Incorporating Telemedicine (TM) to Reduce the Rates of Rehospitalizations in the Chronic Heart Failure (CHF) Population Roshini M. Mathew RN, BSN, Erica.

Slides:



Advertisements
Similar presentations
Effects of Telehealth on the Self Management of Heart Failure Brendon Colaco, M.B.B.S., M.H.A Kathryn H. Dansky, PhD, RN Kathryn H. Bowles, PhD, RN.
Advertisements

THE ROLE OF THE CARDIAC NURSE PRACTITIONER
Kailey Hamrick NURS /24/13 COMMUNITY ASSESSMENT: RURAL/REMOTE LIVING, LOW-INCOME, AND UNINSURED PATIENTS WITH DIABETES.
Disease State Management The Pharmacist’s Role
Keeping it Simple: Using IVR to Enhance Wellness Janelle Howe Sr. Director, Health Enhancement HealthCare Partners Medical Group Co-Investigator, HealthCare.
Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins Chapter 36 Implementing and Evaluating Care.
Each Home Instead Senior Care franchise office is independently owned and operated. Each Home Instead Senior Care ® franchise office is independently owned.
It’s A Success! Achieving Cost-Effective Disease Management in CHF Sherry Shults, RN BSN CIO South Carolina Heart Center.
Barriers to Care Transitions Each health plan has different forms and different requirements for authorizations Multiple health plan formularies Providers.
Chris Gaur, Co-Founder Vital Care Services TeleHealth Research : Assistive Remote Patient Monitoring – Effective e-Health Intervention Pace University.
Strengthening partnerships: A National Voluntary Health Agency’s initiatives in managed care Sarah L. Sampsel, MPH* Lisa M. Carlson, MPH, CHES* Michele.
Care Coordination What is it? How Do We Get Started?
Sensor Systems for Monitoring Congestive Heart Failure: Location- based Privacy Encodings Edmund Seto, Posu Yan, Ruzena Bajcsy University of California,
1 Special Innovation Project: SIP-CA-02 “Cardiac Health Disparities and Collaboration with the Regional Extension Centers to Support Blood Pressure Measurement.
DO DIETITIANS HAVE A ROLE? Renee Wing, Sodexo Dietetic Intern Orange Park Medical Center January 22, 2013.
PREVENTING READMISSIONS OF CONGESTIVE HEART FAILURE PATIENTS Daidreanna Whiteman Senior Project Columbus State University Summer 2014.
Memorial Hermann Healthcare System Clinical Integration & Disease Management Dan Wolterman April 15, 2010.
Medication Adherence in Heart Failure University of Central Florida Tessa Dillon.
Overview Community Care of North Carolina. Our Vision and Key Principles  Develop a better healthcare system for NC starting with public payers  Strong.
Pan American Health Organization.. Protecting the Health of Health Care Workers: Experience from the Americas Marie-Claude Lavoie Decision Making for Using.
Research Day Sustainable TeleHealthcare delivery model for diverse socio-economic communities in New York City.
Perspectives on the Age Wave: Key Issues, Solutions, and Opportunities Robyn Golden, LCSW Director of Older Adult Programs Rush University Medical Center.
Reduction Of Hospital Readmissions Hany Salama, MD Diplomat ABIM IM Hospice and Palliative Care Sleep Medicine.
Learn more about ways to Bend the Curve in health care costs at: Made possible through support from: Preventing Hospital Readmissions:
Connected Health: Using patient-centric technologies to change behavior and improve outcomes Joseph C. Kvedar, MD Director Center for Connected Health.
Reaching Out to Reduce Readmissions William C Crowe, Jr, DNP, APN, ACNP-BC, FNP-BC; Paul M Smith, RN; Jodi Whitted, MSSW, LCSW Erlanger Health System,
The Pathways Program “Bridging your way to better breathing” Advocate Health Care, Advocate Home Health Services, Cardio-Pulmonary Rehabilitation, and.
Community Paramedic. Benchmark 101 We need a description of the epidemiology of the medical conditions targeted by the community paramedicine program.
An Innovative Approach to Managing Diabetes in a Large Public Health System Donna J. Calvin, PhD, FNP-BC, CNN Post Doctoral Research Associate University.
June 11, IOM, Reducing Suicide, 2002 Statement of Task w Assess the science base w Evaluate the status of prevention w Consider strategies for studying.
Thinking Differently about Hospital Readmissions Presented by Glenna Yaroch, MBA,PT Owner/President Home Instead Senior Care September 12, 2014.
Clinical Nurse Leader Impact on Microsystem Care Quality Miriam Bender PhD(c), MSN, RN, CNL National State of the Science Congress on Nursing Research.
Care Management 101 Governor's Office of Health Care Reform October 28, 2010 Cathy Gorski, RN, BS, CCM.
Creating Value for Health IFA 2012 Global Conference on Aging Dr. John Tarrant 118 Old Lafayette Ave Lexington, Kentucky USA
TeleHomecare Management of Congestive Heart Failure in Rural Mississippi Cathy Smith, RN, BSN North Mississippi Medical Center Home Health Cardiac Outcomes.
Mary Gardner, RN, MA, CCM, CDE Program Manager, High Risk Diabetes and COPD XLHealth Member Management Using The Med-eXpert System and Med-eMonitor Patient.
 Demographics  Estimated Population 10,500  Population of Zip Code 29,000  21% of population 65 or older  Satellite Beach Fire & Paramedic.
Fundamental Nursing Skills and Concepts Chapter 2.
Asthma Management and the Allergist: Better Outcomes at Lower Cost.
Population Health Janet Appel, RN, MSN Director of Informatics and Population Health.
Telehealth Technology
Quality Improvement and Care Transitions in a Medical Home Maryland Learning Collaborative May 21, 2014 Stephanie Garrity, M.S., Cecil County Health Officer.
Module 3: Alzheimer’s Disease – What is the Role of Public Health? A Public Health Approach to Alzheimer’s and Other Dementias.
Connecting Hypertensive Patients at the Physican’s Free Clinic to a Primary Care Provider Ariel Kanevsky, Ranjit Ganguly, Brittany Shrefler, Maarten Galantowicz.
 Promote health, prevent illness/injury  Broad knowledge base needed to meet patient needs in different health care settings.
Can Nurses Assist Older CHF Patients With Self-Care? Sallie A. Alvarez NGR 5800 American Heart Association.
BANNER HOME CARE TELEHEALTH. Objectives Overview of BHC Telehealth program Home Health and Telehealth Patient selection and admissions Results and Revisions.
PRACTICE TRANSFORMATION NETWORK 2/24/ Transforming Clinical Practice Initiative (TCPI) Practice Transformation Network (PTN)  $18.6 million –
Chronic disease management: Doctor’s office to remote patient monitoring November 2, 2015 Presenters: Rusty Williams - Vice President and Chief Information.
PREVENTION OF READMISSIONS By Michael Burns Widener University.
Regardless of distance, it enables physicians, nurses, and healthcare specialists to: assess diagnosetreat.
Cebu Normal University College of Nursing - Graduate Studies Clinical Nursing Information System A report by Carmenila S. Inso, RN Submitted to Domino.
Department of Public Health Presentation to the Health Cabinet June 14, 2016.
 Presented by Kara Derry, Oksana Marchenko, Sonja Wrobewski, and Carolyn Zielinski.
Chapter 36 Implementing and Evaluating Care
Collaboration of Care through Home Telehealth for HF
Home Health Remote Patient Monitoring For Heart Failure
1.03 Healthcare Trends.
Hypertension Control through 6|18 Interventions
Using the SafeMed model for transitions of care approach
IMPROVING OUTCOMES IN FEE FOR SERVICE MEDICARE
Management of Type II Diabetes
Community Step Up Program
Hypertension Management at the VA Geriatric Clinic
Using the SafeMed model for transitions of care approach
Concepts of Nursing NUR 212
Pharmaceutical care planning 2 Ola Ali Nassr
North Florida/South Georgia Veterans Health System
Risk Stratification for Care Management
Presentation transcript:

Incorporating Telemedicine (TM) to Reduce the Rates of Rehospitalizations in the Chronic Heart Failure (CHF) Population Roshini M. Mathew RN, BSN, Erica Robertson RN, BSN, Jennifer Hoggatt RN, BSN, Chadwick Boberg RN, BSN Clinical Problem Background Evidence Favoring TM Practice change team/agents: Administrators, RN’s, Nurse Practitioner, Cardiologist, Primary Care Physician, PT, OT, Nutritionist, Telehealth Nurse, HomeMed reps Key Informants/reps/agents: Hospitals, Heart Failure Clinics, Home Health Agencies, Social Workers, Patients, Caregivers Intervention Clinical Implications Evidence Based Practice Model (Rosswurm & Larrabee, 1999) Step 1-Assess need for Change in Practice Step 2-Locate the Best Evidence Step 3-Critically Analyze the Evidence Step 4-Design Practice Change Step 5-Implement /Evaluate Practice Change Step 6-Integrate /Maintain Practice Change PICOT In patients with CHF (P), how effective is the implementation of TM in the home (I) compared to the visitation of home healthcare nurses (C) in the prevention of rehospitalizations (O) over a 6-month time period (T)? With a TM system, CHF patients are required to take blood pressure, heart rate, oxygen saturation, and weight on a daily basis at the same predetermined time. Patients are prompted to answer yes/no questions regarding the CHF process with a single key press. The data is collected within 5-10 minutes and sent via phone line to the health care agency, where telehealth nurses review the data, and follow-up with a phone call for abnormal readings. The telehealth nurse provides education on the importance of body weight measurements, medication compliance, dietary and fluid restrictions, and symptoms of worsening CHF. The telehealth nurse is able to collaborate with the patient’s provider for new orders, and make a home visit if necessary. Outcomes (Clarke et al., 2011) Level 1 (Klersy et al., 2009) Level 1 (Polisena et al., 2010) Level 1 (Weintr aub et al., 2010) Level 2 # CHF related Hospitaliz ations TM patients ↓ Mortality Rate TM patients ↓ TM patients (a lower trend) In U.S. 660,000 new cases of CHF diagnosed yearly. 5.8 million in U.S. and 23 million people in the world have CHF. CHF is the most common cause of rehospitalizations and the mortality rate is 50% within 5 years of diagnosis. CHF healthcare costs total to $34 billion. 1 million rehospitalizations in the year 2000 & 2010, signifying no improvement in care. 50% of CHF-related rehospitalizations are avoidable (AHA, 2012; CDC, 2012) Verbal or written education and 2-3 weekly homecare visits by nurses are insufficient methods to manage disease. TM delivers safe, cost-effective care by providing constant remote surveillance of high- risk patients using digital technology. TM improves access to care, eliminates disparities, and improves patient outcomes. TM promotes self-management of disease process, resulting in lifestyle changes. TM assists in identifying signs and symptoms of CHF exacerbation, thus resulting in earlier implementation of medical care and preventing rehospitalizations. (IOM, 2012; Taylor-Clarke et al., 2012; Weintraub et al., 2010) Stakeholders Baseline hospitalization data was compared with the post study data to reveal Cronbach’s alpha was greater than 0.80 (0.85). The pilot study supports the use of TM in the CHF patient population to reduce rehospitalizations. Intermediate outcomes: lower blood pressure, greater medication and diet adherence, improved mental, physical, and emotional well-being. TM, while a costly initial intervention, supports long-term benefits of cost savings and increased quality of life in the CHF population. Clinicians can better monitor and educate CHF patients via TM while still maintaining personal contact. TM improves access to care, avoiding barriers such as inadequate transportation and financial resources. TM assists patients and caregivers in learning about CHF disease process and prevention strategies. Evaluation Donabedian Method: Supports IOM priority concern regarding CHF disease process by evaluating all aspects of care that may contribute to the outcomes.