South Shore VNA’s Telehealth Program Reduces Readmissions and Improves Patient Outcomes

The standard equipment used for telehealth patients includes a scale, pulse oximeter, blood pressure cuff, and a tablet
The standard equipment used for VNA telehealth patients includes a scale, pulse oximeter, blood pressure cuff, and a tablet.

South Shore Visiting Nurses Association (VNA) was ahead of its time when the pandemic brought telemedicine to the forefront of healthcare.

What started in 2006 as a program with one nurse and 30 machines has grown to include coverage seven days a week using medical equipment that has the capacity to remotely monitor up to 175 patients – an approach shown to reduce hospital readmissions and ensure the appropriate utilization of home visits. 

Patients with chronic medical conditions that can be managed at home, such as chronic obstructive pulmonary disease (COPD) or congestive heart failure (CHF), are typically referred to the VNA's telehealth program.

The VNA equips the patient with the devices needed to provide remote monitoring by our nurses, including a scale, a pulse oximeter that measures the blood's oxygen levels, and a blood pressure cuff.

An accompanying tablet transmits the daily readings to our nurses who closely follow these patients.

The goal of the telehealth program is not necessarily to detect an emergency in the moment, but to prevent one.

By collecting and reviewing a patient's basic health data, such as blood pressure and weight, nurses are able to establish a baseline and detect deviations that might preclude an acute health event.

This information allows them to intervene, consult with the other members of the patient's care team, and potentially avoid a poor outcome, such as hospitalization or a decline in health status.

“In addition to seeing our patients in their homes, we are able to have eyes on them remotely and are talking with them on the phone frequently," says Nancy Daly, RN, who has coordinated the telehealth program since its inception. "We know what's normal for them and what is not. Our patients get to be engaged in their healthcare, and it gives them a sense of comfort knowing they're being watched closely."

The telehealth program not only gives patients the opportunity to actively help manage their health and gives family members additional comfort that their loved ones are being monitored, it also enables the VNA to optimize its own resources while improving the appropriate utilization of other health services around the system.

Telehealth patients average about seven visits a month, while non-telehealth patients usually require closer to 15 visits. Because the nurses are getting data on their patients remotely seven days a week, they can prioritize each day's home visits for those patients who need them the most.

Further evidence of this program's benefits is demonstrated by the fact that the re-hospitalization rate for telehealth patients is about half that of all other VNA patients.

Readmissions to the hospital are costly, stressful for the patient and their families, and can contribute to volume challenges for providers.

“Our telehealth program has demonstrated itself to be beneficial to both patients and the health system," says Tammie Ryan, Director of the South Shore VNA.

Did you know...?

  • The South Shore VNA serves more than 30 communities across the region.
  • VNA caregivers conducted more than 141,000 visits last year.

Learn more about the South Shore VNA.