Remote Patient Monitoring in Home Health

Pam Miller, RN,MSNVice President

Archbold Health Services

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.

Reasons for Remote Monitoring

• Obtain Data to Effectively Evaluate and Proactively Manage Symptoms

• Keep Patient in Home Environment

• Lower the Cost of Care

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

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%

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

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

Monitoring System Overview

• Eleven Languages• Male or Female Voice Gender• User Friendly- For Patient and Staff• Transmits Data to Central Station at Office

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

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 ??