1. Presented by Elizabeth Lee Kelsey Madden Judith Mercatili
TeleHomeCare
Presented by
Elizabeth Lee
Kelsey Madden
Judith Mercatili

2. Objectives Describe TeleHomeCare Monitoring Describe hardware
List, describe, and evaluate software
Describe and review the information system
Describe advantages/disadvantages
Examine legal and ethical issues
Describe the technology related competencies of the professional nurse working with TeleHomeCare
Describe the functions of the informatics nurse working with TeleHomeCare

3. TeleHomeCare Monitoring Description
Collects and securely transmits data quickly
Records and tracks patient information 24/7
Completes health assessments accurately in the home environment
Features automatic prompting; and
Includes technological support
(Honeywell, 2008)

4. System Hardware Sentry Telehealth monitor Genesis Telemonitor
Collects and transmits patient data
Genesis Telemonitor
Monitors patient vital signs
(Honeywell, 2008)
Sentry Telehealth monitor- Used to quickly collect and transmit data on heart rate, blood pressure, oxygen saturation, temperature, and weight. The monitor is able to guide patients through the monitoring process through the use of text or voice prompts.
-The monitor will ask the patient subjective questions to assist in assessments.
-Information is sent to the Central Station Diagnostic Software via a telephone line
Genesis Telehealth Monitor-
-Monitors heart rate, blood pressure, and weight
-Asks disease-related questions to provide a complete picture of the patients health
-Prompts patients when it is time to take vital signs
-Allows clinicians to focus on particular disease states
-Has the ability to add peripherals such as glucose meter or PT/INR device
-If the users vital signs are outside the set parameters, or they fail to respond, the monitor alerts the local healthcare agency

5. System Hardware cont’d
Computer system
Medical sensors
-sphygmomanometer and stethoscope
-scale
-pulse oximetry
Human interface
Standard modem (Honeywell, 2008)
Medical sensors are modified commercial products-periphery could be basic as listed and could include BGM, video, and ECG.
Human interface includes the buttons to send information to the central monitoring station (not a keyboard).

6. Software Windows 95 or newer Syngo
-Windows 95 or newer is used to display and graph client data through the main system at the central monitoring station
--Syngo- “The software platform for medical systems and applications”

7. Siemens Syngo software
Workflow applications
Imaging applications
Knowledge applications
Soarian quality measures
(Siemens, 2009)
-This software uses diagnostic, therapeutic, and information technologies to connect departmental levels with acute point of care
-Syngo- “The software platform for medical systems and applications”
-Workflow applications- Increase workflow efficiency
- Faster report turn-around
- Increased patient satisfaction
-Imaging applications- Improve confidence when making diagnoses
-Knowledge applications- Measures and improves quality of care
-Soarian quality measures- Eliminates manual charting
Faster feedback
Improved quality of care

8. Usability of software Useful and safe Increases productivity
Decreases cost
Manages resources
i.e. time, energy, error rates
(Staggers, 2003)
According to Staggers, usability goals include effectiveness, efficiency, and satisfaction of users
Syngo software is:
-Safe and effective in incorporating human-machine interaction
-Efficient in managing resources
-Easy to learn

9. Hospital information system
Manages information needed for daily operations
Associated with patient care information systems
(McGonigle and Mastrian, 2009)
-Patient care information systems- Focused on collecting data and disseminating information related to direct care
-Comprehensive, integrated information system designed to manage the administrative, financial and clinical aspects of a hospital

10. Software review Hospital information system Used by Registered Nurses
Function
Recommendation
(Siemens, 2009)
Siemens Syngo Applications
-Classified as a hospital information system
-Designed for human-machine interaction
-Used in healthcare to monitor patients from home
-Integration with other systems
-Ensures smooth functioning of healthcare
-Provides support for organizational processes
Function: Monitors vital signs of patients with chronic illness.
We would recommend this system for Telehealth Monitoring.
-Honeywell Hommed won 2008 Medical Design Excellence Award
-Increased patient satisfaction

11. Honeywell HomMed Evaluation
Patient Testimonial
Professional Testimonial

12. Advantages Increase in: Communication between patient and provider
Patient and professional satisfaction
Reduction in:
Hospital stays
Home visits
Recertification
(Gauthier 2006)

13. Disadvantages Less nurse-client interaction Technical failure
Patient knowledge
High cost of equipment
Physician resistance
Reimbursement for services
Less nurse-client interaction- Many clients rely on being able to ask questions and learn by example.
Technical Failure- power outage, computer reliability, transmission failure.
Patient Knowledge- Due to the decrease in nurse-client interaction, it is difficult to assess the comprehension of each patient and may take multiple home visits to teach patients.
Base system costs around $5,000 per unit not including staff training and peripheral add-ons.
Some insurances may not cover telehealth monitoring

14. Ethical/ Legal Issues HIPAA Possible violation within agency or home
-Patient monitors grouped together
-Accessible to all healthcare personnel
-Home results available to all members of home

15. Nurse Competencies
Effective, proficient, and safe use of telehealth technologies/medical devices
Understanding of technology limitations
Understanding of the knowledge, skills, and judgment necessary to identify, acknowledge, and interpret the changes that a distance factor creates
The body of nursing knowledge and competencies remain constant, it is the medium of delivery that is different from traditional nursing care.
There may be specific competencies required for the effective use of various technologies used.

16. Nurse Competencies (cont’d)
Adequate knowledge to facilitate decisions about when a client requires an in-person evaluation
Enhanced communication skills are an integral part of using this medium to deliver healthcare

17. Functions of the Informatics Nurse Specialist
Responsibilities
While using telehome care monitors the informatics nurse must be able to:
-Use home monitors
-Educate client on use of monitors
-Use hospital monitors to translate data
-Recognize critical values and/or system failure

18. Telehomecare Monitoring Overview
Collects and securely transmits data
Automatic prompting
Records and tracks patient data
Decreases ER visits and hospital stays
Telehomecare monitoring collects patient data and transmits it to the healthcare agency where the patients vital signs can be monitored
The system will automatically prompt the patient when it is time to use the machine

19. References
Honeywell HomMed. (2007). The future of telehealth at your fingertips. Retrieved January 26, 2009, from Honeywell Web site:
McGonigle, D., Mastrian, K., (2009). Nursing Informatics and the Foundation of  Knowledge. Sudbury, MA: Jones and Bartlett Publishers.
Siemens. (2009). Siemens healthcare. Retrieved February 20, 2009, from Siemens website:
St-Jule, D. & Gauthier, Margaret. (2006). Regional home care service for chronic pulmonary diseases of Montreal. Retrieved January 26,2009, from Newittech Web site:
Staggers, Nancy (2003).Human factors: Imperative concepts for critical care. AACN Clinical issues. 14,