Congestive heart failure is one of those medical conditions that has patients in and out of emergency rooms constantly. That’s tough on the Navajo Nation, where hospitals, are few and far between. So the Indian Health Service, the National Institutes of Health and several private companies have formed an unprecedented health care partnership to come up with a solution.
Garrickson Begay is 37. He was diagnosed with diabetes at 21. A predisposition to it and a diet of fast food led to obesity, chronic kidney disease and congestive heart failure.
"It’s scary but then you take it in perspective that you’re glad you’re still alive," Begay said.
Begay has lost track of how many times he’s been rushed to the hospital. And living on the Navajo Nation, 60 miles away from the facility, often means traveling by emergency helicopter and spending many nights hooked up to machines.
"I’ve cried, literally cried in the hospital because I miss my family," Begay said.
These emotional costs and financial costs -- hospital stays, flights, ambulance rides -- add up for patients with congestive heart failure: About a million dollars per patient.
So Flagstaff Medical Center, with the help of the telecommunications company QualComm and other private partners, are handing out backpacks equipped with smartphones, blood pressure cuffs and other health-monitoring devices. It costs about a thousand dollars per patient. And Begay can now check his vitals every day at home.
Begay sends his blood pressure, weight and blood oxygen level to Kelly Degraff’s computer in Flagstaff. Degraff is the chronic disease care coordinator. Currently she’s monitoring about a dozen patients in this pilot program. With congestive heart failure a patient’s condition can worsen quickly, so she checks to see if there’s been any changes from one day to the next.
"For instance I saw someone’s weight increase a lot over night," Degraff said. "I can call the patient. ‘How are you feeling? Do you have extra swelling in your ankles, your feet?’ And sometimes the doctor might want the patient to take extra dose of medication, or maybe they might want them to come in and have an appointment."
She says some physicians are overwhelmed with all the extra data. But most welcome it, seeing how it cuts back on emergency visits. The hospital hopes to have 50 patients enrolled by the end of the year. And once they figure out how to pay for it, they’d like the program to become a permanent resource.
San Diego-based Qualcomm funds similar programs in developing countries, where access to providers and specialists is scarce. This first program here in the United States is designed to demonstrate to federal regulators the safety and efficiency of the technology.
"This is part of a larger strategy," said Erica Whinston, senior manager of Qualcomm's Wireless Reach Initiative. "Our hope is more companies, more health care providers will see what we’re doing and implement new ways of providing health care using wireless technologies."
Gigi Sorenson oversees the program from Flagstaff and says the overall savings and benefits for the patients are great.
"Congestive heart failure is a chronic, progressive disease," Sorenson said. "It doesn’t go away. This program, it gives them a safety net so they’re not alone and that they don’t have to go through this progressive disease by themselves, nor do their family members."
Begay said he almost gave up. "I almost shut the doors, turn the lights off, curled up in my fetal position," he said. "But it’s just feeling that backbone there to have support. You know it does touch you emotionally because who else is watching out for you?"
Although the odds are against him, Begay is now hopeful he may one day be able to take care of himself and maintain a job.