On Thursday, May 4, Harriett Ramsey recorded her blood pressure, her weight and received one-on-one medical consultation from a registered nurse. This is all standard procedure for a trip to the …
On Thursday, May 4, Harriett Ramsey recorded her blood pressure, her weight and received one-on-one medical consultation from a registered nurse. This is all standard procedure for a trip to the doctor’s office, so why does it matter?
She never left her home.
For Ramsey and more than 100 other local patients, healthcare has changed forever. Horizon Health’s Mobile Integrated Healthcare (MIH) and Remote Patient Monitoring (RPM) programs are nothing new for many urban hospitals – but they are groundbreaking for rural areas like Edgar County.
Horizon Health’s MIH program took off in November 2020, modeled after a similar program used at Carle Hospital in Urbana prioritizing patients with congestive heart failure. Horizon’s program does the same and has expanded over time to accommodate patients suffering from COPD, hypertension, diabetes, pulmonary fibrosis and COVID-19.
“We knew all along that there was a need for it in the community, to go out to the patients' homes,” said Nic Thomas — an advanced practice registered nurse and one of the first paramedics to make in-home visits as a part of the MIH program. “(We want to) kind of help keep them out of the hospital, keep them out of the ER, those kinds of things.”
The RPM program complements Horizon’s MIH offering, equipping patients who suffer from chronic conditions with tools to monitor their blood pressure, oxygen levels, weight and other health metrics from their own homes. The data is monitored by Cody Muchow, MIH/RPM program coordinator, registered nurse and paramedic.
Ramsey, an 88-year-old MIH and RPM patient with congestive heart failure, enjoys frequent visits with Muchow in the comfort of her own home. After one of her physicians recommended she enroll in both programs, Ramsey exchanged the doctor’s office for the warmth and comfort of her lakeside home, her trinket collection and her dog.
“I really do like this. It makes me feel safer,” said Ramsey of the program, adding, “Anytime I need him (Muchow), all I’ve got to do is pick up my phone.”
Ramsey suffered a heart attack in 2013, requiring doctors at Carle Hospital to place a stint in her heart. When her heart rate dipped to just 40 beats per minute in August 2022, she spent eight days at Horizon Health.
Eventually, her care provider recommended she enroll in MIH and RPM. When asked if the program has reduced her return visits, Ramsey was quick to answer.
“I definitely think so.”
Ramsey uses a scale and a blood pressure cuff to ensure her medicine is doing its job. While the results of her daily measurements go straight to Muchow, her direct participation in her healthcare journey motivated her to keep a record of her numbers as well.
“Even though Cody and them do that, I still like to do that myself,” Ramsey said, later adding. “I try to watch what I eat and exercise.”
Stories like Ramsey’s motivate the MIH/RPM team. Monitoring a patient’s health remotely ensures faster feedback and can help patients minimize emergency room visits and follow-up appointments.
While the program is especially helpful for the elderly, or patients who struggle to find consistent transportation, Muchow also finds it particularly helpful in providing care for younger patients. His youngest patient is 22.
“These aren’t just programs for the elderly. We see a lot of younger adults,” he said. “I think younger people don’t always accept the fact that they have health problems, or they don’t go to the doctor a lot… So being able to do stuff electronically and not having to come to the hospital makes it a lot easier on them.”
Both the MIH and RPM programs are seeing staggering success. Patients enrolled in the programs have seen an average blood pressure drop of eight points in systolic pressure and seven points in diastolic pressure over the last 12 months — a figure which leads all similar programs nationwide according to CareSimple, a company partnering with MIH providers throughout America.
Horizon Health’s success becomes more impressive considering the area in which they operate.
“This (MIH) is popular in the urban area because the resources are more plentiful,” said Samantha McCarty, Director of Critical Care Services at Horizon Health. “But in the rural setting you’re working with very limited resources, staff, money, and your patients are more widely spread out.”
Thomas and Muchow will travel to French Lick, Ind., on June 13 to share their insight and experience on bringing mobile health to rural patients at the 25th Annual Indiana Rural Health Conference.
Even with the program’s success, however, some roadblocks remain.
While Horizon Health has ballooned in size over the last few years, Paris’ population has not. Medical program graduates often look to urban areas for work due to higher pay and visibility, so finding staff to expand the programs’ coverage will likely take time.
This compounds the logistical issues Muchow currently faces. Horizon’s MIH program covers an area extending from Georgetown in the north, West Union in the south, Charleston to the east and all the way to the Indiana border.
Muchow can spend hours of his day on the road.
McCarty hopes to devote additional resources to the program if it continues to grow.
“I would say in 2024 we will look at if the program is continuing and successful… we will take a look at additional staffing,” she said
Finally, connectivity issues for devices can also affect patients. All of Horizon Health’s monitoring equipment uses cell service to transmit data, but in some areas, reception is spotty or nonexistent, even within Paris city limits.
“There are several places in Paris where there is no service,” said Muchow, who commonly travels to a home just to reposition monitoring equipment and transmit patient data back to the hospital.
Still, Muchow, Thomas and McCarty are optimistic about the future of the program and are encouraged by the impact it has already made. For patients like Ramsey, the program saves time, money and preserves peace of mind in the face of challenging health conditions.
MIH and RPM simplify the flow of information to a patient, drastically decrease return visits and encourage patients to take ownership of their health.
Most importantly, it helps patients heal.
“This is their (Nic and Cody's) purpose and their passion,” said McCarty. “They both are very connected to their purpose of providing quality health care and meeting people where they need to be met, not forcing them into a box.”