FirstHealth's telehealth program began as an innovative idea from the medical professionals in FirstHealth Home Care.

It received early support from the Foundation of FirstHealth and was later expanded with a grant from the Duke Endowment.

In five years, the telehealth service has benefited more than 3,000 patients in Moore, Montgomery, Richmond, Scot-land, Lee and Hoke counties.

A three-year, $750,000 Telehealth Network Grant from the U.S. Department of Health and Human Services (DHHS) will now allow the program to reach even more patients.

"When we first started imagining the possible benefits of telehealth monitoring for home care, we had no idea that, in just five years, we would be making a difference for so many patients," says Patty Upham, director of FirstHealth Home Care Services. "This program is an example of the successes we can achieve when we work together. The vision and financial support of the Foundation of FirstHealth enabled us to take the first step and launch a program that has improved health care throughout the communities we serve."

Telehealth is the wave of the future for home health care. Using simple, easy-to-understand computer technology, patients transmit specific health information over their home phone line to a centralized monitoring station where it is read by qualified medical personnel. Anything unusual is noted, and appropriate follow-up is scheduled.

Telehealth monitoring not only enables the Home Care staff to stay closely connected to patients even when they are not actually in the home, but it also helps patients understand how to better manage their own health.

"As patients or caregivers send us the information each day, they begin to recognize how simple actions make a difference in their health," Upham says. "They make the connection between the country ham biscuit that they ate for breakfast and their elevated blood pressure. One of the unexpected advantages of telehealth is the educational opportunity it provides for our patients and families."

FirstHealth's telehealth service, which uses equipment provided by ViTel Net of McLean, Va., began with a pilot program funded by the Moore Regional Hospital Foundation. The pilot worked so well that FirstHealth and the Foundation partnered to purchase 18 telehealth units and four digital camera kits to be used for wound assessment.

A $250,000 grant awarded through the Duke Endowment in the summer of 2006 allowed FirstHealth to acquire 70 additional monitoring units for a total of 90 as well as four additional high-resolution digital cameras. Funds also assisted with employment of a full-time telehealth nurse coordinator to manage the program.

The new grant will allow the program to add at least 50 monitoring units and support the addition of three staff members: a coordinator, a community liaison and a technician.

"To optimize this service, we are networking with the FirstHealth Emergency Departments and Family Care Centers, area health departments and the Moore Free Care Clinic," Upham says. "When we work as a team, our patients score. It's a winning combination."

The success of the telehealth program at FirstHealth is in no small part due to the financial support of the Foundation of FirstHealth.

"This program is an example of how our Foundation members' investments affect the quality of life and health in our communities," says Kathleen Stockham, president of the Foundation of FirstHealth. "We provide the dollars that support the ideas and nurture them into sustainable, successful programs that make a real difference. Our initial $20,000 investment has reaped great returns for our patients. The outcomes speak for themselves."

Telehealth monitoring helps keep patients at home, where they want to be. One of the primary goals of home care involves reducing admissions and emergency department visits.

According to data collected over the first six months of the program, the overall agency rate for home care hospitalizations was 25 percent while the FirstHealth telehealth rate was 18 percent.

For emergency department visits, the overall average agency rate was 20 percent while the rate for telehealth patients was just 14 percent.

"Our overall hospitalization rates consistently remain below the state and national averages," Upham says. "Our patients are very happy with the program. We are able to detect subtle changes before they become real health problems. We believe that this program is making a difference, and our patients prove it."

Here are a couple of examples:

n A 68-year-old female with high blood pressure recently added telehealth monitoring in her home. Her blood pressure started out normal, but began to trend upward over time. The Home Care nurse was able to contact the patient's doctor and make medication adjustments without a trip to the office or the hospital. The patient now reports feeling much better.

n A 73-year-old male with chronic obstructive pulmonary disease (COPD) has been a telehealth patient since early September. His wife, who is his caretaker, is nervous about his condition. When his oxygen levels fall below the accepted numbers, the monitoring nurse can help assess his condition.

Telehealth does not replace nurse/patient contact. Instead, it extends the resources of home care organizations and offers daily interactions that benefit each patient.

Nationally, patients who use telemedicine are found to become more self-aware and gain invaluable knowledge about their medical conditions and overall well-being.

In addition, the tools help the telehealth staff to make accurate, data-driven decisions that improve care and reduce recovery time.

Every patient who is admitted into FirstHealth's Home Care program is considered for telehealth eligibility. Patients stay in the program as long as they are eligible for home health services. The average length of participation is about 40 days.

"The nurse/patient contact will always be the most important part of what we do," Upham says. "We cannot replace that. This technology simply gives the nurse another tool, a very powerful tool, to improve the quality of patient care."