United States Department of Veterans Affairs
 Health Care
Home Telehealth: I Just Called to Say...Here's My Blood Pressure
Patient adjusts a blood pressure cuff connected to a monitor.
Veteran Chester Hayworth sets up his blood pressure cuff in preparation for his daily stats check-up over the phone.

Chester Hayworth, 69, was having difficulty breathing. The oxygen tank he used 24/7 had always stabilized his air intake, but this time was different. He grabbed his pulse oximeter and realized his oxygen level was at 85% - far below the average 96-99% level.

With a quick phone call to VA Telehealth staff and a transfer of his vital signs through the phone line, his VA care coordinator was able to immediately assist Hayworth and get him to the medical center to stabilize his condition.

The Home Telehealth program allowed Hayworth to acknowledge and expeditiously react to his "health scare." In the six years he has utilized the service, Chester has been able to regularly monitor his Chronic Obstructive Pulmonary Disease (COPD) and detect abnormalities in his vital signs.

Telehealth is the delivery of health-related services and information via telecommunications technologies. Home Telehealth is a key component of the Veterans Health Administration's Telehealth program, designed for Veterans with chronic diseases in need of constant monitoring. The home-based patients can record and send health vitals to their primary care staff by means of a home telephone.

"Telehealth has helped me a lot," said Hayworth. "I feel like I get more participation with my vital signs and I have a little more control over my life."

Photomontage of a patient reading a monitor device on the left, and a clinician view the results on a computer monitor on the right.
A Veteran uses a messaging device to send his medical data to a care coordinator who then reviews the information.

Telephone Replaces 50-Minute Drive

The devices he utilizes at home send his blood pressure, oxygen level and weight information through his telephone land line. This allows his primary care doctor to monitor his health without requiring a daily visit to the Loma Linda Medical Center, 50 minutes away from Hayworth's home in California.

Care coordinators are the immediate contacts for Home Telehealth patients. They provide information and support for Veterans, working closely with patients' primary care physicians. Each coordinator is a qualified nurse practitioner, registered nurse or social worker who helps patients and their caregivers.

"It's a live medical person I can talk to. I feel more involved and in more control with health issues and can see if any part of my health has changed," Hayworth added.

Caregiver Support is an additional feature of Home Telehealth. It is tailored for caregivers of Veterans participating in the program. Hayworth's wife, Connie, has participated in Caregiver Support since her husband began the service and she regularly meets with care coordinators for information and support for her husband.

Eugene Good, 67, is another patient in the Home Telehealth program. After several visits to the Loma Linda Medical Center because of health complications, Good was invited to try Home Telehealth.

As a patient with COPD, asthma and diabetes, Good measures the same stats as Hayworth, and also records his glucose levels to monitor his diabetes.

Come to the Hospital...Now!

On two occasions, the Vietnam Vet was advised to get to the hospital quickly because of abnormal readings on his daily stats. If Good had not sent information about his vitals every day, he may not have noticed any health problems until circumstances got much worse. The VA staff's early detection of abnormal symptoms allowed him time to get to the hospital for treatment.

"I probably wouldn't be here if it weren't for the staff at the VA," said Good when asked about Telehealth. "They take very good care of me - especially when I don't realize I need to be taken care of."

The goal of Home Telehealth is "to make the home into the preferred place of primary care, when it is appropriate to do so," said Dr. Adam Darkins, Chief Consultant of Care Coordination Services at the VA.

"Chronic disease is a very prominent healthcare issue, so we provide case management, coordination of care, and self management education to manage that disease in the Veteran's own environment," added Patricia Ryan, Associate Chief Consultant for the VA Office of Telehealth.

The VA is a world leader in Home Telehealth technologies and currently provides care to over 40,000 patients, which is projected to expand to 75,000 by the end of 2011.

More information about Telehealth can be found on the VA web site.

By Megan Tyson, VA Staff Writer