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Honolulu Star-Bulletin, April 7, 2009, Telehealth Bolsters Patient Care at Home 

St. Francis launches a service to keep nurses and clients better connected

St. Francis Healthcare System began providing services to some Oahu patients over phone lines yesterday.

With telehealth services, a monitor that looks like an automatic blood-pressure machine prompts patients to check their weight, blood pressure, blood sugar and oxygen in the blood. It also provides medication reminders.

"It's working out really well and we decided to extend it," said Corinne Suzuka, registered nurse and executive director of St. Francis Home Care Services.

She said the service has about 60 clients on Kauai and about 120 on Oahu. Home health nurses usually visit them two to three times a week to monitor and assess their medical conditions, she said.

Patients or family members are taught to use the monitors.

"The beauty of telehealth monitoring is that it provides real-time patient data to us instantly and allows our nurses to be in contact with their patients virtually on a daily basis so they can take appropriate action and keep their doctor informed," Suzuka said.

The data can tell them if something is out of whack, she said, such as increased blood pressure or pulse, fluid retention, weight gain or loss and changes in blood-glucose levels.

The information can be forwarded to the Web site and put on a laptop "so we can be anywhere looking at the data," Suzuka said. "We can call up to see what's happened. If we can't get hold of them, we make a visit."

The Oahu program will begin with 10 monitors, and more will be added as referrals from physicians grow, Suzuka said.

The first Oahu telehealth patients will be those with congestive heart failure, emphysema, diabetes or chronic obstructive pulmonary disease, Suzuka said.

To qualify for the free service, patients not only must be referred by a physician, they must be homebound or unable to leave home without assistance and in need of skilled nursing, physical or speech/language therapy.

Early symptoms of a medical problem can be identified with telehealth monitoring to allow intervention and prevent emergency-room visits and hospital stays, she said.

Dardanelle Kaauwai, a registered nurse who directs St. Francis Home Care Services on Kauai, said 13 patients have been in the telehealth program since it began last November and that it has had a positive impact.

For example, she said, a patient with asthma who would normally go to the emergency room with difficulty breathing was reminded by nurses over the phone to use his inhalers to control his symptoms.

"Another patient's weight gain often caused him fear of congestive heart failure," Kaauwai said. "Again, our nurses were able to instruct the patient over the phone about taking his medications properly."