Page 3 Case Studies in Telehealth Adoption Centura Heal that Home Telehealth as the Standard of Care
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FoCuS: 30 DAyS To MAke A DiFFerenCe focus: title
remote patient monitoring, shorter pro-
vider feedback intervals, and patient edu- Table 1: Alerts and Protocols.
cation will significantly decrease systolic
and diastolic blood pressures, while also
resulting in patients’ feelings of empow-
erment and ability to self-manage their
hypertension.
Previous and ongoing successful remote
patient monitoring (RPM) programs have
shown RPM successful in “reducing hospi-
talizations and health care costs; improving
patient knowledge, satisfaction, and clini-
cal outcomes; and activating patients to bet-
3
ter manage their own health and care.” Yet,
RPM use for hypertensive patients is not
yet widespread. With half of all patients
who are under antihypertensive drug ther-
apy not meeting treatment goals, there is
an opportunity to apply RPM and patient
engagement to improve the outcomes
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and treatment of hypertensive patients.
What has not been shown is whether such
improved outcomes can be expected within
a 30-day program. way device, which in turn transmits val- A weekly summary report was sent
To investigate whether a combination of ues via a mobile cellular network to the to the physician office, including a trend
RPM, shortened provider feedback inter- monitoring and engagement center’s data graph, table including blood pressure /
vals, and patient engagement/education servers. Patients were also provided with heart rate measurements, date and time of
results in improved systolic and diastolic hard copies of educational materials to measurements, a summary of the weekly
blood pressures, and increased patient feel- be referenced during weekly telephonic follow up questionnaire responses, medi-
ings of empowerment for self-management engagement and education sessions over cation reconciliation, any medication alert
of their condition (self-efficacy), we enrolled the course of the study. During an initial messages, educational topics covered and
34 patients with baseline systolic blood pres- courtesy call, a registered nurse trained symptoms if applicable.
sure >140 mmHg or diastolic blood pressure the patients regarding the setup of the Blood-pressure readings were taken twice
>90 mmHg for a minimum of 30 days. equipment, informed them as to how to daily: between 8 a.m. to 9 a.m. and 5 p.m. to
take their blood pressure, and provided an 6 p.m. Bilateral measurements (from both
MEtHOdS introduction to the educational materials. arms) were taken on Monday mornings.
Study design Weekly calls began with a patient Study Oversight
In this single arm, self-control study, a com- questionnaire (e.g., “How are you feeling The pilot was sponsored by Vitaphone
parator arm was not used due to the small today?”; “Any changes to your medica- USA, whose representatives performed
sample size and the likely heterogeneous tions?”), and then proceeded with that the monitoring and engagement activity
nature of study population characteristics. week’s educational session. At the end of from the Las Vegas-based Vitaphone Tele-
Inclusion criteria were patients with chron- the fourth week, a post-survey (regarding medicine Service Center (TSC). The TSC
ic hypertension and baseline office blood the educational content) was administered. is nurse-managed and physician super-
pressure found to be >140/90 mmHg. Sys- When each patient completed their study vised. A single registered nurse, with
tolic blood pressure >140 mmHg or diastolic period, they also completed a patient sat- nurse manager backup, monitored and
blood pressure >90 mmHg was acceptable. isfaction survey. engaged the patients, scheduled and per-
Private physicians enrolled 34 patients As patients were enrolled on a “rolling formed the courtesy calls, weekly ques-
with an average baseline systolic blood basis,” the entire study period consisted of tionnaires and educational sessions, and
pressure of 155.9 +/- 18.0 and average approximately 60 days. All patients were produced summary and alert reports for
diastolic blood pressure of 88.7 +/- 9.7. residents in the Los Angeles area, and were the physician offices. Two cardiologists
Enrolled patients received a blood pres- patients of private physician practices. committed to the study, enrolling qualified
sure cuff that transmits values via the Alerts and protocols as described in patients. Vitaphone staff were in contact as
Bluetooth wireless standard to a gate- Table 1 were established: needed with the physician offices during