Focus on Research
Penn State Intercom......November 8, 2001

Interactive video visits
aid home patients

By Barbara Hale
Public Information

A University-led study has shown that substituting interactive video sessions for up to half of a visiting nurse's in-home meetings with post-surgical or chronically ill patients can be a cost-effective way to provide care. RESEARCH_Dansky

The study is the first to identify the specific costs associated with the new technology and to show that while the new approach imposes additional initial expenses for care delivery, it contributes substantial savings without compromising quality.

Kathryn Dansky, associate professor of health policy and administration, led the study. "Video visits are not a complete substitute for in-home nursing care," she said. "You are always going to need home visits because patients benefit from the personal touch."

However, the team found that over a typical 60 days of care, savings of $300 per patient could be achieved by substituting video visits for seven in-home visits and $700 per patient was saved if half of the visits were made via advanced communication technology.

The sources of savings include less travel time and travel costs, fewer travel accidents, less car theft and the ability to see more patients in the same amount of time.

The researchers included Dansky, Lisa Palmer, who earned her doctorate in health policy and administration at Penn State; Dennis Shea, professor of health policy and administration; and Kathryn H. Bowles, assistant professor of nursing at the University of Pennsylvania.

Skilled nursing care in the home requires a registered nurse to drive to the patient's residence, conduct examinations and assessments, provide patient care and education and then drive to the next patient's house. The process is time consuming, dangerous at times for the nurse and expensive.

To see if new technology could help both patients and nurses without incurring additional costs, the researchers initiated a 24-month evaluation of the use of telecommunications as a supplement to skilled nursing visits for people with diabetes. Called the TeleHomecare Project, the effort was a partnership of Penn State, American Telecare Inc. and the Visiting Nurses Association of Greater Philadelphia, a large, urban, home health agency. A group of 171 diabetic patients discharged from the hospital and referred to the association participated in the study. Half of them were randomly assigned to receive a patient telecommunication station in their homes while the remaining patients received traditional in-home nursing visits. The patient station included a computer and monitor equipped with two-way voice capability and a video camera. A blood pressure cuff and stethoscope were also attached to the computer.

Using the patient station, which works over ordinary phone lines, the patient could see and talk with the nurses. The system also allowed the nurses to see and hear the patients and to take temperature and blood pressure measurements, listen to heart and lung sounds and discuss diet and blood sugar results.

Patients who used the telecommunications system scored higher on positive outcomes of treatment, had fewer re-hospitalizations and fewer visits to hospital emergency rooms. Dansky noted that, in general, the patients liked working with the telecommunications equipment. The stations gave patients a sense of security because they could keep in touch with their nurse at all times. Dansky sees many possibilities for broader application of the telecommunications systems. She is currently working with Sun HomeHealth to study whether the systems can aid nurses in helping patients manage their medications especially when there is a danger of drug interactions. She also sees the possibility of physical therapists using the system to supervise family members or aides who are helping patients exercise in the home. Dieticians also could use the system to supervise meal planning and preparation.

Barbara Hale can be reached at

Spontaneity, access is
the key to e-learning process

E-learning's real potential as a tool for developing leaders is around interactivity and networking, but accomplishing its potential is going to take dynamic e-platforms, a University professsor said.

"Everyone sees the potential of e-learning, but the movement forward is at a glacial pace at this point. What people are looking for in a learning experience is the opportunity for learning and exchange," said Al Vicere, professor of Strategic Leadership in the Smeal College of Business of Administration.

He envisions a new role, called an e-coach or personal learning consultant. Such an adviser diagnoses each learner's developmental needs and connects them to the right resources, based on his or her time, budget, bandwidth and personal needs. The entire relationship may be conducted online.

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Study: Perceptions of justice
vital to
workplace ethics

By Steve Infanti
Smeal College of Business Administration

Many organizations are devoting substantial resources to formal ethics programs in efforts to discourage unethical behavior, but a new study shows that the success of those efforts will depend in part on whether employees perceive that their organization treats people in a generally fair way.

"Perceptions of organizational justice not only reduce a broad range of unethical behaviors that can harm the organization, but they also increase helpful behaviors, particularly employees' willingness to cooperate with the goals of organizational ethics programs by reporting ethical problems to management," according to Linda Treviño, professor of organizational behavior and chair of the Department of Management and Organization in The Smeal College of Business Administration.

Treviño co-authored an empirical study of four large corporations on the topic with Gary R. Weaver of the University of Delaware.

"When they perceive the organization to be unfair, employees engage in harmful unethical behavior in order to rebalance the scales of justice and improve their own outcomes at the organization's expense, by stealing for example. However, when they perceive that the organization treats employees fairly, they give back by going above and beyond the call of duty to help management, by reporting ethical problems," Treviño said.

This study found that employees' perceptions of ethics program follow-through decreases unethical behavior and increases the extent to which employees will support an ethics program.

Treviño noted that the impact of such follow-through is even higher when employees perceive the organization to be unfair. When employees perceive unfair treatment, they are motivated to rebalance the scales of justice. Therefore, company efforts to act on ethical problems have even greater impact.

The randomly selected sample for the study was drawn from a larger survey of ethics/compliance management in four companies with formal ethics/compliance programs in place: a utility company, a telecommunications company and two energy-related companies.

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