Posts Tagged ‘remote patient monitoring’

Overcoming ‘Clinical Inertia’ and 7 Other Barriers to Remote Patient Monitoring

February 26th, 2015 by Cheryl Miller

It’s important to identify potential barriers from both patients and providers before implementing a telehealth program, says Susan Lehrer, RN, CDE, associate executive director of the telehealth office for the New York City Health and Hospitals Corporation (NYCHHC), because both groups need to change behaviors. Resistance to change is universal, and if you’re changing any kind of work flow or communication, there will be initial resistance.

  • Slow buy-in and some resistance by clinicians (referrals).
  • Clinicians concerned with appearance of decreased productivity.
  • Resistance to change in clinic work flow.
  • Inability to “integrate” Web site data and electronic medical records (EMRs).
  • Language and literacy.
  • Complexity of chronic disease management.
  • Lack of protocols for use of email in coordination of care.
  • Not all clinicians utilize secure email system.
  • Source: Remote Monitoring of High-Risk Patients: Telehealth Protocols for Chronic Care Management

    Remote Monitoring of High-Risk Patients: Telehealth Protocols for Chronic Care Management profiles a successful eight-year initiative by New York City Health and Hospitals Corporation’s (NYCHHC) House Calls Telehealth Program that significantly lowered patients’ A1C blood glucose levels. Susan Lehrer, RN, BSN, CDE, associate executive director of the telehealth office for NYCHHC, shares key aspects of the real-time monitoring program, including how the program blends telehealth, electronic medical records, electronic communication with providers and direct communication with patients by nurse case managers, and much more.

    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.

    Humana Remote Monitoring Tools Assess Frail Elderly with Functional Limitations

    November 18th, 2014 by Patricia Donovan

    In nine separate pilots of remote patient monitoring, Humana is testing technologies to keep the frail elderly safe and healthy within their homes for as long as possible. Here, Gail Miller, vice president of telephonic clinical operations in Humana’s care management organization, Humana Cares/SeniorBridge, reviews some of the tools and challenges of remote care management of individuals experiencing difficulties with activities of daily living (ADL).

    Question: What assessment tools do you use to measure functional limitations and ADLs?

    (Gail Miller): Besides the Charleston Frailty Index, we have a proprietarily developed tool that was started with Green Ribbon Health that manages all of the functional capabilities. That is the one that we use to help scale people. We also use the PH12 and the Subjective Global Assessment (SGA), as well as a couple of other assessment tools. It will often depend on how the person is presenting, but our primary assessment tool for functionality is the mDAT, which we developed internally.

    Question: How does Humana define ‘frail’?

    (Gail Miller): We use the clinical definition of frail — people more likely to fall, unable to keep their balance, on various medications, etc.

    Question: How do you coordinate care for the functionally challenged?

    (Gail Miller): If someone is having problems falling in their home, we will send our care managers into the home to do a fall and safety assessment, and then we will work with that member to complete the actions on the plan and to try and make their home safer for them to be able to move around in. If the person is having issues with their balance for example, and it isn’t due to the construction of their home or the way items are placed there, then we will get them to the appropriate provider so that they can be assessed, and see if there are things that we can do to improve on that.

    In that case, we would not only be taking them to one of our providers, but also getting them enrolled in one of our Silver Sneakers classes, which is a class we offer that focuses specifically on balance and core strengths.

    remote patient monitoring
    Gail Miller is vice president of clinical telephonic operations for Humana Cares, the complex care and chronic management arm of Humana, Inc. Her responsibilities include the oversight of the complex and chronic care programs provided telephonically to members of Humana.

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

    6 Criteria for Remote Patient Monitoring Applications in Managed Care

    July 10th, 2014 by Cheryl Miller

    Among the six criteria that Humana uses to evaluate vendors for remote patient monitoring applications are reducing medical costs and generating a positive ROI at a program level, says Gail Miller, vice president of telephonic clinical operations in Humana’s care management organization, Humana Cares/SeniorBridge. Applicants have a tough bar to pass, because programs not only have to work, they have to work better on those already being care managed.

    First, we put together criteria for what we wanted to do in a managed care application. We were looking at reducing medical cost and generating positive return on investments (ROIs) at a program level. Our studies are more difficult to set up because all these people are under care management. Whenever anyone is going to work with us, they have to understand that they have a tough bar to pass, because not only does the program have to work, it also has to work better on someone who is already being care managed. We are looking for that incremental lift that we could get from remote monitoring.

    Everything has to be customer friendly and easily adaptable to our members’ lifestyles. We want our members to feel rewarded by their efforts to monitor their health. We want to involve the members, physicians, caregivers and families so that everybody in the care circle is included, and we want to test with little disruption to our large organization.

    We have more than 2,000 nurses and social workers on the telephone. This is something that you have to consider to introduce new pieces of technology, in addition to considering how you are going to put it into your operational stream. We have been able to do that. We decided to move forward with this new care management model using all of the tools that we had and to extend our reach by using remote monitoring.

    We were specifically looking for remote monitoring technology to help our members manage their conditions, to reduce hospitalizations, and to improve their consumer experience. We have nine remote monitoring care management pilots underway. We have a tenth pilot that is in development. People have to consent to both care management for Humana Cares as well participation for the pilot.

    The member selection for our remote monitoring program was based on complex clinical analysis. There was no additional cost to our members to participate in these pilots, and the equipment that we use is considered a loan to the member for the duration of the pilot or as long as they are members of Humana if that pilot is rolled out.

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

    Infographic: The Growing Industry, Effects of mHealth

    April 11th, 2014 by Jackie Lyons

    mHealth is currently a $1.3 billion industry that is expected to reach $20 billion by 2018, according to a new infographic from Mobile Future and Infield Health.

    This infographic shows savings attributed to remote patient monitoring and medication adherence resulting from mHealth. It also assesses how mobile tools are transforming healthcare as more Americans, including healthcare providers, adopt mobile devices and wireless connectivity, and more.

    Learn more about mHealth in 2013 Healthcare Benchmarks: Mobile Health, which delivers a snapshot of mHealth trends, including current and planned mHealth initiatives, types and purpose of mHealth interventions, targeted populations and health conditions, and challenges, impact and results from mHealth efforts. This 50-page resource provides selected metrics on the use of mHealth for medication adherence, health coaching and population health management programs.

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