Home Monitoring System Helps Congestive Heart Failure Patients Avoid Hospital Stays

But a physician at the University of Illinois at ChicagoMedical Center has an innovative solution to this looming healthcare problem. Dr. Boaz Avitall, director of cardiacelectrophysiology at UIC, working with Advanced Medical Devicesof Milwaukee, developed a system called the Home Health Monitorthat closely monitors congestive heart failure patients in theirhomes several times daily, resulting in fewer readmissions to thehospital and substantially lower health-care costs. [The systemreceived FDA approval Feb. 11, 1997.]

In a pilot study conducted by Avitall, the hospitalreadmission rate for 35 congestive heart failure patients usingthe system was just 14 percent over a six-month period, comparedto the national readmission average of 42 percent over athree-month period. Patients reported the system was easy andconvenient to use.

The cost per patient for the Home Health Monitor is $408($6.28/day) compared to the average $1,000-2,000 cost of homecare for congestive heart failure patients which provides for 10to 20 visits.

The Home Health Monitor includes a computerized centralmonitoring station at the UIC Medical Center staffed 24 hours aday by cardiology nurses and technicians, with cardiology fellowsand attending physicians on call. The system's hardware in thepatient's home consists of a small, portable monitor, a

scale for body weight, an automatic blood pressure cuff, afinger probe to measure blood-oxygen levels and pulse rate and aglucose meter. When the patient takes his or her measurements,the monitor stores the data and then automatically transmits itover the patient's existing telephone line to the station forreview. Any patient who does not transmit data within 24 hours iscontacted by telephone.

"The Home Health Monitor provides rapid and earlydetection of any complications before they become severe andrequire hospitalization," says Avitall. "It also makespatients feel more secure in their home environment by havingcontinous contact with the Medical Center.

"For example, the system detects increases in body weightor changes in blood pressure, common indicators of problems incongestive heart failure patients," explains Avitall."Any time the system picks up a deviation in a patient'svital sign from a pre-set level, an alarm will sound at theMedical Center station, prompting a follow-up call to thepatient. In cases of elevated body weight or blood pressure, thepatient's physician can adjust the patient's medication."

Avitall says the Home Health Monitor teaches patients tocomply with diet and medication requirements."Non-compliance and ignorance of their disease are often thecauses for patient readmissions," says Avitall. "Wecall our patients every week to discuss their vital signs and letthem know if they are doing well or make suggestions on how theycan do a better job of following their diet and medicationregimens."

Congestive heart failure is the primary diagnosis for morethan 750,000 hospital admissions annually in the United States,requiring a total of nearly six million hospital in-patient days.A 1994 study concluded that the total cost of avoidable,unncessary hospital readmissions for congestive heart failure inthe United States was more than $600 million a year.