Following a selection process that has gone on for two years but intensified over the last six months, Partners Home Care announced that it has selected McLean, Virginia’s Visual Telecommunications Networks Inc. (ViTel Net) to bring telemonitoring services to the Boston agency’s patients. ViTel Net’s bedside telemonitor, the VitelCare™ Turtle 400, is a light-weight, portable monitoring device that delivers daily vital signs through a standard phone line to clinicians at a central location.

ViTel Net offers telemedicine applications and scalable, remote health monitoring equipment to home care and other healthcare providers. The Washington, DC-area company was founded in 1989. Partners Home Care (PHC) conducted a number of telemonitoring research trials over the last few years (see “Payers Encourage Telehealth Pilots“) that have demonstrated positive results for the agency’s patients. When it came time to select a long-term partner, however, the consensus was to move away from experimental prototypes toward a set of established products.

Partners Home Care is one of New England’s largest non-profit home care providers, providing certified, specialty, and private home care services throughout Eastern Massachusetts. The agency is a member of Boston’s Partners HealthCare, which serves over 140 New England communities. We spoke recently with home care president Marcia Reissig.

“With two years of research and testing prototypes, we knew what patients like and don’t like,” she told HCAR. “Our IS and clinical team that looked at home telehealth vendors kept that in mind as we reviewed a number of devices over the last 18 months. The ViTel Net Turtle stood out for several reasons. We liked its color display against a black background. We thought that would make it easier for older patients to read. And we liked that fact that it displays pictures as well as names and words of medications and medical devices. It was one of the few products we saw that our clinical and IS people both liked.”

Reissig added that the company itself was a factor in the decision, as well as its products. Some monitors that worked well or were otherwise attractive to clinicians were found to have too proprietary a technology foundation or were offered under a too-restrictive business model. “We will need a lot of customization so that our home telehealth system integrates with Partners HealthCare’s intranet and our home care applications,” she explained. “We liked that ViTel Net is privately owned and very engineering-oriented. During the selection phase, they were able to demonstrate some of their adaptation ideas for us, rather than just talk about them, so we felt they are small enough to be responsive to our needs. They were not the least expensive of those we saw but we thought they would fit our needs.”

Home care IT Director Cara Babachicos added that her department was primarily looking for a vendor that would be easy to work with, skilled enough to create complex interfaces to the parent healthcare organization’s sophisticated enterprise systems but flexible enough to customize its products to meet the home care department’s needs. “We already upload patient data to our system-wide dashboard so that Partners physicians can track patients online,” she said. “We want telehealth data to be available there too in order to alert physicians when vitals are problematic and they need to summon early responders to make adjustments.”

The IT Director added that her department’s goal was to find a way that data could be integrated with a server without creating too many data transfer challenges. “Telehealth data will have to be uploaded to a server and from there to Partners’ enterprise system through a firewall without creating problems,” she explained. “ViTel Net seems to have already figured out a way to set up an ISP email account to upload patient results.” The vendor, she added, has also agreed to set up a backup server and to make support available for extended hours in order to help minimize downtime.

Partners has purchased 35 units initially and will grow the program to 125 telemonitors within the next four to six months. The home care division is not separating from the systems’ remote monitoring effort with this vendor selection but will continue to work closely with Partners Telemedicine, a Partners HealthCare department under the direction of Dr. Joseph Kvedar with the mission of connecting healthcare providers and patients around the world through the use of communications technologies. Kvedar’s department will provide resources and expertise to support the home care project. “I speak with Joe at least once a week,” Reissig said. “He has assigned one of his people to home care full time as we get this project going.”

One aspect of the project that will be worth watching over time is one that will be conducted through member hospital Massachusetts General. With funding from Partners HealthCare, it will study the effects of telemonitoring on patients with chronic conditions but who are not homebound and therefore not Medicare-eligible. One of the most significant obstacles to home telehealth adoption is that the monitoring device must be removed from the home at the end of a Medicare episode, regardless of the fact that leaving it there would help to prevent the need for future episodes or even re-hospitalizations. If the Mass General study can prove cost savings from monitoring non-homebound patients, it may eventually influence DHHS or Congress to reconsider the way it funds home care services.