Improving Quality of Life for Some Ozarks Residents through Virtual Medicine

Jun 30, 2017


Mark Heady suffers from several health issues:  congestive heart failure, COPD and multiple sclerosis.  Because of those health concerns, he used to drop by his primary care physician’s office in Springfield without an appointment.

That, and the fact the he lives in a rural area, made him an ideal candidate for Mercy Virtual, which started up last summer.

The 61-year-old Heady sat at a table in his yard outside Buffalo as blue-tailed skinks crawled along the side of his house, birds sang, and traffic whizzed by on the busy highway he lives along, and he remembered the day, about a year ago, that he got a call from St. Louis.

"I was working in the yard and she (caller) said, 'I have something I need to talk to you about,'" Heady said.  And I said, 'well, alright, I'll take a few minutes here,' and she said, 'it's a new program, and we're starting out in your area.'"

That program, Engagement@Home, part of Mercy Virtual, has made a big difference in Heady’s quality of life.  Heady was hesitant at first.  He had never used a computer and didn’t know about YouTube or Ted Talks, which would become important sources for helping him learn about his illnesses.

"And I told her, I said, 'well, this sounds like something I would never go for in a million years'...and I said, 'I'm the least technical minded person that you have ever met in your life,'" said Heady.

But the caller, from Mercy’s Virtual Care Center near St. Louis, told Heady she thought the program could improve his health.

He received equipment—an iPad, a scale, a pulse oximeter and a blood pressure cuff—and, despite, his initial hesitation, he took to it immediately.

Little did he know, but he was part of bringing innovation to the Ozarks:  he was the first to sign up.

His virtual care team asked him to find ways to apply the program to his own life.

"So I said, 'well, certainly, I'll take that challenge.'  And I started meditating using guided meditations on the computer, and I found out about white noise, which improved my sleep problems," Heady said.

He was able to drop a sleeping pill, and he’s used information on diet to lose weight.  Tests have shown his health has stabilized and, in some cases, improved.  And he now calls the virtual health care “indispensible.” 

Engagement@Home now has more than 200 patients signed up in southwest Missouri and around 600 in the entire state.  They can call for help at the touch of a button if they need to.

According to Dr. Gavin Helton, medical director of Mercy Ambulatory Medicine, the program has resulted in a 50 percent drop in hospital admissions and emergency room visits in those who are enrolled.  That has led to a 30 percent decrease in their total cost of care, he said.

Patients check their own pulse, weight and blood pressure each morning, and that information is uploaded directly into the computer for the virtual team to see.

And the online healthcare professionals make sure a patient’s other needs are being met, too—such as social support, behavioral health, transportation, and financial among other things.

Heady, who meets with his virtual care team from his home once a week, considers the nurses and doctors his friends.

On a recent visit, he had his visitors help him sing happy birthday to his online nurse, Debbie.  And he allowed his fox terrier, Angel, to be part of the visit by holding her up to the camera.

After the nurses praised Heady for taking control of his health by making changes for the better and gave him suggestions of other things he could be doing, they steered the conversation away from their patient’s health.

"How's the garden doing? they asked.

Heady walked outside with his iPad so his healthcare team could see his flowers.

Heady’s longtime primary care physician, Dr. Patrick Dopp, is pleased to see his patient doing so well.  He sees him now only every six months after giving the OK for Heady to take part in Engagement@Home.  At the last visit, he was amazed at how well his patient was doing.

"The last time I saw him it was the best I've ever seen him.  His eyes were brighter, he was more up, and he felt better, could breathe better, could function in life better," Dopp said.

According to Dopp, the program saves him time so he’s able to see more patients, but what’s more important is the improvements he’s seeing in people who are using it.

Engagement@Home is free to participants.  Helton said it represents an investment in a patient-centric model as opposed to traditional healthcare, which is more provider or facility-based.  And it represents the reality that healthcare systems are facing, "which is a shift," he said, "from the volume-based fee for service model to a value based model where where healthcare systems are assuming risk, not only for providing quality of care for for their patients, but also they're at risk for the cost of that care, and, if you can improve quality while decreasing cost,  that's a way for a healthcare system to be not only sustainable but highly successful in a value based system."

But he said they’re very careful not to replace their primary care physicians.  Instead, Engagment@Home augments the care already being provided.

"So, really, the whole program is a patient-focused program with the various care team members, including the virtual care team, being there to support the patient when and where they need us," he said.

That’s something that Dr. Dopp is happy about.  While he said there are some who fear virtual care will replace traditional medicine, he believes that won’t happened—and shouldn’t.

"Because there's nothing like what I call the eyeball test.  You can have all the data you want on paper, but regardless of what that says you can kind of just look at a patient, feel a patient, listen to a patient, and say, 'hmmm.  I know what the paper says but, and then fill in the blank,'" he said.

Mark Heady still looks forward to seeing Dr. Dopp every few months, but he’s glad he doesn’t have to see him as often.  He says he feels much more confident knowing expert advice is available at any time.

"When you need help," Heady said, "all you have to do is go to your computer and touch it and it says, 'Mark, what can I help you with?'"

Being part of Engagement@Home has kept him out of the hospital a few times—for example, by getting approval by his healthcare team to start taking Lasix at home for his congestive heart failure.

And he’s now an expert at surfing the web—on his own computer that he purchased.