Telehealth Alerts and Nurse Response

Health monitoring within a telehealth program is a strategy to efficiently care for older adults with heart failure (HF). Limited description is identified in the literature for the extent participant submissions trigger an alert or monitoring nurses transfer telehealth alert-range data to the medical record.

The aim was to describe the initial 90 days of participant submissions measuring within alert range and nurse response to alerts with documentation to the medical record.

Review of telehealth and medical records of 187 older veterans with HF participating at one Veterans Administration Care Coordination Home Telehealth program led to reporting the proportion of participant telehealth submissions measuring within alert range and nurse response to alert-range data.

Less than 2.5% of self-rated health status and nearly one-quarter of physiologic submissions measured within alert range. Timely nurse response averaged 28.7% and increased when submissions for vital signs, weight, or medication alerted for consecutive days. Neither alert nor nurse response data were significantly associated with characteristic measures.

Clinical relevance of alert-range telehealth data is uncertain partly due to frequent alerts triggered by physiologic submissions, few health status changes noted by the participant or the monitoring nurse, and the nonsignificant association between the proportion of alerts or nurse response, respectively, with demographic or clinical baseline measures.

Future studies are needed to identify telehealth program measures that decrease alerting data not associated with clinical worsening and increase recognition-of-change in HF health status by the participant and monitoring nurse.