Home > Who We Are > Stories > Telescales Monitor Montefiore ...

Telescales Monitor Montefiore Heart Patients At Home

Many Americans step on the scales every morning to see how they are doing in the battle of the bulge. But for approximately 100 patients with congestive heart failure being cared for by Montefiore Medical Center, that morning weigh-in has more serious health implications. These patients are using high-tech "telescales" to transmit data about body weight and other medical indicators via phone lines to nurses at Montefiore's care management organization (CMO) miles away in Yonkers, New York.

"If something is amiss, such as a rapid gain in weight overnight (an indication of worsening heart failure) the nurse contacts the patient immediately," said Anne Meara, RN, director of medical management at the CMO. The Montefiore CMO manages the care of more than 115,000 patients in partnership with five regional HMOs.

"When we see early changes in a patient's condition, we can intervene in a variety of ways," she said. "Our goal is to help manage our patients' conditions so we can keep small things from becoming bigger ones with even more serious consequences to their health." In addition to checking weight, the telescales automatically run through a daily assessment questionnaire with each patient. The scales prompt patients by voice and on a digital monitor with questions about shortness of breath and dizziness, swelling of the ankles and other symptoms of heart failure.

"A patient's answers register on a computer screen that is monitored by a nurse manager in our office, who takes immediate action if there are indications of a worsening condition," said Meara. "The data also become part of the patient's ongoing medical record."

Most of the patients in Montefiore's telemedicine program had previously been hospitalized, some multiple times, for chronic heart failure. The Montefiore program has reduced the need for hospitalization for participants about 50 percent and has also reduced the need for visits to the emergency department.

Success Triggers Possible Expansion of Telemonitoring to Other Conditions

"The results are so compelling and the technology advancing so quickly we are looking into expanding to include other monitoring modalities," said David Bernard, MD, medical director of the program. "We're also looking into helping patients with other conditions that require monitoring, such as diabetes or lung disease," said Dr. Bernard. "This has real potential for helping even the frail elderly who are living alone."

"Montefiore's telemonitoring program is a huge success on many levels," said Meara. "Patients tell us they love the ongoing reassurance of being monitored in this way and they agree their conditions are being better managed," she said.

Goal: "To Make Sure Each Patient is in Best of Health"

Reducing patients' need for hospitalizations to treat more serious conditions is only one measure of the program's success.

"My daily goal is to make sure each patient is in the best health possible and taking their medications, exercising, sticking to their diet, not gaining or losing too much weight and visiting their doctors," said Kris Becker, a registered nurse and clinical care manager, who monitors 120 heart failure patients daily at Montefiore's CMO.

"I do whatever the individual patient situation calls for, whether it is working with a physician to change medications, getting transportation for a patient to a physician's office, or referring an acutely ill patient to the hospital emergency department," said Becker.

While patients in this program are enrolled in health maintenance organizations, heart failure patients with traditional insurance being cared for in Montefiore's Home Health Program are also using telescales with comparable success.Â’