Robotic telepresence pilot seeks to improve patient outcomes and reduce costs
The term "robotic telepresence" in home healthcare might give pause to even the most up-to-date technology junkie. Rest easy. It doesn't refer to a Skype meeting with Rosie from "The Jetsons." Though it is something akin to what we're seeing from NASA's Martian rover.
The Visiting Nurse Association of Vermont and New Hampshire is using the technology to find more efficient and cost-effective ways to deliver specialty care to patients in its rural service area, a 4,000 square-mile stretch of the Connecticut River Valley.
"We're finding patients are getting discharged earlier and need more acute care," said Craig Amoth, the group's director of development and community relations. "We want to bring all of our resources to bear to keep patients in their homes, and help provide positive outcomes."
The VNAVNH cares for more than 5,000 people each year, making over 132,000 home visits. Travel time between patient homes is a growing concern.
Amoth's group turned to New Hampshire-based VGo Communications, which makes a four-foot-tall wheeled device called a VGo that has Wi-Fi, an LCD display, high-quality cameras and audio equipment on board.
For VNAVNH's pilot, a typical scenario has a visiting nurse bring a VGo unit into a patient's home. Using Wi-Fi, the unit provides a video conference-like connection to a wound-care specialist at the home office. The specialist can remotely drive the unit down a hallway in the patient's home, say, to track a patient's movement, or drive around a bed or chair to change the specialist's vantage point. The specialist then assesses the patient's condition and directs nursing care.
"We want to enhance the care we're already providing," said June Manley, clinical director of maternal and child health and high-tech programs at VNAVNH. "We want to catch infections before they get out of control, and maybe prevent a patient from being badly infected, where they have to be readmitted."
While there are no hard numbers yet on the projected cost savings of using robotic telepresence technology, savings may be found in better outcomes, which reduce hospital readmission rates.
The technology also allows for more efficient use of higher-cost staff specialists and savings on items such as cost of transportation.
"Sometimes it can take two hours to get from place to place," Manley said. "If everything works as we'd like, the VGo will reduce man hours and allow us to deliver care faster and problem-solve faster."
"For about $10 a day," said Peter Vicars, CEO of VGo, in a press release about the pilot, "(VNAVNH) nurses can visit more clients, spending more time with each one and less time on the road."
The pilot that began in September uses four units, with an initial focus on wound care assessment and treatment consultation. Additional uses could include care for clients recovering from surgery or with complex medical needs, clinical specialty support, and consultation for chemotherapy, antibiotics, hydration or other infusion therapies.
The pilot will help VNAVNH determine how well the technology works in its service area, how it is received in patient homes, and how attendant telemedicine reimbursement coverage would need to evolve to make use of the technology worthwhile.
"It's cutting edge because there isn't a lot of wide-scale research collecting information on technology like this in this setting," said Latoya Thomas, the associate director of the Home Care Technology Association of America. "While there may be standards on how a particular device should be made, there are no rules yet for how it should be used.
"(Industry leaders) are still getting their hands around how to use technology like the device in this project. Pilots like this are very welcome."