Catching and addressing these signs quickly can avert a crisistrips to the emergency room, hospitalization and worse.
Hoping to catch the process in its earliest stagesto avoid both the health risks and the costs critical care incursome clinicians are prescribing blood cuffs and weight scales that can transmit readings from a patient's home to a health care facility.
Whole suites of medical devices exist that can zip data straight from a patient's bathroom scale to a clinician's screen.
"The devices are wireless and transmit to a phone hub. The patient stands on the scale, the scale [data] goes to the hub, then into the phone line, and then the nurses will look at the data," explains Gerrye Stegall, a clinical specialist with American Healthways Inc., a disease management company, which covers more than a million patients for a range of diseases.
If the data trigger an alarm, nurses call patients to figure out if they need to change medication, visit an outpatient clinic or modify behavior in other ways.
The goal is not just to keep patients healthier but also to cut health costs by cutting down the need for expensive hospitalizations and services.
So-called remote monitoring devices are being used to treat children with asthma, adults with mental health disorders and older patients with everything from heart diseases to diabetes.
Some 50,000 patients with severe chronic diseases such as diabetes, congestive heart failure, hypertension and breathing difficulties had remote monitoring devices in their homes in 2003, according to Sachin Thukral, a health care analyst with Frost and Sullivan. He singles out home monitoring systems as one of the two most successful areas in telemedicine. (The other area is teleradiology.)
Some systems allow for real-time audio and video consultation with a physician.
Eclipsys Technologies Corp. is developing "a highly mobile robot equipped with extremely high-performance two-way video and audio, remote control mobility and communication system, and a medical-grade wireless connectivity," according to Thukral.
The Health Buddy device made by Health Hero has ports that can connect to anything with USB, like cameras and identification devices, as well as medical equipment.
Motiva, from Philips Medical Systems, communicates with patients through their televisions.
Most programs send patient data to a Web page that collates information from several patients, flagging those whose blood pressure, pulse rate or other vital signs pose a cause for concern. Clinicians regularly review and respond to these data.
American Healthways' Stegall uses remote monitoring for patients with heart failure.
More than 90 percent of patients approached about the devices agree to take them, she said, and added that with the devices, patients "feel more supported than threatened."
Devices can do more than simply take a reading; some can ask patients questions about how they're feeling.
And some, like the Health Buddy device manufactured by Health Hero, use this information to coach patients into better behavior.
The device is in 5,000 homes, being used to help manage diseases including childhood asthma and heart failure.
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