Page 2 Case Studies in Telehealth Adoption Centura Heal that Home Telehealth as the Standard of Care

www.himss.org FALL 2013 VoLume 27 / NumBeR 4 29
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FoCuS: 30 DAyS To MAke A DiFFerenCe

Facilitated by a combination of remote patient

monitoring using mobile and wireless devices, and patient

engagement the average systolic blood pressures for

34 patients dropped by 20 points in week four,continuing

to a 30-point drop in week five.

quality, reduced costs, and an improved mined by preset protocols, provided to the ventions on the entire patient population,
patient experience—the Triple Aim. physician office where a nurse practitioner the effectiveness and positive impact of the
Background determined whether an adjustment to a comprehensive program are obvious.
Whether an approach that incorporates patient’s medications or other treatment Conclusion
mobile remote monitoring of blood pres- change was necessary. This follows the A 30-day program combining daily mobile
sure, shortened provider feedback intervals, remote patient monitoring (RPM) process of remote patient monitoring, near-real time
and use of a monitoring and engagement “collect, transmit, evaluate, notify and inter- provider feedback and associated medica-
center to provide live telephonic engagement vene” promoted by the Center for Technol- tion changes, and patient engagement and
and education can improve outcomes and ogy and Aging. Patients also participated in education was shown to produce signifi-
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increase patient satisfaction for hyperten- weekly assessment and education calls. We cant reductions in high blood pressure, and
sive patients within 30 days is unclear. evaluated outcomes based on the effects on improvement in patient feelings of empower-
Objective systolic and diastolic blood pressures, and ment for self-management of their condition,
To assess the efficacy of a 30-day approach responses to a patient satisfaction survey with a likely reduction in office visit costs
combining mobile remote patient monitor- performed at the close of the study. (Funded by Vitaphone USA Corporation).
ing, shortened provider feedback intervals, Results
and patient engagement and education on The improvement of average blood pres- IntROduCtIOn
the treatment of hypertensive patients. sure including a decrease in the systolic Chronic hypertension affects an estimated
Goals from baseline 155.9 +/- 18.0 to 133.2 +/- 6.8 30.4 percent of the U.S. adult population,
Primary: To improve subjects’ average in week four, and a decrease in diastolic but only 46.5 percent of those have their
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blood pressures by 10% (systolic or diastolic from 88.7 +/- 9.7 to 76.2 +/- 2.6 over the high blood pressure under control. The
blood pressure). same time period (P<0.001). Patient satis- societal cost of hypertension in the US is
Secondary: To assess patient satisfaction faction scores were also extremely positive, estimated at $131 billion annually. Con-
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and feelings of empowerment to self-man- especially regarding the patients’ perceived trolling hypertension depends primarily
age at the end of the study period. value of the educational sessions on their on both the use of appropriate medica-
Methods self-management of hypertension. Feed- tions and patients’ self-management of
Thirty-four hypertensive patients were back of filtered monitoring data to physi- their conditions. A faster, yet non-intru-
enrolled by their cardiologist to measure cian offices enabled medication changes as sive, and efficacious approach to both of
blood pressure at home twice a day, having deemed necessary by a nurse practitioner, these is needed if comprehensive thera-
it immediately transmitted to the monitor- saving both physician time and office visit pies are expected to scale nationally and
ing and engagement center. The data were time and costs. Though it is difficult to iden- internationally. It is not known whether a
monitored by a nurse and, when deter- tify the specific impact of individual inter- 30-day approach which combines mobile