Proactive Care with Telemonitoring

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Proactive Care with Telemonitoring

• Beverly Gillund
• Hendricks Community Hospital Association
• Hendricks, Minnesota

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Traditional Home Care and Hospice versusNew
Model of Proactive Carewith Telemonitoring
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Traditional Home Care and Hospice

• Nurse visits are pre-scheduled and not
  necessarily in response to health needs of the
  client
• Limited insight on clients condition from day to
  day which can result in gaps of service
  intervention

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Traditional Home Care and Hospice Care Model

• Sat. Sun. Mon. Tues. Wed.
  Thurs. Fri.
• Nurse visits are pre-scheduled in the traditional
  model. In the above
• example, there are five days in the week the home
  care or hospice team
• does not have access to clinical information of a
  clients condition.

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Comprehensive Clinical Management Utilizing a New
Model of Care with Telemonitoring

• Sat. Sun. Mon.
  Tues. Wed. Thurs. Fri.
• Telemonitoring lends itself to proactive care for
  optimal clinical
• management. Agency has seven days of clinical
  information.
• Visits are made when the client needs them, not
  on a predetermined
• schedule.

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New Model of Care

• Proactive Care Management
• Agency has insight on client condition every day
• Care is more responsive to client clinical
  changes
• Provides a sense of security and comfort for
  clients and families

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Independent AnalysisMonitored/Non-Monitored
PatientsJanuary 2002-March 2004

• Outcome
• Reduction in hospitalization
• Reduction in emergent care visits
• Patient functional status improved or maintained
  as related to terminal condition expectations
• STRATEGIC
• HEALTHCARE
• PROGRAMS

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HCHA Home Care Outcome

• Date Range January 2006 thru June 2007
• Emergent Care
• NonTelehealth Clients CMS Reference
• 11.5 21.3
• Telehealth Clients CMS Reference
• 11.7 23.6
• Hospitalization
• NonTelehealth Clients CMS Reference
• 21.6 26.1
• Telehealth Clients CMS Reference
• 12.8 29.5

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Client/Family Benefits

• Educational tool to reinforce medication use and
  diet restrictions
• Encourages client self-management by reinforcing
  positive behavior and lifestyle changes
• Tracks and reinforces compliance with treatment
  plan
• Provides sense of security for clients and
  families through daily monitoring
• Care provided based on client clinical needs
• Facilitates client and caregiver participation in
  the plan of care producing better outcomes

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Physician and Staff Benefits

• Complete objective, clinical data is available
  immediately upon request for the health care team
• Allows for pre-emptive care, supporting
  adjustments to the treatment plan and/or
  medication profile
• Reinforces education and compliance to treatment
  plan
• Breaks cycle of emergency care and hospital
  re-admissions
• Customizable to meet specific disease management
  needs

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Agency Benefits

• Strengthens multi-discipline team approach in
  care
• Maintains or improves clinical outcomes which has
  a quality benefit promoting consumer value
• Creates strong patient satisfaction and loyalty
• Offsets unscheduled visits and phone calls
• Efficient utilization of nursing staff with
  increase in nurse/patient ratio
• Strategy for nursing recruitment and retention

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Agency operational impact

• Skilled Nurse Visit utilization
• Medicare clients
• Cost savings with decrease in number skilled
  visits/episode
• Minnesota and South Dakota State funding
• Enhanced referral base
• Connectivity with chronic care population
• Telemonitor nurse implementation
• Enhanced nursing efficiency
• Contractual relationship opportunities
• Helping Hearts Medicare Research Project
• Medi-sota Hospital Consortium
• Blue Cross/Blue Shield of Minnesota

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Strategic Planning

• Additional Revenue opportunities
• Strengthen referral base
• Hospital Discharge Planning
• Provider relations
• area clinics
• outreach specialists
• Disease Management
• Corporate and Community Wellness program
  development
• Market services to private pay market

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Criteria for Telemonitoring

• Who should receive a monitor?
• Any client condition requiring frequent
• monitoring or trending of health status
• information to facilitate optimal clinical
• management and promotion of wellness.

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Implementation

• Successful transition to a proactive model of
  care with
• telemonitoring promotes cost effective quality
  care by
• Early detection of clinical changes
• Prompt intervention
• Optimal clinical management with positive
  outcomes in care delivery
• Effective utilization of clinical staff resources

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Evaluation

• Client satisfaction
• Clinical outcomes
• Provider satisfaction
• Referral activity
• Program growth
• Contract relationships
• Staff recruitment and retention
• Staff productivity

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Overview

• Quality Telemonitoring promotes timely access
  to accurate, trended health information to
  facilitate early detection of changes in a
  clients health status. Interventions are
  proactive and preventative improving clinical
  outcomes.
• Cost Management Supplementing traditional
  skilled visits with telemonitoring helps lower
  the cost of delivering quality health care. This
  results in financial viability for health care
  providers and lower cost to consumers.

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Overview

• Client empowerment Health information promotes
  self-care in the familiar, supportive environment
  of the home. It facilitates collaboration in
  care planning between the client, family,
  caregivers and health care providers.
• Consumer Value Health information oversight and
  management by health care professionals provides
  the client and family peace of mind. It supports
  confidence in managing health conditions in the
  comfort of home.

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• Beverly Gillund BSN PHN LSW
• Director of Clinical Services
• Hendricks Community Hospital Association
• PO Box 106
• 503 East Lincoln Street
• Hendricks, Minnesota 56136
• beverly.gillund_at_hendrickshosp.org
• 507-275-3134