Data collected on the Sentara system show that "we're saving one life per monitored bed per year," says Fuhrman. One independent study of Sentara Norfolk General Hospital published in 2004, for example, revealed a 25 percent drop in mortality rates of ICU patients compared to before the system went online. Patients' length of stay also dropped by 17 percent. Fuhrman says that since then, the teleICUs have maintained 20 percent lower mortality rates than predicted for intensive care units.
One of the most exciting developments in telemedicine, experts say, is the potential for discharged hospital patients to be monitored from home, and for everybody to stay healthier through ongoing self-surveillance. Smartphones and tablets, now used by more than 50 percent of the U.S. population, are already outfitted with the camera and microphone needed to monitor heart rate, cough and lung function, and with a few extra components, they can take electrocardiograms and blood-pressure readings. MD Anderson, which recently announced $1 million in funding from AT&T to jumpstart a program to remotely manage surgical patients, is piloting an initiative to send some people who have just undergone a pancreas removal home with a computer and a wireless stethoscope and thermometer. Such patients are at high risk for readmittance, says Surena Matin, a urologist and surgeon who is leading the initiative. This way, they can check in with a nurse and share their vital signs and avoid panicked trips to the ER.
The Cleveland Clinic's Heart Care at Home program discharges heart patients with a small telehealth unit that monitors vital signs such as blood pressure and weight fluctuations, which might indicate fluid buildup, and transmits the data through a phone line to a support team at the hospital – no Internet or smartphone needed. Nurses stop by as often as is necessary during the 40 days after discharge. Presbyterian Healthcare Services in Albuquerque, N.M., similarly refers patients with congestive heart failure or chronic obstructive pulmonary disease to their homes with equipment capable of video and of analyzing measurements taken by the patient. The program has a 96 percent patient satisfaction rate, and readmissions are down to 1 percent from 6 percent at the start of the program in 2001. One prevented hospital visit saves $5,500, about the cost of one patient's home equipment.
"I can manage things myself instead of every six months going to the doctor," says Heidi Dohse, 49, who suffered a dangerous heart arrhythmia at 18, underwent then-experimental ablation to effectively rewire her heart, and is on her seventh pacemaker. That's a good thing, because now that she is a program manager for Google in Somerville, N.J., her cardiologist at the University of California, San Francisco Medical Center is a continent away.
An athlete who has competed in 100-mile bicycle races and wants to continue to ride longer distances, Dohse is helping to test out a type of self-guided telemedicine called mobile health that enables patients to collect their own stats, from heart rate and blood pressure to weight and food consumed, on an ongoing basis and share it with their doctors. She wears a watch that keeps track of her ticker, letting her know whether she's cycling within a healthy heart rate range; an EKG device attaches to her smartphone when she experiences an episode of tachycardia, or quickened heart rate. Her doctors can access the EKG results, and consider them over time to make decisions about medications or pacemaker settings. Dohse can also use an app to correlate her cardiac data with her diet and see, for instance, what the effects of drinking caffeine have been on her heart rate.