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Monday, April 14, 2014

Tele-medicine allows for virtual house calls from doctors and nurses

David Brooks

Tele-medicine sounds pretty futuristic – doctoring over the Internet! – and you can be sure that Wednesday’s Science Cafe will embrace a Jetsons-like vision, thanks to participation by Nashua’s VGo robotics firm.

But the monthly eat-drink-and-be-knowledgeable gathering will also contemplate tele-medicine’s present, and to some extent its past. ...

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Tele-medicine sounds pretty futuristic – doctoring over the Internet! – and you can be sure that Wednesday’s Science Cafe will embrace a Jetsons-like vision, thanks to participation by Nashua’s VGo robotics firm.

But the monthly eat-drink-and-be-knowledgeable gathering will also contemplate tele-medicine’s present, and to some extent its past.

“We’ve had tele-health for about 9 years,” said Lisa Snow, a registered nurse with Home Health & Hospice Care in Merrimack who will be one of the panelists on Wednesday evening at Killarney’s Irish Pub in Nashua, starting at 6 p.m.

The service has 43 units made by Phillips that it gives to Medicare patients at high risk for heart failure and heart disease. Patients take their own blood pressure, blood-oxygen level and weight daily, and the unit encrypts the data and sends it over the phone line to Snow’s computer.

“I can see results based on individually set parameters per patient,” said Snow. “The idea is to get a nurse visit more appropriately, when they need it rather than just saying I’m coming out every Monday and Thursday.”

The goal is straightforward: Keep sick people at home as long as feasible.

“We’ll see that they’ve gained two pounds overnight and we want to assess that fluid overload, before they end up in the hospital,” she said.

This isn’t exactly cutting-edge technology, Snow said, noting that it requires a landline phone connection. But it works, which is why the service will expand to 45 until this July. Further expansion is limited by money because of Medicare rules.

“It is a costly endeavor for us; it is not reimbursable. That’s why we only target certain patients,” said Snow.

The service is in talks to upgrade equipment to units that will work over cell-phone networks. What they’d really like in this era of Skype and online meetings is a video service to the home.

“We are hoping to do that in the future,” said Snow. As a benefit, she noted, “We could open it up to some of our wound care patients, see what the wounds look like without bringing them in or making a visit.”

VGo takes that idea further. Its tele-presence robots work sort of like Skype atop a remote-controlled Segway. Using them, a doctor or nurse can not only look at and talk with the patient but move around inside the patient’s home as needed (although stairs remain an obstacle). Some systems can even dispense pills on command.

Medicine has become one of the major markets for this brand-new industry.

Along with the obvious benefits, tele-medicine has potential drawbacks particularly if it comes to replace human contact rather than augment it. And it certainly has the possibility of just adding more expensive geegaws to health care, which has no shortage of them

Of course, any technology has potential drawbacks that deserve intelligent consideration – which is good, because intelligent consideration is what Science Cafe does best. That, plus eating and drinking.