New device helps monitor heart patients at home
Vital signs sent through phone lines to doctors save on hospital visits
The Detroit News

YPSILANTI - Ernest Williams walks up to the scale in his bedroom and pushes a button on its waist-high electronic display. The scale starts talking. It asks Williams in a tiny, digitized voice: "Are you short of breath? " The 80-year-old retired tool maker from Ypsilanti pushes the "No" button on the scale's display. His daughter, Lillian, 51, supervises. The scale continues to quiz Williams about his health. After he's answered all of its questions, he steps on its base. In seconds, the machine tells him he weighs 167.8 pounds - and points out that he's more than 4 pounds over his doctor's prescribed weight limit. Then, the scale sends Williams' responses and weight over a phone line to his doctor at St. Joseph Mercy Hospital of Ann Arbor, more than 20 miles away. The device is a high-tech tool that doctors are using to keep people who have congestive heart failure (CHF) like Williams out of emergency rooms and improve their health. The scale allows doctors to track the weight of CHF patients daily and warn them before it becomes a serious problem.

"One benefit of this new system is our ability to monitor the condition of our patients on a daily basis without the patient having to leave their home," said Lakshmi Halasyamani, one of Williams' doctors at St. Joseph Mercy Hospital. The health system started using the scale with CHF patients a couple of months ago. "Should a problem arise, the system notifies us so we can immediately treat patients, rather than waiting until symptoms worsen to the point of an emergency room visit and possible re-admission," she said.

People with CHF have weakened hearts that don't pump enough blood as well as they should. It's brought on by years of high-blood pressure, clogged arteries or other medical problems. People of all ages live with the condition, but it's more common in senior citizens. Congestive heart failure is fast becoming a major health concern for Americans. Nearly 5 million people live with CHF, the American Heart Foundation reports. The group also says more than 550,000 new cases are reported yearly and it expects that number to grow as the population ages. Half of those diagnosed with CHF will die within five years, according to the National Heart, Lung and Blood Institute in Bethesda, Md.

One of the symptoms of the condition is edema, where the body retains excess amounts of fluid in its muscles and organs. As a result, CHF patients often have swollen legs and ankles and fluid in the lungs. The excess fluid forces an already weakened heart to work harder than normal to circulate blood, they keep other vital organs from getting enough oxygen and nutrients and they hinder a body's ability to remove wastes. All of which make the incurable condition lethal. But if doctors can catch edema early enough, they can adjust medications - usually diuretics that remove excess salt and water from the body - to treat the problem. That's where the scale - designed by Cardiocom LLC, a disease management product and services company based in Minneapolis - comes in. Each morning, CHF patients use the device - the Cardiocom Telescale - and answer a series of questions about their symptoms and health before they weigh themselves. The Telescale is accurate to a tenth of a pound and can measure even the slightest increase in weight. It's also equipped with a modem, so it can transmit patients' data every day to a special computer at their hospitals, their doctors' offices or their health insurance companies. There physicians and nurses keep track of weight gain caused by edema. If patients fail to weigh themselves, or their machines identifies a health problem, they automatically alert medical professionals via their computer terminals.

"We designed it to be as easy as possible for people to use," said Daniel Cosentino, president of Cardiocom. "And we designed it so that it doesn't disrupt CHF patients' daily activities." Over the last couple of years, hospitals in Florida, Illinois, Minnesota and Ohio have used Cardiocom's scale. With the addition of St. Joseph Mercy Hospital of Ann Arbor, Michigan has two using the device. CHF patients in the Covenant Health Care System in Saginaw have used them since since 2000. The technology appeals to hospitals because it not only improves their CHF patients' chances for longer lives, it helps health systems save money. For example, St. Joseph Mercy Hospital admits 600 CHF patients yearly at an average cost of $7,000 per patient. Of those, 15 percent of them are re-admitted to the hospital in 30 days, costing the hospital an additional $630,000 for which it often isn't reimbursed.

For Williams, you can't put a price on what the scale does for him. "It saves me from having to go into the doctor's every day to get weighed," he said. "I like it."