Virtual Medical Checkups on the Rise

Wayne Wilson is cheered when the computerized voice tells him his blood pressure and heart rate are holding steady.

The 82-year-old stays on top of his health with weekly checkups at an electronic kiosk in the lobby of the Beverwyck assisted-living home. On this day, he finds out he's even lost half a pound.

"That means I can have ice cream tonight," he says.

Wilson is part of a growing number of people monitoring their vital signs through "telemedicine," which allows health care providers to perform checkups by video.

The technology can be as basic as the kiosks Wilson uses, which transmit blood pressure and weight readings to a remote facility monitored by a nurse. On more sophisticated devices, live doctors appear on a screen to listen to everything from a patient's heartbeats to lung waves. Some machines let patients aim a camera at injuries so doctors can instruct them how to properly dress a wound.

While the technology shouldn't replace face-to-face consultations, American Medical Association president J. Edward Hill agrees that it can greatly enhance the patient-physician relationship.

Advocates say telemedicine can also save valuable time and money in caring for those who require frequent medical attention — particularly in the face of a national nursing shortage.

For patients, the technology gives peace of mind.

"I want to make sure I'm alive every morning," jokes 87-year-old Thomas DiFrancesco, one of the 50 residents at the Beverwyck in Albany who use the kiosk.

Though there is little hard data tracking its growth, there is mounting evidence that more people are using telemedicine.

The number of companies manufacturing home telecare devices in the last three years has tripled to 15 and the Veterans Administration plans to double the number of patients it puts on home telecare to 20,000 over the next year, said Jonathan Linkous, executive director of the American Telemedicine Association.

About 3,500 hospitals, clinics, schools and other facilities use telemedicine today, up from 2,000 six years ago, he said.

Several studies show that patients who use telemedicine make fewer trips to emergency rooms and hospitals. One study by Kaiser Permanente compared two groups of 100 patients and found the group that used the technology cut hospitalizations by 200 days from May 1996 to November 1997.

Health care providers can catch warning signs early and take action to prevent a stroke or heart attack, said Johanna Lupoli, an Eddy VNA nurse who specializes in delivering telemedicine.

Patients also tend to be less alarmed by symptoms when they have medical assistance at their fingertips, said Cheryl Articola, program manager at Eddy Visiting Nurse Association in Troy.

At Eddy VNA, patients who started using home telecare saw a 29 percent reduction in emergency room visits and a 37 percent reduction in hospitalizations.

The association is also able to reach more patients in remote areas, a major convenience for those living hours away, especially during rough winter months.

"We can cover 13 counties with this," Articola said.

Eddy started using home telecare five years ago with a dozen units. Now it has nearly 200, and three insurers have agreed to cover the costs associated with it.

A growing number of states with a lot of rural areas, including Minnesota, offer Medicaid coverage for telemedicine. That's not the case in New York, but state officials are showing interest in the technology.

Some 40 agencies in New York state employ about 1,000 home telecare units. That's set to rise to about 1,500 after the state Health Department rolls out $4 million in grants this year to help agencies invest in the technology, said Alexis Silver, spokeswoman for the Homecare Association of New York State.

"It saves time, money, can be done instantaneously," Silver said. "This is going to become as common as a cell phone in our industry."

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