Cleveland Clinic Pioneers E-Medicine for Heart Patients

E-medicine is advancing far beyond online doctor visits. An innovative Cleveland Clinic telehealth monitoring program called Heart Care @ Home allows heart patients to provide a team of Cleveland Clinic heart care specialists key vital signs — including daily weight, blood pressure and heart rate — for up to 40 days from the comfort of their homes. The program also provides patients with traditional home health services — including access to nurses, aides, nutritionists, social workers and physical therapists —as well as patient education via the monitoring technology and by phone.

After leaving the hospital, patients get a wireless monitoring box installed in their home. The box is connected to a digital scale, blood pressure cuff and other items that track vital signs. Once daily, patients send their vitals, via a landline, to clinicians. Two pounds of weight gain within a day for these patients can portend trouble. Nurses can now help patients head off early signs of problems and advise them accordingly.

"We're trying to coordinate care and create a virtual care unit without walls," says Cleveland Clinic cardiologist Eiran Gorodeski. Heart Care @ Home, a joint effort of Cleveland Clinic Home Health and the Heart and Vascular Institute of Cleveland Clinic, aims to help certain older patients with heart disease care for themselves better so they don't have to be readmitted to the hospital.

The program has come into being just as Medicare is encouraging hospitals and doctors to step up efforts to avoid preventable patient readmission to the hospital.

According to the Cleveland Clinic, Heart Care @ Home has reduced hospital readmissions and provided patients the tools to monitor their vitals and keep health-related journals while they are in the program, resulting in better behavioral change.

"I truly am a miracle a walking," says Karen Mathis, 63, of Oakwood Village, Ohio, who was largely immobile and told to consider hospice before she entered the Heart Care @ Home program in July 2009. "Now I'm walking and driving. I've come a long way."

"This is important, it does help and it is not hard to use," says Mathis. Without it, "I probably wouldn't have been around by now."