remote patient monitoring in home health
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Remote Patient Monitoring in Home Health
Pam Miller, RN,MSNVice President
Archbold Health Services
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Objectives
1. Identify reasons for remote patient monitoring in the home health environment.
2. Recognize the value and benefits of remote patient monitoring for the patient, family, agency and/or physician.
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Reasons for Remote Monitoring
• Obtain Data to Effectively Evaluate and Proactively Manage Symptoms
• Keep Patient in Home Environment
• Lower the Cost of Care
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Value and Benefits• Physician:
– Data Driven Decision Making– Improve Patient Oversight & Management
• Patients and Families:– Maintain Control and Feeling of Security– Improve Patient Compliance– Patient Education
• Agency: Clinical and Financial– Early Intervention for At-Risk Patients– Improve Patient Management, 7 Days a Week – Decrease ACH and ER Visits– Decrease LOS for Hospitals– Decrease SN Visits; Manage more Patients– Decrease Mileage
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Patient Scenarios
• Mr. BP - Blood pressure increased at 9am each day and “out of control” most of day
• Ms. CHF - Weight gain of 4 pounds in 2 days, tired, mild shortness of breath on ambulation
• Mr. COPD – Pulse ox below 88%, shortness of breath; Assessment noted wheezing
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Outcomes of Remote Patient Monitoring
• Acute Care Hospitalization (Quality)Archbold Home Health Patients
– 2004 38.6% No monitors
– 2005 32.4% 40 monitors, NationalTelehealth Value Study
– 2007 29.1% 60 monitors
– 2010 26.8% 105 monitors
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Outcomes - continued
New England Healthcare Institute, 2009: “the available evidence demonstrated that
using Remote Patient Monitoring for heart failure improves patient outcomes and decreases health care costs.”
July 2010: (Quality)Archbold Hospital Readmission for CHF = 9%
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Outcomes - continued
• Archbold, HH- CAHPS (Patient Satisfaction)– “…Helped you manage your health better.” 78%– “…Made you Feel more involved in your care.” 81%– “…Gave you sense of security.” 74%
• Skilled Nursing Visits per Patient Episode ($$)– 12 for non-monitored patients– 7 for monitored patients
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Monitoring System Overview
• FDA Approved Telemonitoring Device
• Records and Documents BP, weight, heart rate, pulse oximmetry (other available peripherals)
• Documents Patient Responses to Programmed Questions
• 30 plus Reminders for Programming
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Monitoring System Overview
• Eleven Languages• Male or Female Voice Gender• User Friendly- For Patient and Staff• Transmits Data to Central Station at Office
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Monitoring System Overview
• Central Station (RN)– Analyzes Patients Data
– Phones Patient to Repeat Monitoring, if Results outside set Parameters
– Sends Nurse and/or Phones Physician if Results of 2nd Reading outside set Parameters
– Schedules Nurse Visit for full Assessment/Interventions
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Monitoring System Overview
• System Interfaces to Clinical Record
• Reports sent to Physicians
• Data Available in Document Imaging for Physicians/Providers
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??Questions ??