Posts Tagged ‘chronic diseases’

11 Statistics About Remote Patient Monitoring

December 23rd, 2014 by Cheryl Miller

Remote monitoring of individuals with multiple chronic conditions reduced hospitalizations, hospital readmissions and ER visits for more than 80 percent of respondents and boosted disease self-management for nearly all of these monitored patients, according to the 119 respondents who participated in the Healthcare Intelligence Network’s inaugural survey on Remote Patient Monitoring in March 2014. Other targets of a remote monitoring strategy included frequent utilizers of hospitals and emergency rooms (ERs) (62 percent) and the recently discharged (52 percent).

Following are seven more statistics from the Remote Patient Monitoring survey:

  • Fifty percent of respondents rely on specific diagnoses sets to identify candidates for remote monitoring.
  • More than a quarter of respondents (27 percent) target the frail and/or home-bound with remote monitoring programs.
  • Reimbursement for remote monitoring, followed by the education of patients in this technology, were identified by respondents as the chief challenges of these remote care management efforts.
  • Two-thirds of respondents said remote monitoring reduced bed days.
  • Telephonic case management is a component of remote monitoring efforts for 71 percent of 2014 respondents.
  • About a third of respondents report the use of either a Web interface or a dedicated mHealth app to supplement remote monitoring.
  • A patient-centered touch, such as a follow-up phone reminder to use a monitoring device or a personal coaching session, was frequently cited as a noteworthy supplement to remote monitoring technology.

Source: 2014 Healthcare Benchmarks: Remote Patient Monitoring

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.

3 Levels of Health Coaches

April 10th, 2014 by Cheryl Miller

While health coaches address the health risk continuum — keeping the healthy healthy without compromising the clinical support needed for high-risk, high utilization individuals, it is necessary to align individuals with the right coaching service at the right time, say Dennis Richling, MD, chief medical and wellness officer, and Kelly Merriman, vice president of service delivery for HealthFitness. Here they explain the three levels of heath coaches needed to address their clients’ wide-ranging needs.

Our approach engages the individual with the right coach for their need. We use three types of professional coaches: there are health coaches, who are lifestyle coaches, individuals with bachelors, masters and doctoral degrees in health-related fields. There are also advanced practice coaches, skilled senior health coaches who have been trained in clinical conditions in chronic disease management. And then there are nurse coaches, who are registered nurses, who also have been trained in behavior change techniques. We take a look at what happens and who fits into which category.

First, there are those people with no chronic disease but who have health risks. They have issues trying to manage their healthy lifestyle and are seeking help. Those individuals go to health coaches.

Next, there are those individuals with chronic diseases but they’re managing their medication appropriately and complying with the preventive and control measures for their chronic disease. But their underlying lifestyle issues remain, and these individuals go to advanced practice coaches.

Lastly, there are individuals who are not following their care plan, their care is not coordinated, they are seeing multiple doctors, and their medication compliance is poor. They do have underlying lifestyle issues, but their biggest problem right now is managing their chronic disease and these individuals go to the nurse coach.

Excerpted from Integrated Health Coaching: Reducing Risk and Empowering Change across the Health Continuum.

Collaboration, Medication Reconciliation, Yoga Key to Successful Population Health Management

January 30th, 2014 by Cheryl Miller

Zumba, yoga, Thank God it’s Free Fruit Friday (TGIFF)?

Maybe not top-of-mind elements of accountable care, but all three are helping healthy employees to stay healthy, and luring others to engage in their own health self-management, the keys to successful population health management (PHM), says Elizabeth Miller, vice president of care management at White Memorial Medical Center, part of Adventist Health, in a recent webinar at the Healthcare Intelligence Network.

In Managing Risk in Population Health Management, Ms. Miller shared the key features of the PHM program at White Memorial, the program’s impact on Adventist’s 27,000 employees and how the program was being rolled out to its patient population.

By incorporating elements of the Triple Aim, and collaborating with all stakeholders, including patients, providers, health plans, employers, hospitals and local community members, a PHM program can achieve optimal outcomes, including minimizing the need for ED visits, lowering costs, maintaining and improving individuals’ health across the continuum of care, and reducing readmissions, Miller says.

Medication reconciliation plays a key part in preventing populations from being admitted or readmitted to the hospital, Miller continues, because it is one of the chief causes for readmission. She cites numerous instances where nurse practitioners go into people’s homes to do medication reconciliation only to find that they are going to two cardiologists simultaneously and taking medications from both of them, not realizing how detrimental it is to their health.

Elements of the PHM program include using robust data sets, risk stratification, and predictive modeling to identify populations, and target high-risk individuals with one or more chronic diseases, including the top five: coronary heart failure (CHF), chronic obstructive pulmonary disease (COPD), asthma, diabetes, HIV. Once eligible populations are targeted and enrollment criteria met, analytics, intervention and program development are established for the top 5 percent, or very high risk, and 10 percent, or high risk, and then wellness programs for the 85 percent, or medium risk.

Ongoing assessments and evaluations of interventions follow, usually by care managers, including periodic reassessments of goals, and measuring outcomes with set metrics.

The goal of any PHM plan is to eventually graduate patients by setting up decision support and self-management tools that will help them do so. Offering employees the right incentives is a key contributor to this. White Memorial was able to engage 95 percent of its employee population in a PHM program by reducing monthly insurance premiums by $50 a month. That percentage grew to 98 percent when the reductions were extended to employees’ spouses,’ Miller says.

Ultimately, says Miller, “we really want to focus on the population and modify the behaviors so that we prevent illness in the future. Right now we have a disproportionate investment in illness after it has already occurred. Once it has occurred, it’s difficult to manage and treat…Our goal is to keep the population as healthy as possible.”

It can be labor intensive, Miller points out, but the outcomes are worth it. Improved health status leads to improved performance, and projected financial savings of $49 million by 2017.

4 Benefits of Online Health Communities in Chronic Care Management

July 12th, 2013 by Jessica Fornarotto

Can blogs, chats and forums replace a cadre of skilled healthcare providers? Probably not, but they can contribute to information exchange, self-management and collaboration among physicians.

Flummoxed by the rapid aging of Western societies, the scarcity of skilled providers to care for people with complex healthcare needs, and the threatened unaffordability of care, researchers recently looked at the use of online health communities (OHCs) as a tool to address some of these challenges.

The OHCs are Internet-based platforms that unite either a group of patients, a group of professionals, or a mixture of both. Members interact using modern communication technologies such as blogs, chats and forums.

There are four benefits to using OHCs in chronic care, according to researchers from the Journal of Medical Internet Research (JMIR):

  • Facilitate the Exchange of Medical Experience and Knowledge: Due to rapid advances in medical knowledge, many health professionals lack specific expertise and experience to address complex healthcare needs. Therefore, healthcare is increasingly organized within specialized networks whose processes occur largely offline during physical encounters, such as medical conferences.

    However, modern communication technologies now support professional networks online. Within OHCs, professionals connect and communicate more easily, regardless of their working place within the network, and regardless of time. OHCs can be used to develop disease-specific expertise among all community members, patients and professionals interested in a particular chronic condition.

  • Enhance Interdisciplinary Collaboration Across Institutions and Traditional Echelons: Healthcare delivery can become fragmented for chronic patients when they acquire relationships with multiple professionals and institutions. To manage complex patients with multiple comorbidities, health professionals must collaborate to make coordinated decisions and share responsibilities in health outcomes.

    OHCs offer a platform for supporting medical decision-making and interdisciplinary collaboration across professionals caring for complex patients. OHCs enable communication between community members, bridging geographical distances and enable interaction across institutions and traditional echelons.

  • Provide a Platform to Support Self-Management: Typically, patients have a passive role and lack the tools to self-manage their condition. However, modern patients search the Internet for medical information, wish to have open communication channels with their physicians, and prefer to participate in making treatment decisions. Supporting patients with chronic diseases like type 2 diabetes, arthritis, and asthma to self-manage their condition helps to improve the quality and safety of care and reduces costly and inappropriate use of healthcare resources.

    Chronic patients using online communication tools become more knowledgeable, feel better socially supported and empowered, and have improved behavioral and clinical outcomes compared to nonusers. Examples that include OHC principles are patient participation in online peer support groups and access to personal health communities (PHCs). PHCs allow patients to have access to medical records, control their own online information, and enable individualized health communication.

  • Have the Ability to Improve Patient-Centered Care: Patient-centeredness is about engaging patients to become active participants in their care to reduce healthcare utilization and improve efficiency, patient-doctor communication, treatment compliance, and health outcomes. OHCs enhance patient-centered care by improved access to personalized information, emotional support and patient participation.

    PHCs are essentially patient-centered, while they engage patients in their care process and tailor care to their individual needs. Professionals can benefit from patient peer-to-peer conversations that take place in OHCs by knowing that they have more effectively addressed their patients’ needs. Blog and forum items often involve aspects of patient-centered care, such as information and emotional support needs, patients’ willingness to participate in treatment decisions, or an experienced lack of continuity of care.

The researchers concluded that OHCs are a powerful tool to address some of the challenges chronic care faces today. Further evaluation should address user needs, risks, benefits, and cost implications before OHCs can be fully adopted in daily practice.