Liz Unruh: Hello, listeners, and thanks for tuning in to the Well Within Reach podcast brought to you by Riverside HealthCare.

I'm your host Liz Unruh and joining me today is Peggy Riegas, who is the director of our Home HealthCare division. Thanks for joining me today, Peggy.

Peggy Regas: Thank you, Liz, having me.

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Liz Unruh: Yeah, we're happy to have you on the show today. We're going to be talking about patient, monitoring remotely for specifically cardiac patients.

But before we get into that, can you tell us a little bit about

Peggy Regas: yourself? Sure. As you mentioned, I'm the Director of Riverside Home Health Care. I am responsible for administration and operational oversight of our home health agency. My career here at Riverside Medical Center began in 2002, working in a few areas, home infusion, outpatient infusion services, in the past 16 years, home health care.

I'm an active member of several home care associations, including the National Association of Home Care and Hospice and Illinois Home Care and Hospice Council. February is Heart Month and I am delighted to share some information about Riverside Home Health Care and our remote patient monitoring program for cardiac patients.

Liz Unruh: Yeah, and we're excited to have you. so before we get into specifics about cardiac patients, can you explain a little bit about what remote patient monitoring is?

Peggy Regas: So our home health agency, we partnered with Health Recovery Solution, also known as HRS, in 2021. With our partnership, our agency is able to provide the necessary technology to monitor patients safely at home. Remote patient monitoring, this is a program that equips providers with the necessary tools to care for their patients in their home with real time access.

Our particular program has an easy to use platform and technology to provide the patients the confidence they need to manage care in their home. The program provides Bluetooth peripherals, such as blood pressure monitoring, a scale, pulse oximeters, and an option to provide a thermometer as well.

Within the kit, the patient will also receive a tablet. It has educational material, an ability to provide virtual visits, and diagnosis specific care plans. Our home care agency has a dedicated nurse that monitors patients vitals and symptoms. daily working very closely with the patient's doctor reporting any changes.

The program is designed to help transition patients safely home and to empower patients to learn how to manage their vitals independently after discharging from the Remote Patient Monitoring Program in Home Health Services.

Liz Unruh: Great. That's a lot of really great information. I know when I first heard, remote patient monitoring, I'm like, Oh, is it going to be like Big Brother and watching over me?

But no, it's just checking those vital signs and making sure that any changes are being reported so that your care team can follow up and make sure that you're still on the right track for sure.

Peggy Regas: That's correct.

Liz Unruh: So obviously before you're sent home with remote patient monitoring, you're probably going to have.

some type of procedure done. And today we're talking about cardiac patients. Can you talk to us about what kind of procedures, someone, might have had to have cardiac remote monitoring?

Peggy Regas: Sure. Let's talk about remote patient monitoring for cardiac care. Remote patient monitoring can be ordered after any cardiac procedure or chronic illness or heart disease.

The most common procedure is a coronary artery bypass graft, which is, commonly known as the CABG procedure. Another procedure is the transcatheter aortic valve replacement. That's commonly known as the TAVR procedure. These are surgical procedures used to treat coronary heart disease right here in our own community.

Another diagnosis specific illness commonly monitored is for heart failure. We are very fortunate to work closely with Sherry Rogers, an advanced practice nurse at Riverside Heart and Vascular Institute in our dedicated heart failure clinic.

Liz Unruh: Yeah, I know Sherry's been on our podcast before, so definitely go back and check out some of Sherry's podcasts about heart failure.

It's definitely a, great program and Sherry does a great job, making sure that her patients are monitored at home and have that empowerment that you talked about and owning their vitals and understanding the importance of those. so you kind of touched on it. How does remote patient monitoring support the transition from the hospital to home for the cardiac patients?

Peggy Regas: Having a cardiac procedure and being hospitalized and then transitioning home, it can be overwhelming not only for the patient but their caregiver their family. So we want to safely help with the transition to home and reduce any fears. If a patient qualifies for home health services, that is, a patient has an intermittent skilled home health need, is homebound, meaning patient has a taxing effort leaving their home needing assistance, is ordered by their physician, and the patient is agreeable, we would then enroll the patient in Remote Patient Monitoring Program.

While in the program under Home Health Services, our team of clinicians closely monitor to ensure vitals maintain inside parameters with blood pressure along with weight monitoring. Feedback we've received from patients that have been on service have been very positive. Having the Bluetooth peripherals in the home provides them with the comfort of being monitored and cared for, with a safe transition from hospital to home.

Liz Unruh: Yeah, I think that's really important. So having that safe transition and then knowing that there's probably a way that home health probably enhances the post operative care experience for not only the patient, but also the provider. Could you kind of touch on

Peggy Regas: that? So for the patients, it's a daily look into vitals and symptoms.

With the tablet, there are many educational videos and quizzes to help learn about their disease or illness and how to better manage to remain at home. Home is where everyone likes to be. So talking with Jennifer Dole, an advanced nurse with CTVSA group, she shared with me and I quote her.

The remote patient monitoring is an invaluable tool for us as providers to be able to assess and evaluate patients from their home environment. The data collected from remote patient monitoring helps with early identification of problems to help reduce rates of emergency department visits and hospital readmissions.

Plus, Remote Patient Monitoring helps guide clinical medical decision making to optimize patient status, ensuring the best possible outcomes. Jen also shared, she looks at her patient's Remote Patient Monitoring numbers at every office visit. This is a true statement of how Remote Patient Monitoring enhances the post operative patient experience.

Yeah,

Liz Unruh: for sure, being able to keep up with those vitals, not just when you're sitting in the office, but to look back at kind of the history and be able to pinpoint, okay, this is where the issue might have started is, really important, in that post operative care.

Peggy Regas: And it's that real time access. So they have real time access to the patient's vitals.

Liz Unruh: Yeah, I think that's really important. So They get that real time access through the technology we provide. So you touched on there's a tablet and then there's a few pieces blood pressure cuff and some other pieces. Can you talk about the technology behind the remote patient

Peggy Regas: monitoring? And as I mentioned earlier, with our partnership with HRS, remote patient monitoring kits, they're delivered right to the patient's home.

So within the box or the kit that the patient receives at home for cardiac care, for the cardiac care follow up, there's a scale, a blood pressure cuff. a tablet, and a PulseOx. So, these devices, they're FDA registered. They're certified with 4G LT multi carrier capabilities. What's this mean? This means all devices work regardless if the home has internet services.

So, a patient does not have to have internet services. and all reminders on the tablet are announced audibly and displayed on the screen. And each tablet has 25 languages and over 90 care plans.

Liz Unruh: I think that's amazing. Just being able to serve not just English speakers, but any of the languages that tablets provide is huge because I know that's a big barrier often for people as need the care, but we can't provide it to them in the language that they need.

But this is a great Great tool for them to use.

Peggy Regas: Yeah, 25 different languages. Yeah, that's

Liz Unruh: crazy. I think I speak English sometimes well. There are some times when I'm like, oh man, I know English is my primary language, but that is not, apparent sometimes. But, are there specific vital signs or metrics that are particularly essential for monitoring the cardiac patients through this remote monitoring system?

Peggy Regas: Yes, there are specific vital signs that are essential to monitor in, the cardiac surgery patients through remote patient monitoring. So we're closely monitoring blood pressures, making sure blood pressures are not too low or not too high. For cardiac patients, it's also very important to monitor weights.

So if a patient's weight increases, this can be a sign of fluid overload and can negatively impact the heart and the patient's breathing. So in some cases, we're also monitoring oxygen levels.

Liz Unruh: Yeah, I know the weight fluctuation is something that Sherry talks about in the heart failure clinic a good amount is that's a key indicator that they look at for the fluid levels as she mentioned podcast.

we're going to take a quick break. To talk about finding a primary care provider, Riverside knows that your health is your greatest asset and that your primary care provider is your partner in health. Find a primary care provider that fits your need at riversidehealthcare. org backslash primarycare.

And we're back! So, as a cardiac surgery patient, what are some of the benefits of participating in remote patient monitoring?

Peggy Regas: Some of the benefits include helping with lifestyle changes, with daily monitoring, education on do's and the don'ts, and some meal choices. At Riverside, we're very fortunate to work with our heart and vascular team, the Cardiothoracic and Vascular Surgery Associates, like Dr.

Pat Pappas, Dr. Phil Alexander, and Jennifer Dole, the advanced practice nurse. from their perspective, they like all of their post surgical open heart patients to utilize the remote patient monitoring program during their initial post operative recovery period, which is the first four to six weeks.

after surgery. Another benefit of remote patient monitoring program was the positive impact on reducing the 30 day re hospitalization. Last year, we had a 26. 4 percent reduction in re hospitalization with the utilization of remote patient monitoring. That speaks volumes of the benefits of remote patient monitoring.

Liz Unruh: It really does because Like you said earlier, people should be recovering at home. they don't want to go back into the hospital. So being able to keep track of this definitely is key.

 How does remote patient monitoring contribute to early detection of potential complications or issues post surgery?

Peggy Regas: So early detection is key to a successful recovery. Liz, like you mentioned, we want the patients to remain in their home. And monitoring blood pressures, weights, and oxygen levels daily.

this provides an early detection of potential complications of possible low blood pressures or too high blood pressures, increased weight, like we talked about before. Physicians, they can reach out to the patients much sooner than waiting for a scheduled office appointment and be treated at home. We want to treat in the home and avoid, an unwanted emergency room visit or rehospitalization.

Yeah, we don't want

Liz Unruh: to increase their stress as they're trying to get better. We want them to be comfortable and get better quickly and efficiently, because that's what we would want for our loved ones. Are there any challenges or limitations associated with implementing remote patient monitoring in our patient population in this

Peggy Regas: area?

So, a potential limitation, which doesn't happen often, but if a patient may live in a remote area where they may not have an internet connection, that may be a limitation, though, it's very rare. The biggest challenge we find in patients are not, being familiar with a program and not wanting to enroll in the program or fear of technology.

So, we try and reduce those challenges. Prior to discharging from Riverside Medical Center or any other facility, if home health is ordered, our home health intake coordinator will talk with you and explain the program and show you the kit to lessen those fears. So we must remember the remote patient monitoring, it's easy to use with advanced technology.

It's simple as turning on the tablet. Signing the consent, stepping on the scale, placing the blood pressure cuff on your, arm, or placing the pulse ox on your finger. Vitals, they're automatically transmitted and monitored and are visible to your doctor. early detection will avoid an unwanted re hospitalization or emergency room visit.

I am hoping by sharing information on remote patient monitoring with you today, during Heart Month, you have a better understanding of the benefits of the monitoring in your home. Liz, we really want the transition from hospital to home to be a positive experience.

Liz Unruh: Yeah, I definitely, think your team does a great job on that transition and I love that you go into the hospital and you show the patients what it is because there are a lot of people that are like, oh, technology, no, I'm not good at it, I can't do it, but showing them that, you know, it's easy to use is definitely a huge benefit.

Peggy Regas: it very much is and as simple as turning on the tablet.

Liz Unruh:Well, is there anything else that you'd like to add today?

Peggy Regas: I'd like to thank everyone for taking the time to listen today and your time today, Liz. and for additional information, I'd like to provide Riverside Home Health Care, phone number. We could be reached at 815 935 3272 for any additional help questions you may have.

Liz Unruh: and thank you for joining us as well, Peggy, and thank you for tuning in to the Well Within Reach podcast with Peggy Regas, who's the director of Riverside Home Health and your host, Liz Unruh. To learn more about heart care or home health care at Riverside, visit riversidehealthcare. org.