Jennifer Bresnick   February 6, 2013

new study provided by the Commonwealth Fund shows that telehealth consultations are effective in reducing the amount of time patients spend in the hospital for care of chronic illnesses.  By examining data from large telehealth programs run by the Department of Veterans Affairs (VA), Partners HealthCare in Boston, and Centura Health, based in Colorado, researchers found that home monitoring programs can cut costs and raise patient satisfaction up to 85%.

Remote patient monitoring “can facilitate interaction and communication between the patient and caregiver and can help to activate and engage patients in the management of their own care,” the brief states, when the program is brought to scale correctly.  “These programs can help realize improved financial and clinical outcomes by facilitating behavior change and by staging timely, interactive care interventions to prevent unnecessary hospital admissions or emergency department visits.”
The VA’s Care Coordination/Home Telehealth (CCHT) program was introduced in 2003, focused on making the patient’s home a primary care site whenever possible.  The VA has seen a 56% reduction in patients seeking hospital services for depression, a 20% reduction for diabetes, and a 40% drop in hospitalizations for other mental health issues.  Significantly, the savings are similar whether a patient has one condition or multiple health problems, showing that the service is robust enough to handle more complex cases.
Partners HealthCare uses telehealth to aid cardiac patients, and has reported a 51% reduction in heart failure hospital readmissions, an improved patient understanding of the condition, and more than $8000 in savings for participating patients.  The total savings from 1,265 patients enrolled in the program totaled more than $10.3 million.  Partners credits widespread physician and patient acceptance of remote monitoring for its success.  The successes with patient education “are critical evidence in demonstrating to providers that such programs can support behavior changes that lead to improved health and quality of care.”
Centura Health saw close to 10% fewer readmissions for congestive heart failure and  COPD in its two participating facilities, and even brought its diabetes readmission rates from 12% down to zero by using case managers to introduce telehealth intervention before a patient’s initial discharge.  Within 48 hours of patient discharge, a personalized telehealth algorithm is created for eligible patients and technicians install and train patients to use the device within their homes.  By introducing the program through trusted physicians in the hospital setting, Centura legitimizes the program for its patients and increases the likelihood of adherence after discharge.
“Each of the programs described in this series of case studies started as a pilot with the support and promotion of a small group of advocates who believed in the technology’s potential and capacity for offering improved care for a targeted population,” the study notes.  “Evidence of each program’s positive impact reinforced that belief and strengthened the case for expansion throughout the organizations. While each organization’s approach to the design and implementation has varied, their collective experience offers other organizations best practices for implementing telehealth-enabled care programs at scale.”
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