduced visits to hospitals by 19 percent and the number of hospital stays by 25 percent. With about 35,000 patients, the VA has the largest telehealth program in the world.

About 430 patients are enrolled in the VA Pittsburgh program. Eileen Mierski, the nurse in charge, said it is an important addition to but not a replacement for traditional services.

"It's not going to give patients their meds. It's not going to give the patients their meals," she said.

But the program does encourage patients to stay on schedule with home medical tests, and it provides them with direct access to a medical professional if they have questions about their care, Mierski said. The VA started the program because it recognized that a small percentage of veterans with chronic illnesses were using a relatively large percentage of the VA's resources.

In addition to checking test results, nurses encourage patients to talk with dietitians and themselves about their conditions. The nurses contact the patients' primary-care doctors if the tests indicate a developing problem.

The more-intensive management and improved access to medical advice has reduced the number and duration of hospital stays for 69 percent of local patients, Mierski said.

Vietnam veteran Clarence Dickerson, 68, of Wilkinsburg said before he joined the program a year ago, he got feedback only when he visited the doctor's office every three months or so. Now, the Army veteran gets feedback daily -- even if it's the "no news is good news" variety.

"I can send my results to the VA and they receive it, and I have no worries about it," he said. "If it's bad, they'll call me right away."

Another advantage: the VA records all measurements, so Dickerson doesn't have to remember to bring them when he does visit his doctor.

"It's always updated," he said.

Mierski said the VA is the only health system that covers telehealth services on a long-term basis. Private insurers typically pay for it only in the recovery period immediately following a heart attack or similar event, she said.

Jonathan Linkous, executive director of the American Telemedicine Association, said Medicare doesn't provide any coverage, but he thinks that soon could change.

"We expect that there will be universal coverage (of home telehealth) in a few years," he said. "It's a very cost-effective way of treating patients who are very expensive patients to treat. If you can keep them out of hospitals, you can save a significant amount of money."

The VA will use its study to lobby Congress and the insurance industry to cover telehealth programs. The 17,025 patients in the study made it several times larger than any other, Linkous said.

"This pretty much makes the case for the cost-effectiveness," he said.

By Brian Bowling, Pittsburgh Tribune Review, bbowling@tribweb.com

http://www.pittsburghlive.com/x/pittsburghtrib/news/cityregion/s_607242.html


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