Category: Q&A

Telemonitoring patients at home

Granite VNA, New Hampshire’s leading home health care provider, has launched a telemonitoring program for patients with chronic illnesses. Leveraging advanced tech tools, the program aims to empower patients to proactively monitor their vital signs. Suzanne Olszak, RN, who has more than 30 years of experience in home health care and manages the program, discussed its impact, benefits and future.

Can you provide an overview of your program and its significance in the context of home health care?

We operate a telemonitoring program at Granite VNA, having launched it almost a year ago in October. With my 30 years in home care and a decade in telemonitoring with other agencies, this new program encompasses 50 telemonitoring units. … We provide these patients with a tablet, scale, blood pressure cuff and pulse oximeter for home use. They’re trained to daily monitor and record their weight, blood pressure and oxygen levels. The tablets, equipped with Bluetooth, transmit this data directly to our telemonitoring nurse’s computer. This allows for immediate tracking, enabling us to detect any detrimental trends. … Typically, we monitor patients for approximately 60 days. … If any alarming trends emerge, we communicate with both the patient and their health care providers to proactively intervene and adjust their care plan, to prevent potential hospitalizations.

Who is this program specifically designed to serve and support?

Our focus is on high-risk patients with chronic diseases such as congestive heart failure (CHF), COPD, and high blood pressure, particularly those with medication changes or frequent rehospitalizations. … We solely cater to patients from Granite VNA who have been recommended for skilled nursing or physical therapy. This telemonitoring service complements the assistance provided by their home care nurses and therapists.

What is the primary purpose and intended outcome of this program for high-risk patients?

Our goal is twofold: reduce hospitalizations and empower patients to be more engaged and informed about their health. … The objective is to instill in these high-risk patients — CHF, hypertension, COPD patients — the significance of daily vitals monitoring. We educate them about diet and the critical aspects of their specific condition. Ultimately, we want patients to become autonomous in managing their health, particularly in identifying when they need medical attention. … Our hope is that with this knowledge and monitoring, patients can become more proactive and independent in managing their conditions.

How are the patients adapting to using this technology?

Many patients initially feel nervous about using the new technology, primarily because the majority of our users are elderly. However, they adapt surprisingly well. We provide hands-on guidance, having them practice while we’re present in their homes. The process is relatively simple for most — stepping on a scale or using a pulse oximeter. The biggest challenge tends to be the blood pressure cuff, as it requires positioning the arm correctly and tightening the loop, but we’ve designed it to be as user-friendly as possible.

Does this program help in freeing up time for the nurses?

Absolutely, it does. Instead of requiring multiple weekly visits for nurses to see a patient, the frequency can be reduced to once a week or even every other week. This is possible because a nurse constantly monitors the vitals, and this data is transferred to the patient’s matrix care chart, which is their home care record. … Additionally, patients appreciate this setup since they don’t have to always wait for a nurse to visit, yet they’re reassured that someone is monitoring their vitals throughout the program duration.

Do you plan to extend the program to other medical conditions or broaden its reach in any way?

The decision is primarily made on a case-by-case basis. If a nurse reaches out to me about a patient with a complex situation whom they believe would benefit from this technology, I’m fully on board with setting it up in their home.

Featured photo: UNH system libraries are located in Manchester, Durham, Keene and Plymouth. Courtesy graphic.

University libraries lend to all state residents

University libraries have traditionally been reserved for students and faculty. However, the University of New Hampshire (UNH) has expanded access to its resources, now allowing the broader community to utilize its collections. We spoke with Tara Lynn Fulton, Dean of the UNH Library, to delve into the reasons behind this decision, the response from the community and the implications for academic libraries in the future. New Hampshire residents (18 years old and older) can obtain library cards from USNH campuses with valid identification and proof of residency. Visit library.unh.edu.

Why did you decide to start offering free borrowing to New Hampshire residents?

First, to offer some broader context: We have public libraries in communities across the state. … If someone requires more in-depth research that their local library can’t fulfill, these libraries offer interlibrary loans. We’ve always participated in this, lending materials. Each of our libraries also traditionally had a small regional group that could obtain library cards. This isn’t a new initiative; most people have relied on their public libraries. But for individuals like writers or high school students involved in advanced research, it’s been a beneficial service. Our primary mission is to serve the campus: our students and faculty. Historically, this meant physical collections like print books, DVDs, and other materials. As the digital era has progressed, more of our collections have transitioned to e-books and digital media. During the Covid era, with a shift to remote learning, our faculty leaned heavily into these electronic resources, and the need for physical materials lessened. This made me wonder: Why not open up our resources more widely? I brought this up with other library directors from the University System of New Hampshire, and they were all on board. Hence, the initiative evolved.

Have you seen an uptick in borrowers?

Several people got cards as soon as the news spread. It’s not a vast number, but for those who wanted it, it’s been valuable. I’ve seen a few people walking around in the library. One individual mentioned how they appreciated the chance to check out materials and were also grateful to know they’re welcome in our building. This offering has reinforced to the community that our facilities are open and available for their use.

What distinguishes your library’s materials from those in a typical town library?

Our library’s core focus is to serve the university by providing materials that support higher education. While town libraries offer a general assortment of classic literature and popular reads, our collection delves deeper, especially into areas like English literature and American literature. The depth varies based on campus programs; for instance, the Durham campus emphasizes science, so we have a substantial array of historical physics materials. We have extensive collections, including non-circulating special ones, such as an in-depth history of New Hampshire, invaluable for researchers or authors seeking historical accuracy. Campuses like Keene and Plymouth, historically centered on teacher education, provide resources beneficial for educators, such as specialized teaching methods for specific grades.

Is there a plan to digitize the special collections, extending their accessibility?

We’re taking progressive steps to digitize, ensuring we adhere to copyright constraints. A notable accomplishment from the past year is digitizing New Hampshire’s town reports in their entirety, which has been well-received. Most of our digitized collections can be browsed on our website.

Do you think other universities might adopt a similar approach, opening their libraries to local residents?

This might differ from state to state. New Hampshire’s tight-knit nature promotes a strong bond between universities and communities. Our effort seems like a logical progression in this partnership. While I’m unaware of similar endeavors in other states, the global trend moving away from print materials might inspire similar initiatives. We’d be delighted to be trailblazers in this movement.

Featured photo: UNH system libraries are located in Manchester, Durham, Keene and Plymouth. Courtesy graphic.