Remote Monitoring Cuts Hospital Readmissions

Chase Doyle

May 12, 2015

LOS ANGELES — A large-scale remote monitoring program is reducing readmission rates and increasing patient satisfaction, according to a presentation here at the American Telemedicine Association 2015 Annual Meeting.

"Broad Axe Care Coordination is achieving a 10.4% readmission rate for rural Virginia patients enrolled in remote monitoring, which is almost 50% lower than the University of Virginia Health System historic readmission rate," said Kirby Farrell, MBA, president and chief executive officer of Broad Axe Technology Partners in Charlottesville, the management service overseeing the program.

The transition to telehealth technology is the inevitable outcome of an increased reliance on value-based billing and decreased resources in the healthcare system, Farrell explained.

"Technology-enabled care coordination is a critical component of value-based billing, but because fees have been cut continually over the past 10 years, most healthcare systems do not have the available staff to put a program like this in place," he said.

Broad Axe uses a "total outsourced" solution to identify a specific patient population. Patients are targeted when they are still in the hospital and are enrolled in the coordination program.

During the identification process, Farrell and his colleagues found that most healthcare systems fail to accurately estimate their readmission penalties.

Our 30-day readmission rate is 45% lower than the best historic data.

"Many healthcare systems overestimate the actual number of patients creating that penalty. The ability to specifically target and enroll those patients makes all the difference between an economically viable program and one that does not succeed financially, regardless of the outcomes," he explained.

The program uses a fully integrated platform to transition the patient to the home, monitor, and oversee communication with clinicians in the healthcare system.

"Our belief was that for information to be meaningful to a clinician, it had to be available in their electronic medical record platform," said Farrell. "Doctors were not going to log onto another system to see any kind of patient data."

At the University of Virginia, the focus of the Broad Axe program is the Centers for Medicare & Medicaid Services (CMS) penalty population. Dramatic improvements in readmission rates have already been seen.

"Our 30-day readmission rate is 45% lower than the best historic data the University of Virginia Health System had for that patient population, and our 30-day readmission rate is 30% lower than previous CMS data," Farrell reported.

The program has also practically eliminated the readmission of hip- and knee-replacement patients, the penalties for which can be enormous, he pointed out.

"The moment you get above the national rate for readmission of 5.4%, each readmission is probably costing your healthcare system about $200,000. Our readmission rate for Medicare hip and knee replacements is less than 1%."

"It's really important to be able to support these patients in their homes and communities," said session moderator Laurie Poole, RN, MHSA, vice president of telemedicine solutions at the Ontario Telemedicine Network in Canada.

Remote monitoring "is the right thing to do, but it's still really hard to achieve because our systems are pretty fragmented," she told Medscape Medical News. "Keeping it really simple, easy, and affordable — that's the key to helping patients manage their diseases."

Broad Axe intends to scale this program for larger patient populations, but Farrell acknowledged that moving beyond the current 1500 patients per year has its challenges.

"We want to be able to take in larger patient populations, but monitoring is going to be very dependent on the predictive analytics related to each patient," he explained. "There isn't a one-size-fits-all program on the monitoring side."

Mr Farrell and Ms Poole have disclosed no relevant financial relationships.

20th Annual Telemedicine Association (ATA) Meeting and Trade Show. Presented May 4, 2015.


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