Health

HEALTH • June 15, 2015 19 distant future, as there has been talk within the Massachusetts legislature of funding a telemedicine pilot to test the effectiveness of this method of care. The ability to bill for telemedicine would allow clini- cians at agencies such as Century to guide patients in taking daily medications through a videoconference, rather than travel to their homes. "I think they're moving (in) the right direction. The question is: When is it going to be done?" Njoroge said. Paying out of pocket to cut readmissions Some health care organizations, mainly hospitals, are conducting telemedicine on their own dime because the benefits pay for the costs. This is true at HealthAlliance Hospital in Leominster, which launched a telemedicine program two years ago that tracks patients who have been discharged from the hospital and have conditions that warrant ongoing care. HealthAlliance purchased 50 monitors that are issued to patients who require daily observation. The tablets prompt them to do such things as take medications and monitor vital signs at regular inter- vals by activating a schedule to prompt the patient, much like an email software application does. Usually, the patients are cardiac or respiratory patients with heart failure or chronic obstructive pulmonary disorder (COPD), two conditions that yield high readmission rates among patients, accord- ing to Christine Dixon, executive director of ACO, Population Health & Home Health and Hospice at HealthAlliance Hospital in Leominster. Readings are transmitted to cardiac nurse specialists via satellite. Patients also receive visits in the home, but the fre- quency depends on their condition; Dixon said it could be as little as every other week. Patients like the service, Dixon said, and some- times they opt to pay a small fee out-of-pocket even after their monitoring period is over to continue the service. health services. Njoroge describes his agency as tech savvy. The company has invested in technology that allows for remote monitoring of patients' vital signs and even videoconferencing between providers and patients. Clinicians update charts via tablets from patients' homes on Century's web-based system. They also use beds that are Internet-ready, so that patients can be weighed while in bed at home, and monitors that allow clinicians to observe patients remotely. Billing lags technology But there are limits on how far Century can take the technology, because many patients are covered by MassHealth, the state's Medicaid program, and Medicare, the federal payer for senior citizens, which do not yet allow providers to bill for this type of remote monitoring, often referred to as "telemedi- cine." That means if a doctor consults with a patient via videoconference, he or she can't bill for it. Njoroge hopes this will change in the not-too- "It's not just, 'Can we deliver care at home, but can we share the necessary information with all the providers who are involved?'" Laurance Stuntz, Director of the Massachusetts e-Health Institute (MeHI) PHOTO/EDD COTE PHOTO/DREAMSTIME.COM Continued on Page 32

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