Two major changes are under way to transform health care in the home. With a grant from the Allyn Foundation, the Cayuga County Home Care Agency in collaboration with Cayuga Health Association was able to purchase five Tele-Health monitoring units. Tele-Health brings medical technology home to patients. The agency began implementing these units in March and all five units have been placed in homes.

The Cayuga County Home Care Agency, a division of The Cayuga County Health and Human Services Department, determines if a patient and their family are eligible for implementation and installation of the home monitoring system. Once the nurse determines that the patient would be a good candidate and benefit from the system, a representative from the association goes to the patient's home to install the unit. While installing and programming the unit, a Cayuga Health Association representative will educate the patient on how to use the system.

The Tele-Health system includes a monitor, scale, blood pressure cuff and a finger sensor. The system will be programmed to start at the same time every day. The monitor will turn on by itself and lets the patient know when it is time to collect their vital signs. Voice prompts and text on the monitor face guide one through each step. After the monitor collects a patient's information, it sends it to the Cayuga County Home Care Agency where a nurse will review the results. The nurse will triage the alerts by telephoning the patient to ask additional questions or request the patient re-test. The nurse will evaluate the findings and inform physicians of any changes in medical orders.

With Tele-Health, daily monitoring of vital signs and weight is possible. Without Tele-Health, the nurse may only visit once or twice a week, depending on doctor's orders and what insurance companies allow. Tele-Health now allows the nurse to monitor and communicate with a patient daily to see how the patient is doing and feeling that day. By communicating daily, a problem can be detected early and resolved much faster.

Once a patient is discharged, a representative from Cayuga Health Association will go back to the patient's home and remove the unit. This unit will be cleaned and then placed in another patient's home. We hope to receive more funding in order to purchase more of these units.

Our goal for patients who use the monitoring system is to increase:

• Reassurance and confidence with their medical care

• Medical stability

• Knowledge of medications

• Improved independence with Activities of Daily Living (ADL)

The Cayuga County Home Care Agency's goals are to reduce:

• Urgent care visits to doctors' offices or emergent care visits to emergency room

• Hospitalization and complications that could occur

The second change will be taking place within the next couple of months. The Cayuga County Home Care Agency will be switching from a paper medical record to an electronic record. The Point of Care Clinical Documentation System will allow nurses to take laptops into the homes, retrieve information and have current patient information for all health care providers.

Elane Daly is director of Health and Human Services for Cayuga County. She can be reached at 253-1560 or cchealth@dfa.state.ny.us