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Employing Enterprise Telehealth

Technology enables providers to address patient needs and intervene before issues escalate.

When consumers think of telehealth, they envision someone using an iPad for a video chat with a doctor, instead of visiting a doctor's office.

While this consumer arm of telehealth is attracting a lot of attention, there is a more profound use of this technology by hospitals and health systems  - enterprise telehealth - which consists of a broad range of remote care solutions that can help tailor services to multiple patient cohorts within a population, ranging from highest cost patients with intensive care and acute needs, to chronically ill patients and  the general population in need of prevention and wellness services.

Proactively identifying and intervening on behalf of patients who need care most in a particular moment not only improves their quality of life, but also helps address growing clinician shortages. Thus, enterprise telehealth is a powerful tool for addressing a wide range of needs created by a transition toward value-based care.

SEE ALSO: Underestimated Value of Telehealth

One of the most important uses of enterprise telehealth is in management of complex patients with very high cost of care. Across the U.S., the top 5% of patients account for nearly half of the nation's healthcare spending, and patients with multiple chronic conditions cost up to seven times as much as patients with only one chronic condition. Because of this, organizations need to leverage technology to make an immediate impact.

Bringing Care Into the Home

As healthcare organizations focus on delivering better outcomes for this complex population, at-home telehealth offers a new way to proactively address patient needs and intervene before issues escalate.

One such program is Arizona-based Banner Health's iCare program, which partners with Philips to offer Intensive Ambulatory Care (IAC) at-home telehealth for patients with multiple comorbidities.

Banner's program focuses on patients with more than six comorbidities, such as chronic heart failure, COPD and diabetes. By combining leading telehealth technologies that monitor and educate patients with a transformed clinical care model, the IAC program helps identify and address the root causes of the patients' frequent admissions and improves their quality of life.

When joining the program, patients are given a tablet to take home with them for virtual interactions with their care team, in addition to being assigned a personal health coach. The tablet, using video technology, enables clinicians to interact with their patients without being with them in person.

With the information collected through the tablet, connected peripheral vital sign devices, and from virtual visits, clinicians can remotely monitor patients' vital signs and send them short surveys about their health status. This combination of objective data and subjective responses, coupled with video interactions, enables clinicians to make informed, timely care decisions. The solution helps care teams collaborate in near real-time on their highest-cost patients, and track and manage the physiological and psycho-social risk factors that might increase the chances of a hospital readmission.

Getting Actionable Results

By building a strong support system around patients, and engaging patients in their own care, Banner's IAC program has shown the impact that at-home telehealth programs can have in reducing costs and improving quality of life. Over the course of a year and a half, Banner was able to achieve impressive results through enrolling 135 of the highest cost patients into their IAC program. The program was able to achieve:

A 27% reduction in the cost of care by lowering hospitalization rates and days in the hospital in addition to the cost savings associated with professional services and outpatient costs

A 32% reduction in acute and long term cost through significant decreased hospitalizations of the patient population being treated in the program.

A 45% reduction in hospitalizations. Prior to enrollment in the IAC program, there were 11.5 hospitalizations per 100 patients per month; after enrollment, the acute and long-term hospitalization rate dropped to 6.3 hospitalizations per 100 patients per month.

Banner Health's results show how a telehealth program can have a profound impact on one of the most difficult patient populations to care for. By doing so, they have shown the impact that similar telehealth based programs can have from both the hospital and patient point of views. With quick access to an integrated care team, patients can receive the necessary support and treatment at home that they may have gone to the ER for in the past. With this in mind, study results show that Banner Health was able to decrease:

Acute short term hospital stays from 7.7 hospitalizations per 100 patients per month to 4.9.

Long term care, home health or other facility stays from 3.9 hospitalizations per 100 patients per month to 1.4.

Average number of days in the hospital per 100 patients per month from 90.2 to 65.8.

Through this powerful technology, patients now have the ability to complete tasks such as taking their own blood pressure and weight, have them directly uploaded to their doctor and have virtual visits that meet their needs from the comfort of their own home.

Building Upon Success

As the program continues to grow, Banner anticipates seeing further proof that telehealth programs can address readmissions rates, reduce costs, and improve the health and quality of life for patients with multiple chronic diseases.

Working with a strong partner who has experience rolling out this technology and has a proven method of clinical process for telehealth program implementations can make a big difference. Implementing new technologies and clinical programs can help care teams balance an increasing patient load and while continuously improving outcomes.

As healthcare organizations need to implement changes to be prepared for value-based care, telehealth will be a powerful tool to deliver better care and improve the bottom line.

Manu Varma is Head of Strategy for Philips Hospital to Home.

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