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Telemedicine program connects specialists with homebound patients

A patient in Staten Island University Hospital’s new telemedicine program talks remotely with her health team.
A patient in Staten Island University Hospital’s new telemedicine program talks remotely with her health team.

Staten Island University Hospital expands Home Visit program


A consultation with a cardiologist or psychiatrist is only a click away for some of Staten Island’s oldest and frailest patients, thanks to a pilot program being launched at Staten Island University Hospital. Think of it as Facetime with a specialist.

Using a cellphone or laptop, about 260 SIUH patients enrolled in the hospital’s Home Visit program – which provides in-home checkups by a primary care physician – will be able to have follow-up visits with subspecialists after discharge from the hospital via telemedicine. A geriatrician-led multidisciplinary team will provide comprehensive geriatric assessments and care oversight to all patients enrolled in the Home Visit program.

“These patients have very limited access to a subspecialist after returning home. When a patient is treated for acute congestive heart failure, follow-up with a cardiologist within the first 72 hours of discharge is crucial,” said Anita Szerszen, DO, a geriatric medicine specialist who is overseeing the program.

We are trying to build a program of care to reduce the avoidable readmission rate,added Dr. Szerszen.

The telemedicine digital platform provides video chats that use encrypted cybersecurity measures to protect the health information shared between the patient and doctor. It can also “teleconference in” the patient’s family member or caregiver from another remote location, as well as include translation services when necessary.

Homebound patients on the rise

To ensure that patients will be able to access and use the technology, a physician assistant will be present when a patient logs on to telemedicine for the first time. About 50 percent of Home Visit patients have Wi-Fi in their homes, explained Dr. Szerszen. For those who don’t, a physician assistant will bring a laptop to the patient so that they can have a telemedicine consultation.

The program is made possible in part through a $150,000 grant from The Fan Fox and Leslie R. Samuels Foundation, Inc. The hospital hopes to expand the program to serve up to 350 patients in the next year or so.

Dr. Szerszen says the number of homebound patients is only going to increase as the population ages in the coming years and with it, the opportunity to serve them through the program.

“There are about 10,000 people aged 80 and older living on Staten Island,” said Dr. Szerszen. “We are also a borough with a large population of patients with mental and developmental disabilities. Again, many of these patients have functional impairments and are home-bound.”

Northwell Health, which has a similar home visit program for its elderly and homebound patients in Queens and Nassau County, will monitor the success of the pilot telemedicine program with this population.

“Being able to get the needed care and attention from multiple members of the care team including geriatricians and specialists when they need it from their own homes should bring significant benefits to medically vulnerable individuals and avoid the need for costly rehospitalizations that impact hospitals, families, patients and the government agencies sharing the costs,” said Martin Doerfler, MD, senior vice president of clinical strategy and development and associate chief medical officer for Northwell Health.