BANNER HOME CARE TELEHEALTH

1
BANNER HOME CARE TELEHEALTH
2
Objectives

• Overview of BHC Telehealth program
• Home Health and Telehealth
• Patient selection and admissions
• Results and Revisions

3
HOME TELEHEALTH MONITORING

• Banner Home Care offers telehealth monitoring to
  patients who are on Banner Home Care services who
  have a primary diagnosis of Heart Failure,
  Diabetes, COPD, Post CABG, Hyper or Hypotension,
  or any other Cardio-Pulmonary condition
• There is no cost to the patient

4
GOAL

• Reduction of emergency room and hospital visits
• Reinforce to the patient, the value of self
  monitoring and taking an active role in their own
  disease management.
• To provide additional education for the home care
  patient
• Enhance physician communication
• Better utilization of home care nursing resources

5
TELEHEALTH MONITORING

• The telehealth monitoring program is provided to
  the patient as an adjunct to the skilled nursing
  care they are receiving
• The monitoring system includes
• scale
• blood pressure monitor
• pulse oximeter
• telestation monitor

6
WEBSITE MONITORING

• The patients and caregivers are taught to weigh
  and take their vital signs every day
• The telestation monitor captures the data and
  sends the information via a phone line, to a
  website
• The telestation also asks the patient to answer a
  short series of questions regarding their
  symptoms that is also sent to the website

7
REVIEW OF DATA

• A Banner Home Care RN reviews the clinical data 7
  days per week
• If a patient alerts on vital signs, weight, or
  symptoms, a clinical telephone assessment will be
  performed
• Further interventions may be taken such as
  contacting the physician, doing a home visit, or
  directing the patient to the emergency room if
  symptoms are severe.

8
CUSTOM TELESTATION

• The telestation monitor is multi-functional
• It can be customized to not only ask assessment
  questions but can also send short pieces of
  education to the patient on a daily basis
• The daily information is a reinforcement of what
  the RN is teaching to the patient during the
  skilled nursing visit
• And an extension of what is taught in the hospital

9
PATIENT SELECTION CRITERIA

• Medicare or Medicare type payor must meet home
  bound criteria
• Frequent emergency room and hospital stays
• Demonstrated difficulty in self- management of
  their chronic conditions
• Lack of knowledge regarding their disease process
  and medications

10
PATIENT SELECTION CRITERIA

• Teachable, motivated, able to follow simple
  instructions
• either the patient or caregiver
• Land telephone line-cellular data transmission is
  being added this year

11
Total Number of Units

• 55 units in Arizona
• 15 units in Colorado
• All patients are monitored via central monitoring
  station in Arizona
• At any given time monitoring station in Arizona
  is monitoring up to 70 patients

12
Strengths and Barriersof Telehealth

• STRENGTHS
• Consistency of staff
• Use of Best Practice
• Vendor support
• System support
• Networking and information availability
• Custom telestation

• BARRIERS
• Consistency with discharge planning
• Reimbursement
• Cost efficiency of marketing
• Technology
• Awareness

13
RESULTS

• REHOSPITALIZATION RATE IN 30 DAYS

14
Open Heart Telehealth module

• Categories
• 1. First week at home
• Incision,breathing,pain,activity nutrition,
• 2. Lifestyle changes
• Diet, exercise, smoking cessation, stress
• 3. Medications
• General medications, Nitro, anti-arrythmics,
• Daily feedback questions and end week quiz

15
Success Stories

• Depression
• Pt was delighted to see feelings she was having
  that day in the module.

• Readmission
• -Improved module by adding questions that flag
  daily action to BHC nurse.

16
Conclusion

• New and innovative approach to healthcare
• Cutting edge for telehealth program.
• Aligns with our mission in the continuum of care
  to make a difference in peoples lives through
  excellent patient care.

17
References

1. Bradley, K.M. Williams, D.M. (1990). A
   comparison of the preoperative concerns of open
   heart surgery patients and their significant
   others. The Journal of Cardiovascular Nursing.
   5(1). P 43-53.
2. Barnason S., Zimmerman L., Nieveen J., Hertzog
   M. (2006). Impact of tele-health and recovery
   outcomes of elderly patients undergoing coronary
   artery bypass grafting. Heart Lung. 35(4). P
   225-233.
3. Hannan, E.L., Racz, M.J., Walford, G., Ryan,
   T.J., Isom, O.W., Bennett, E., Jones, R.H.
   (2003). Predictors of readmission for
   complications of coronary artery bypass graft
   surgery. Journal of the American Medical
   Association. 290(6). P 773-780.
4. Martin, C.G. Turkelson, S.L. (2006). Nursing
   care of the patient undergoing coronary artery
   bypass grafting. Journal of Cardiovascular
   Nursing. 21(2). P 109-117.
5. Mika, V.S., Kelly, P.J., Price, M.A., Franquiz,
   M., Villarreal, R. (2005). The ABCs of health
   literacy. Family and Community Health. 20(8).
   P 351-357.
6. Murphy-Knoll, L. (2007). Low health literacy
   puts patients at risk. Journal of Nursing
   Quality. 22(3). P 205-209.