Caring for People with Chronic Illness: The Role of Telehealth Technology

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Caring for People with Chronic Illness The Role
of Telehealth Technology
Steve Brown CEO, Health Hero Network 29 November
2006
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Our Shared Vision

• A better model of care serving people who
  struggle with chronic conditions.

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What the world is thinking about right now
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What the world is thinking about right now
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What the world is thinking about right now
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What the world is thinking about right now
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What the world is thinking about right now
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What do we want?
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Whats Telehealth Got To Do With It?

• A Better Model of Care
• Change Behavior and
• Moving Care to the Home

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How to Change Behavior and Move Care to the Home

• Personal Coaches for Everyone?
• Nurses with Phones?
• Nurses with Cars?
• Doctors with Phones and Cars?
• Remote Health Management Technology!
• What Gets Measured Gets Done!

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The Market Has Arrived
Mr. Bohana, an 82-year-old World War II
veteran, has been able to move from living in
hospice under round-the-clock medical supervision
to a Brooklyn studio apartment with the help of a
relatively simple monitoring system from Health
Hero Network. The hand-held Health Buddy
console, which plugs into his phone, delivers his
blood pressure and weight readings to a Veterans
Affairs nurse. It also prompts him to answer a
series of qualitative questions about his lung
and circulatory ailments, like whether his
breathing is better or worse than the day
before. This is so simple a 2-year-old could
do it, Mr. Bohana said.
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Success Story Veterans Administration

• Today
• 16,000 patients enrolled in daily home
  telehealth with Health Buddy
• Deployed in 120 clinical sites
• Over 100 programs for 30 chronic conditions

February 2006
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Care Management Process with the Health Buddy
System
Scripted messaging, monitoring and reporting
platform
Education, monitoring and feedback at home
Personalized, remote care management and support.
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Technology Enabled Model of Care

• The Health Buddy System

Patient Centric
Technology Enabled
Provider Directed
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Expanding the Reach of the Health Buddy System

• The Next Step
• Platform Independent Content Delivery Solutions

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Health Buddy Teleguidance
Health Buddy Teleguidance Project
Contributors Health Hero Network Meavita Sananet
B.V. Impact Media

• Delivery of Health Buddy Program content through
  the television with IPTV
• Pilot Program
• Available for Meavita customers in the
  Netherlands
• Initial program for diabetes patients
• Health Buddy Teleguidance will Launch in 2007

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Care Management Process Technology-enabled,
Provider-directed Model
Health Buddy Desktop

• Keeps care provider in touch with patient
• Monitor patient daily
• Assess patient risk
• Identify change in patients health
• Intervene before crisis occurs
• Improves productivity
• EMR Integration
• Secure web application

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Health Buddy Desktop Tools to Enable Management
by Exception
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Health Buddy Programs

• Library of 100 programs
• Over 30 health conditions
• English Spanish
• Ready to deploy
• Customizable

• Evidence based practice guidelines
• Patient education
• Care management

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Care Management Process Personalized Coaching
and Monitoring

• Dynamic branching logic collects information on
• Symptoms
• Behavior
• Knowledge
• Delivers unique reply to each patient response in
  the form of
• Call to action
• Information / education
• Further assessment
• Reinforcement / reminder
• Acknowledgement

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Care Management Process Creating Feedback Loops
Knowledge

• Identify high risks potential problems
• Address needs through dynamic content

Behavior
Symptoms
H
M
L

• Move risks to lower levels
• Stabilize health status

• Identify changes in status early on
• Manage by exception

Stabilize Patients Over Time
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VA Outcomes 2002 Telehealth Reduces Inpatient
Utilization

• 40 reduction in ER visits
• 63 reduction in hospital admissions
• 63 reduction in hospital bed days of care
• 64 reduction in nursing home admissions
• 88 reduction in nursing home bed days
• Significantly improved Quality of Life SF36V

1-Year Telemedicine Care Coordination
Demonstration
Published in Disease Management Volume 5,
Number 2, 2002.
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VA Outcomes 2005 Telehealth Improves Clinical
Outcomes

• Hospitalizations declined from 630 inpatient days
  pre to 122 during intervention period
• Bed Days Of Care fell from 8.63 to 1.65 (p lt
  0.001)
• Blood Pressure 129/73 to 119/69 (p lt 0.05)
• Weight 196 to 192 (p lt 0.01)
• Shortness of Breath 0-10 Scale 4.0 to 2.7 (p
  0.02)
• ACE Inhibitor Avg Daily Dose 24mg/d to 35 (p lt
  0.01)
• ?-Blocker Avg Daily Dose 84 mg/d to 94 (p
  0.05)

1-Year Telemedicine Care Coordination
Demonstration
Published in Telemedicine and e-Health Volume
11, Number 1, 2005.
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SPAN-CHF II Study 2005 Telehealth Reduces
Hospital Readmissions
All Cardiac Hospitalizations
Heart Failure
Re-Hospitalizations
63 Reduction (p0.029)
72 Reduction (p0.03)
Hospitalizations PPPY
Health Buddy
Control
Health Buddy
Control
Presented at American Heart Association Annual
Meeting, Scientific Sessions, 2005.
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Mercy Study Compliance Drives Outcomes
Medication Compliance as Measured by Pharmacy
Claims and Patient Self-reporting
Hospitalization Costs for CHF patients decreased
52 PPPY
25,013
1-Year Diabetes HF Study
11,854
Health Buddy
Before
Health Buddy
Standard
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Patient Acceptance
Patients enjoy significant improvements in
quality of life1

• 95 patient satisfaction2
• 86 better understand their treatment and are
  better able to manage their health condition
• Patients feel more connected to their care
  provider2

1 Diabetes Technology Therapeutics, Volume 4,
Number 6, 2002. 2. Henry Ford Medical Center, CAD
Study, 2004. (n602)
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The People We Serve

• Health Buddy is the best thing to come down the
  pike. When I get up in the morning, I feel
  confident I am good for another day.

Wally Browning 1941-2006
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Contact Information

• Steve Brown, CEO
• Health Hero Network, Inc.
• 2000 Seaport Blvd.
• Fourth Floor
• Redwood City, CA 94063
• stevebrown_at_healthhero.com
• 650-779-9101