Archive for the ‘Telehealth & Telemedicine’ Category

Replicating Home Care Telehealth for Non-Homebound Curbs Readmissions

July 15th, 2014 by Patricia Donovan

Community Health Network considers it a failure of the system if a patient with chronic illness has to go to the hospital. Deborah Lyons, Community Health Network's disease management executive director, describes how the integration of telehealth into care of heart failure patients is helping to keep hospital readmission rates down for this population.

It’s all part of Community’s network strategy. That’s really a failure of the system if a patient has to go to the hospital—at least for those with chronic diseases. Our strategy has been to keep patients out of the hospital regardless of disease type. We want to keep patients out of the hospital.

As part of an integrated strategy, we’ve used our experts in home care to do high-risk home visits rather than creating a siloed entity to do this. Home care was doing telehealth for their homebound patients in home care, and we didn’t want to recreate this functionality. We chose to work with our home care telehealth experts and expand this to the non-homebound population.

This network strategy helps us to better manage the health of patients by looking at what expertise exists and then expanding it to meet the population needs.

When we first started developing the strategy, we also started with heart failure originally because we have a lot of heart failure patients and an issue with readmissions.

When we looked at the heart failure patients, we found that first, about 43 percent of our patients that were readmitted were patients that were discharged home to self-care, meaning they didn’t qualify for traditional home care. They weren’t going into a facility. These were people that were going home alone. And this group was driving 43 percent of our readmissions.

When we looked at what was occurring in our own network, we also found that our home care agency was doing telehealth with their home care patients and had a national best readmission rate. We asked ourselves how we could replicate this for our non-homebound patients. There are experts there that are getting great results. Now we want to apply this to our non-homebound population. And that’s where we decided to do this with IVR, the automated telephonic system that calls the patients at home.

Excerpted from: New Horizons in Healthcare Home Visits

Infographic: Healthcare Embraces the Cloud

June 27th, 2014 by Jackie Lyons

Eighty-three percent of healthcare organizations use cloud services. The top reasons healthcare organizations adopt cloud services is a reduction in maintenance costs, increased speed of deployment and addressing staffing challenges, according to a new infographic from HIMSS.

This infographic also identifies the challenges, barriers and successes healthcare organizations are having with cloud services.

Remote monitoring is another crucial healthcare technology utilized by organizations to obtain patient information and reduce costs. 2014 Healthcare Benchmarks: Remote Patient Monitoring delivers a comprehensive set of metrics from more than 100 healthcare organizations on current practices in and ramifications of remote monitoring for care management of chronic illness, the frail elderly and remote populations.

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Infographic: Public Opinion of the Affordable Care Act

June 20th, 2014 by Jackie Lyons

Nearly 60 percent of individuals want Congress to improve the Affordable Care Act (ACA) rather than repeal it, according to a new infographic produced by the Journal of the American Medical Association.

This infographic also illustrates the barriers to obtaining health insurance, and the effects of the ACA since its rollout in 2010.

Want to know more about healthcare trends and effects of reform? Plunkett's Health Care Industry Almanac 2014 provides a complete market research report, including forecasts and market estimates, technologies analysis and developments at innovative firms. This resource provides vital insights into how the healthcare industry is evolving and effects of healthcare reform.

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Infographic: Healthcare in the Cloud

June 9th, 2014 by Jackie Lyons

Security, agility and accessibility are among the top healthcare benefits of cloud computing. Furthermore, cloud storage could potentially reduce health IT costs by $11 billion, according to a new infographic from MBAHealthcareManagement.org.

This infographic also identifies the three types of cloud computing, additional benefits of cloud storage, types of information that can be stored in the 'cloud,' and more.

Remote monitoring is another crucial healthcare technology utilized by organizations to obtain patient information and reduce costs. 2014 Healthcare Benchmarks: Remote Patient Monitoring delivers a comprehensive set of metrics from more than 100 healthcare organizations on current practices in and ramifications of remote monitoring for care management of chronic illness, the frail elderly and remote populations.

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Remote Care Management Improvements As Close As Telephone

June 3rd, 2014 by Patricia Donovan

Telephonic care management leads the list of remote patient monitoring strategies.

Remote patient monitoring in all its embodiments is here to stay, as results from our 2014 survey validate, with everything from interactive voice response (IVR) to video visits to home sensors driving results in population health management, particularly for the frail elderly.

Even CMS shows signs of softening its stance toward telemedicine. A key provision of a May 2014 rule issued by the Centers for Medicare and Medicaid services removed some barriers surrounding the umbrella issue of telehealth. In particular, this rule reduced the burden on very small critical access hospitals, rural health clinics and federally qualified health centers (FQHCs) by no longer holding physicians hostage to a prescriptive onsite schedule. This provision addresses the geographic barriers and remoteness of many rural facilities, and recognizes telemedicine improvements and expansions that allow physicians to provide many types of care at lower costs, while maintaining high-quality care.

More of these concessions are likely to come as the industry embraces value-based care and the market for devices to track home-based biometrics and activity continues to explode.

But sometimes, it's not the clinical emergency averted by the use of remote monitoring but the assurance provided by a simple phone call. Analytics by naviHealth, a convener in the CMS Bundled Payments pilot, identified healthcare utilization patterns by the elderly that might benefit from telephonic care management.

“Often we found that some of our beneficiaries re-admit [to the hospital] because they simply want social interaction with someone else. A telephone call can sometimes be gratifying enough for that beneficiary so that they’re not seeking social engagement back at the hospital again,” notes Kelsey Mellard, vice president of partnership marketing and policy with naviHealth.

“If you think about how you target your population, you have high risk, low risk and maybe medium risk, depending on your analytics and clinical team. This is not rocket science,” Ms. Mellard continues. “It is a lot of work. It’s a lot of use of analytics against a target, but once you’ve identified that target population, it’s a question of how to turn up the engagement or turn down the engagement based on where that patient is. "

"It can be very simple telephonic care management in the form of brief conversations,” she concludes.

Excerpted from 2014 Healthcare Benchmarks: Remote Patient Monitoring

6 Key Elements of Population Health Management

May 20th, 2014 by Patricia Donovan

A carefully curated population health management program begins with risk stratification and fosters collaborations with stakeholders that can raise the bar on health outcomes while educating participants about appropriate utilization of services such as the hospital emergency room.

Beyond that framework, for the great majority of respondents to a 2012 survey on population health management by the Healthcare Intelligence Network, this strategy should also encompass health coaching.


With healthcare’s value-based purchasing increasingly favoring a population-centric approach to health management, the top PHM program components cited by respondents are the following:

  • Health coaching: 78.7 percent
  • Provider feedback on care gaps: 46.8 percent
  • Support group: 29.8 percent
  • Telemonitoring: 25.5 percent
  • Other: 23.4 percent
  • Group visits: 19.1 percent

Excerpted from: 57 Population Health Management Metrics: Assessing Risk to Maximize Reimbursement

HINfographic: Making the Connection with Telephonic Case Management – 4 Key Areas

May 12th, 2014 by Jackie Lyons

Telephonic outreach helps to bridge the care divide, supporting and engaging vulnerable and high-risk populations. The optimal length of time to follow members to help manage and maintain life changes is one year, according to this new infographic from the Healthcare Intelligence Network.

This HINfographic offers tips to improve telephonic connections with vulnerable individuals, from Jay Hale, director of quality improvement and clinical operations at Carolina Behavioral Health Alliance. It includes advice on how to connect with patients, identify warning signs, provide easy-to-use surveys, and develop qualities to become a successful telephonic case manager.

The infographic is available for purchase as a downloadable Adobe Acrobat PDF file. Click here for details.

Want more data on telephonic case management? Answer our "10 Questions" survey by May 31 to receive an executive summary of the results.

You may also be interested in this related resource: Telephonic Case Management Protocols to Engage Vulnerable Populations. This 30-page resource describes a suite of tools to facilitate identification, interaction, surveys, follow-up action, resource matching, and member engagement and outreach for a behavioral health population that is also a template for case management and care coordination of any organization's hard-to-reach or vulnerable members.

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Value, Convenience Key to Successful Use of Telehealth Technology

May 8th, 2014 by Cheryl Miller

The most sophisticated technology in the world will not engage patients and members in health improvement if they are not convinced of the value of the program to their health, the commitment of their providers to the process and the credibility of the entire care team says Dr. Randall Williams, chief executive officer for Pharos Innovations. Here, he discusses the importance of convenience when it comes to engaging members or patients into a daily self-care program.

AHRQ performed a technology assessment looking at the use of information technology (IT) and the adoption of IT by patients and members of health plans who were elderly and had chronic illness, or who were underserved and had chronic illness. This technology assessment focused on looking at interactive consumer technologies that were geared toward helping consumers improve their health. This assessment describes several factors that influence the use, usefulness and usability of these technologies, in particular in populations that we as a company and others would describe in their populations, which are the elderly or the underserved and who have chronic illness.

This review concludes that from a consumer’s perspective, programs and technologies that are used to support those programs need to have a perception of benefit to the individual who will be using them. Also, they have to be perceived as convenient and as something that can be easily integrated into the daily activities of that individual patient or member.

Ultimately, the successful use of these interactive technologies is predicated on engagement into the use of that program or technology. That is directly linked to the amount of value that the consumer might perceive about the intervention that’s being offered to them — that those technologies will have a positive impact on the health and wellness of those populations if indeed there’s a feedback loop that’s provided. This feedback loop is something that’s also crucial to the design of the engagement and ultimate intervention programs. The feedback loop may include an assessment of the current health status, interpretation of that status in light of established treatment plans and treatment goals, adjustments made to that treatment plan as needed and communication back to the patient or the member with targeted recommendations or advice. This cycle then repeats.

Lastly, this report also notes the importance of convenience. Convenience is critical when it comes to engaging members or patients into a daily self-care program. Engagement is higher when that intervention is delivered via technologies and resources that the consumers are use to using on a daily basis for other purposes. We have been fortunate to take advantage of some of that learning in our program design and in our technology design as well.

Excerpted from Health IT in Care Management to Improve Health and Effect Behavior Change.

Infographic: What Healthcare CEOS Worry About

May 5th, 2014 by Jackie Lyons

Some 57 percent of healthcare CEOs are worried about the rapid speed of changing technology, and 41 percent feel like their IT departments aren't ready for the change, according to a recent survey from PricewaterhouseCoopers and an infographic from ICE Technologies, Inc.

This infographic also shows the technological progression occurring in healthcare today, including changes in IT departments, technological investments and more.

Want to know what other trends are transforming the industry and affecting healthcare CEOs? Healthcare Innovation in Action: 19 Transformative Trends examines a set of pioneering efforts supporting the industry's seismic shift from a volume-based culture to one rewarding value and patient-centeredness. This 40-page resource delivers succinct descriptions of programs that are transforming healthcare delivery, grouped around six key innovation areas.

Get the latest healthcare infographics delivered to your e-inbox with Eye on Infographics, a bi-weekly, e-newsletter digest of visual healthcare data. Click here to sign up today.

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6 Criteria for Evaluating Vendor Partners for Remote Patient Monitoring

April 22nd, 2014 by Patricia Donovan

Just as there are guidelines for identifying individuals most likely to benefit from remote monitoring, healthcare organizations must also choose remote monitoring vendor partners with care, advises Gail Miller, vice president of telephonic clinical operations in Humana's care management organization, Humana Cares/SeniorBridge, who shared lessons gleaned from vendor selection for Humana's nine separate pilots of remote patient monitoring.

I want to share how Humana chose the partners that we work with in these programs, because there are so many potential vendors to work with in the remote monitoring space. We had been evaluating companies off and on for about a year. We ended up doing a request for information (RFI) process with the top 25 we had identified internally. They weren't necessarily the biggest vendors or the companies with the strongest balance sheet, but rather those that met the different capability criteria we were looking for and possessed the flexibility and creativity to work with us.

Some think that it’s a good idea to warn people when you’re going to be working with a large entity like Humana, so that the companies we choose are prepared to deal with our procurement and legal processes, and understand it will take some resources on their side. Since the change to the HIPAA rule in 2013 there iss more downstream liability, so we require additional business liability insurance, and our business information agreements are quite stiff. All of those things must be worked through before we can work with a vendor.

We were also looking for companies that could be easily scalable. You could have a great piece of equipment, but if it’s going to take ten months or a year to procure another thousand, that’s not going to work for us because we have to be thinking on a national basis. We also were looking for vendors willing to work with members with various home situations. We did not want to exclude anybody from our pilot.

For example, some of the equipment we looked at would only run if there were broadband in the home. We needed someone to put some type of device that they could plug in, that would help boost them or create a 4G or 3G network wherever they were. We needed to adapt to the different home situations that our individuals lived in.

Then, the equipment had to be senior friendly. We learned a lesson from a great study with Intel about three years ago. The results had some positives and some negatives, but one thing we learned was that the size of the equipment was important. At that time, the piece of equipment we were using weighed about 37 pounds. Because of the frail nature of some of our members, we had to hire an intermediary to do setup and delivery and then package it up and send it back afterward. It created a lot of extra cost and a little more confusion trying to arrange those deliveries and pickups.

One thing that we are dedicated to doing this time is making sure that whatever equipment we had in the home that we could manage it easily, and that hopefully the senior themselves or their caregiver would be able to set it up.

Excerpted from: Remote Patient Monitoring for Enhanced Care Coordination: Technology to Manage an Aging Population