Telehealth Best Practices

CP320.01 5/4/2015

Goal and Objectives

Goal: Provide health care organizations with best practices for

implementing a telehealth program.

Objectives:

• Understand the importance of leadership’s role in running a

successful telehealth program

• Clearly define the goals for the program

• Analyze the patient population to determine monitoring needs

• Track results for sustained success

2

Best Practices for Creating a Telehealth Program

Top-Down Leadership Commitment

Build an Innovative Culture

Establish Financial Objectives

Identify Program Goals

Establish Model of Care and Resource Allocation

Develop a Targeted Implementation Plan

Integrate Standards and Plan for Scalability

Develop a Targeted Marketing Strategy

3

Golden Rule: Leadership Commitment

Leadership Commitment

Commitment from C-Level is critical to success

5

Strategy

Tactics

• Create the vision through your model of care

• Drive cultural shift with defined staff

roles/responsibilities

• Develop a business plan

• Establish realistic goals

• Hold staff accountable for implementing and

managing the program

Integrate telehealth into the care management of the patient

Build an Innovative Culture

6

7

Innovative Culture

The Power of Vision drives cultural change within your organization

The vision identifies where you want to be, rather than where you are today

• Fosters commitment and energizes people

• Establishes standards

• Creates a bridge between the present and future

Remote Monitoring Value

• Increased Access Increased Volume

• Improved Communication Improved outcomes and care coordination

• Presence in Remote Community Competitive Edge

• Driver of Ancillary Services Private pay, mPERS

Financial Objectives

9

Revenue Generation

Cost Avoidance

Expense Reduction

Increase Other

Services

Business Development

Test New Markets

What are Your Financial Objectives?

Why Measure Your Program Results?

11

Be a star referral source for hospitals

CMS Penalties for Low Performers

October 1, 2011

Hospital readmission rates are measured for

Medicare patients with: CHF, AMI and Pneumonia

October 1, 2012

The worst performing hospitals (bottom 25%) will

lose 1% of total Medicare payments with thefollowing disease added: COPD, CABG, PTCA and post-surgical vascular conditions

Oct 1, 2013

Hospital readmission rates are reassessed for all

7 diseases and worst performing hospitals (bottom 25%) are penalized 1% of Medicare payments

October 1, 2017Percentage of Medicare payments lost to the

worst performers will rise to 2%

Cost Per Visit

Traditional (HHA , MD office, ED) 48 minutes (cost/encounter)

Genesis Touch:

Video 20 minutes (cost/encounter)

Tele-triage

(phone call/assessment after VS acquisition) 5-10 minutes (cost/encounter)

Savings: XX minutes $XX.XX

Visit Type Time Cost / Visit

Identify Program Goals

13

Clearly Identified Program Goals

Develop Goals consistent with the Telehealth Vision:

14

Achieve stakeholder satisfaction

Improving Outcomes

• Reduce re-

hospitalizations

• Improve care

management

• Patient

• Clinical Provider

• Payer

Financial ROI

• Increase referrals

• Increase market share

• Partner with providers

Example Program Goals

15

Example GoalsKey Performance Indicators

(KPI)

Realize a x% improvement in the acute care hospitalization rate within 6 months from the start of the telehealth program when x% of the average daily census is using telehealth.

Achieve a high satisfaction rate based upon survey results from physicians and patients each quarter.

Reduce cost per visit, increase nursing efficiencies, reduce LUPA’s, reduce re-hospitalizations within 60 days.

Achieve stakeholder satisfaction

Improving Outcomes

Financial ROI

Measurement Criteria

How to measure outcomes:

• Analyze a geographic subset of your patient population

• Establish baseline measurements for the subset

– Number of monitors vs. average daily census

– Current rehospitalization rates

– Number of nursing visits per episode

– Number of monitored days per episode

• Utilize the above measurements as a benchmark for comparison after

telehealth is implemented

16

Checkpoint: Do you have enough monitors on enough patients to positively impact

outcomes?

Data Analysis

Measure results against goals• Patient Management:

– Management and triage of patient health data

– Care management and the coordination of care

– Clinical interventions 

• Clinical Efficiency

– Allocation of clinical resources to meet the needs of the patient

– Clinical documentation practices which outline a consistent plan of care

– Utilization of best practice product and process tools

– Predetermined product capabilities and best practice supported workflow   

• Program Effectiveness

– Alignment of resources/roles/responsibilities to support processes and procedures  

17

Data analysis is the most critical, yet most overlooked practice.

18

Establish Model of Care

and Resource Allocation

Telehealth Delivery Model

Considerations:

• Share leadership vision and goals

• Evaluate your resources and determine program roles / responsibilities

• Outline expectations for nursing practice and expectations for success

• Create a workflow processes:

• Case Management

• Triage

• Equipment Management

• Data collection and analysis

• Awareness of increased consumerism within our healthcare system

19

Case Management – Care Coordination

A process for managing patient data should be

Implemented to provide oversight 7 days a

week, holidays and weekends.

The ideal candidate to oversee the program is your

strongest clinician.

20

Stratify the Patient Population

Monitor Placement: Which patients should be monitored?

21

Disease state: Review the patient’s current condition(s)

Number of nursing visits per episode: Can the number of visits be reduced through the introduction of telemonitoring?

Number of monitored days per episode: Recertify if patient hasn’t fully recovered

High-risk populations: Polypharmacy

Develop a Targeted Implementation Plan

22

Rollout Program

Implement your model of care with a small

segment of your patient and nurse population

before rolling out more widely

Review results to:

23

Know when the patient needs a visit

Teach patient about disease process

Provide information to physician as needed

Empower the patient to take an active role in their care

Program Evaluation

Review all aspects of your initial targeted program:

• Revise your model of care to suit agency needs

• Identify your long-term telehealth champions

• Develop a contingency plan to maintain the program in the event of

employee turnover

24

Every agency is different and will find a model that best suits them

Peer Review

Utilize information gained from the program participants:

• How could we manage the patient more effectively?

• Could we have prevented the hospitalization?

• Did we miss the signs of deterioration?

• What are the key takeaways from installing and utilizing the

monitor with patients?

25

Integrate Standards and Plan for Scalability

26

Integrate Standards

27

• Document the processes and procedures you created for

your telehealth program

• Communicate them to your team to ensure that every

patient who is placed on a monitor receives consistent

care

Plan for Scalability

• Develop a plan to expand the program within your

current agency location

• If you have multiple branches, identify a strategy for

incorporating telehealth within each location and a

timetable for deployment

28

Develop a Targeted Marketing Strategy

29

Marketing and Wide-Scale Deployment

Marketing is a great resource and provides much needed referrals in

a competitive environment

30

Marketing Materials

• Create a Solution Overview that

communicates your value

• Develop a case study based on your

initial targeted implementation

• Seek co-branded marketing

opportunities

Grow Your Census

• Contact referral sources, including

hospitals and physicians

• Contact current patients to educate

them about your telehealth program

Look for 3rd party validation of your program results

Conclusion

Telehealth can provide tremendous value to patients and care providers when a thorough strategy is developed.

Telehealth is like a garden, it requires constant care and attention in order to flourish!

31

Learn More

Get in Touch with Me at:Anne.Evans@Honeywell.com

Reach out to your regional representative or call 1-888-353-5440

Learn More about Honeywell Life Care Solutions online:www.honeywelllifecare.com

32

Select ServicesReduce costs and improve care coordination with Honeywell’s telehealth monitoring services. We help remove the complexity associated with offering telehealth by monitoring your patients from our nurse call center headquarters.

https://www.honeywelllifecare.com/SelectServices