Telehealth
by Chris Otto and David Taylor
March 24, 2016

Home health agencies (HHAs) are in the challenging position of providing continued care for patients once they leave the confines of a hospital or clinic. HHAs are often the final point of contact for patients as they move through the care continuum and work to transition into their daily lives after being discharged.

During the past decade, telehealth technology has evolved into a reliable means for HHAs to better supervise a larger number of patients by regularly monitoring their vital signs and providing clinical intervention when required. In addition, recent studies have demonstrated that use of remote patient monitoring can reduce readmission rates by better managing chronic disease states through ongoing vitals monitoring.

But what happens when the paths of HHAs and patients diverge? For years, patients have lacked an effective step-down solution to aid in the transition from clinical oversight to managing their own health.

Long-term Benefits of Telehealth

Chronic disease is prevalent and costly in the U.S., especially among older adults. Chronic disease is the primary cause of death in 7 out of 10 deaths, and in 2010 86 percent of all health care spending was for people with one or more chronic medical conditions. Nearly 92 percent of older adults have at least one chronic condition, and 77 percent have at least two.

The Department of Veterans Affairs (VA) has made a strong commitment to telehealth among its veterans by developing a national program called the Care Coordination/Home Telehealth (CCHT) program. The purpose of CCHT is, “to coordinate the care of veteran patients with chronic conditions and avoid the unnecessary admission to long-term institutional care.”

The VA has broadly deployed a range of remote patient monitoring (RPM) technologies in 50 different health management programs across 18 Veterans Integrated Service Networks, and conducted various studies showing improved chronic disease management, cost savings and reduced hospital admissions and emergency department (ED) visits.

Telehealth technology and its ability to impact patients long-term is significant. The biggest issue, however, is the ability to scale to larger patient populations. The technology—comprised of front-end hardware monitoring tools for the patient and back-end software, on which a nurse reviews progress—is too expensive to maintain in the long-term across broad patient populations.

This begs the question: Is there a telehealth solution that removes the more expensive long-term clinical component, while still delivering the core benefit of monitoring vital signs?

A New Solution

As a provider of medical alert devices, MobileHelp has been working to develop an effective consumer step-down solution for patients moving out of a clinical care environment, or for those who simply want to proactively manage their own health.

The new MobileVitals system is a “telehealth-lite” solution, which allows people to monitor their own vital signs with the added benefit of a medical alert system for personal safety—allowing users to access emergency help if they need it. The average medical alert customer manages at least two chronic illnesses. MobileHelp added tools such as blood pressure cuffs and glucometers to the MobileVitals platform to aid in disease management. Any information collected is transferred via Bluetooth to a secure hub in the user’s home, and sent via a cellular network to a cloud server, which allows users access to personal health data that can be stored and shared.

Pilot Program

The VNA of the Rockford, Illinois, area recently tested the MobileVitals system in a pilot program. The VNA saw the benefit of MobileVitals as a step-down solution to help patients transition from the clinical oversight of the VNA to managing their own care. The VNA’s own telehealth program had been successful in preventing readmissions for high-risk patients through early recognition of symptoms and successful clinical intervention.

The VNA noted early on that many patients wanted to keep their monitors and continue to track their own vital signs after their release. This was an unmet need for patients to leverage the educational benefits of working with VNA nurses every day—without the high cost of clinical involvement.

Patient Benefits

Under the program, VNA patients now have the ability to track and monitor their vital signs on a daily basis, but without clinical intervention. In addition, they still have access to emergency help if they need it.

Patients have responded positively to the ability to manage their own data, and have appreciated the additional features available within the system, such as activity tracking and medication management tools.

Ease of use is another benefit. Typical telehealth vendors usually have products that have to be installed by a nurse. The MobileVitals system, on the other hand, is shipped directly to the customer. The benefits extend beyond patients and providers to family members as well. The system provides a secure portal for family members to keep tabs on their loved ones.

Competitive Advantage

Because re-hospitalizations occurring within 30 days of hospital discharge carry punitive implications for organizations, increasing focus on periods as long as 60 to 90 days is becoming more common. With chronic illnesses, the key to effective management (and ongoing improved health outcomes) is long-term monitoring.

With technology solutions in the marketplace, long-term monitoring is possible without the high cost of clinical oversight. Leveraging this technology allows HHAs to transition patients back to their home with greater peace of mind they can remain healthy and in control of their own health.

This means readmissions after the 30-day period can be reduced—even after the patient has transitioned out of the care of HHAs.

As HHAs continually look for new ways to promote themselves within the landscape of a changing care industry, successful patient results reinforce their ability to provide a competitive solution as they work within hospital and ACO networks.