BANNER HOME CARE TELEHEALTH BANNER HOME CARE TELEHEALTH

ObjectivesObjectives

• Overview of BHC Telehealth program• Home Health and Telehealth• Patient selection and admissions• Results and Revisions

HOME TELEHEALTH MONITORINGHOME TELEHEALTH MONITORING• Banner Home Care offers telehealth

monitoring to patients who are on Banner Home Care services who have a primary diagnosis of Heart Failure, Diabetes, COPD, Post CABG, Hyper or Hypotension, or any other Cardio-Pulmonary condition

• There is no cost to the patient

GOAL:GOAL:• Reduction of emergency room and hospital visits• Reinforce to the patient, the value of self

monitoring and taking an active role in their own disease management.

• To provide additional education for the home care patient

• Enhance physician communication• Better utilization of home care nursing resources

TELEHEALTH MONITORINGTELEHEALTH MONITORING• The telehealth monitoring program is

provided to the patient as an adjunct to the skilled nursing care they are receiving

• The monitoring system includes:– scale– blood pressure monitor– pulse oximeter– telestation monitor

WEBSITE MONITORINGWEBSITE MONITORING

• The patients and caregivers are taught to weigh and take their vital signs every day

• The telestation monitor captures the data and sends the information via a phone line, to a website

• The telestation also asks the patient to answer a short series of questions regarding their symptoms that is also sent to the website

REVIEW OF DATAREVIEW OF DATA

• A Banner Home Care RN reviews the clinical data 7 days per week

• If a patient alerts on vital signs, weight, or symptoms, a clinical telephone assessment will be performed

• Further interventions may be taken such as contacting the physician, doing a home visit, or directing the patient to the emergency room if symptoms are severe.

CUSTOM TELESTATIONCUSTOM TELESTATION

• The telestation monitor is multi-functional– It can be customized to not only ask

assessment questions but can also send short pieces of education to the patient on a daily basis

• The daily information is a reinforcement of what the RN is teaching to the patient during the skilled nursing visit– And an extension of what is taught in the

hospital

PATIENT SELECTION CRITERIAPATIENT SELECTION CRITERIA• Medicare or Medicare type payor must

meet home bound criteria• Frequent emergency room and hospital

stays• Demonstrated difficulty in self-

management of their chronic conditions• Lack of knowledge regarding their disease

process and medications

PATIENT SELECTION CRITERIAPATIENT SELECTION CRITERIA

• Teachable, motivated, able to follow simple instructions – either the patient or caregiver

• Land telephone line-cellular data transmission is being added this year

Total Number of UnitsTotal Number of Units

• 55 units in Arizona• 15 units in Colorado• All patients are monitored via central

monitoring station in Arizona• At any given time monitoring station in

Arizona is monitoring up to 70 patients

Strengths and BarriersStrengths and Barriersof Telehealthof Telehealth

STRENGTHS• Consistency of staff• Use of Best Practice• Vendor support• System support• Networking and

information availability• Custom telestation

BARRIERS• Consistency with

discharge planning• Reimbursement• Cost efficiency of

marketing• Technology• Awareness

RESULTSRESULTS

REHOSPITALIZATION RATE IN 30 DAYS

0

5

10

15

20

25

BHC (19 of490patients)

National AVG forHeart Failure

Open Heart Telehealth moduleOpen Heart Telehealth module

Categories1. First week at home

Incision,breathing,pain,activity & nutrition,

2. Lifestyle changesDiet, exercise, smoking cessation, stress

3. MedicationsGeneral medications, Nitro, anti-arrythmics,

**Daily feedback questions and end week quiz

Success StoriesSuccess Stories

Depression– Pt was delighted to

see feelings she was having that day in the module.

Readmission-Improved module by adding questions that flag daily action to BHC nurse.

Conclusion

New and innovative approach to healthcareCutting edge for telehealth program.

Aligns with our mission in the continuum of care to make a difference in peoples’ lives

through excellent patient care.

ReferencesReferences

1. Bradley, K.M. & Williams, D.M. (1990). A comparison of the preoperative concerns of open heart surgery patients and their significant others. The Journal of Cardiovascular Nursing. 5(1). P 43-53.

2. Barnason S., Zimmerman L., Nieveen J., & Hertzog M. (2006). Impact of tele-health and recovery outcomes of elderly patients undergoing coronary artery bypass grafting. Heart & Lung. 35(4). P 225-233.

3. Hannan, E.L., Racz, M.J., Walford, G., Ryan, T.J., Isom, O.W., Bennett, E., & Jones, R.H. (2003). Predictors of readmission for complications of coronary artery bypass graft surgery. Journal of the American Medical Association. 290(6). P 773-780.

4. Martin, C.G. & Turkelson, S.L. (2006). Nursing care of the patient undergoing coronary artery bypass grafting. Journal of Cardiovascular Nursing. 21(2). P 109-117.

5. Mika, V.S., Kelly, P.J., Price, M.A., Franquiz, M., & Villarreal, R. (2005). The ABCs of health literacy. Family and Community Health. 20(8). P 351-357.

6. Murphy-Knoll, L. (2007). Low health literacy puts patients at risk. Journal of Nursing Quality. 22(3). P 205-209.