Page 6 Case Studies in Telehealth Adoption Centura Heal that Home Telehealth as the Standard of Care

www.himss.org FALL 2013 VoLume 27 / NumBeR 4 33
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focus: titleoCuS: 30 DAyS To MAke A DiFFerenCe

the results oF the patient satisfaction survey

indicate a high degree of satisfaction, improved

education of the patients regarding their knowledge of

their hypertension and how to manage it, and interest to

recommend the program to others.

their condition, is deemed a success. A
primary goal had been to improve blood Figure 3: Center for Technology
pressure (either systolic or diastolic blood and Aging Remote Patient Monitoring Process.
pressures) by 10 percent in 30 days: systolic
was improved by 14.6 percent and diastolic
by 14.1 percent at four weeks, bringing them
not only to the <140/<90 range, which is
associated with significant reduction of car-
diovascular disease (CVD) complications,
but also into the <130/<80 range, which is servers. control. Globally, suboptimal blood pres-
2
the target for hypertension patients that n ■ Telemedicine Service Center Staff sure ranks first in the list of risks of death,
8
also have renal disease or diabetes. The evaluated the data, with the assistance of affecting an estimated 1 billion individuals.
patient satisfaction survey showed that the specialized software, containing algorithms Additionally, the prevalence and hospital-
patients “Strongly Agree” regarding both which compare incoming data with estab- ization rates of congestive heart failure
their experience with the program, and the lished thresholds. (CHF) patients continue to increase, with
positive impact the program had on their n ■ Weekly, and as needed, physician readmission of CHF patients a national
knowledge of and ability to self-manage offices were notified of patient status and priority, and the majority of CHF patients
9
their hypertension. potential problems. have hypertension before developing CHF.
The process and program for this study n ■ Providers intervened as needed, in Any improvement that can be made in the
followed closely the RPM process identified some cases with nurse practitioners mak- management of hypertension, especially
by Center for Technology and Aging, which ing adjustments to medications. if lifestyle management is also positively
is shown in Figure 3. 1 The addition of patient educational affected, should reduce the prevalence
The above-described process has been modules, which included discussions of and severity of CHF. Thus, management of
recognized as a best practice by the Center risks and complications, medications, and hypertension, and increased patient self-
for Technology and Aging, and should con- diet and exercise had the complementary efficacy should be a national and interna-
tinue as the foundation for effective scaling impact of increasing the patients’ feel- tional health priority, not just for the impact
of this program. ings and knowledge of self-management. on hypertension, but for its cause-effect
In this study, the RPM process was fol- This increased confidence in the ability to relationship of hypertension with other
lowed as described here: manage their condition is known as “self- chronic disease and their health and eco-
■ Data was collected via the wireless efficacy,” and is thought to be critical to nomic impacts.
n
(Bluetooth) blood pressure cuff. adherence to behaviors that will control The patient satisfaction survey indi-
■ Data was transmitted from the blood chronic disease. 5-7 cates that patients would not pay for this
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pressure cuff to the cellular-enabled gate- As noted earlier, 30.4 percent of the US service if it is not covered by their insur-
way, which in turn transmitted the data population have hypertension, yet only ance. Unfortunately, at this time, RPM is
to the Telemedicine Service Center’s data 46.5 percent have their hypertension under not reimbursable by Medicare, nor by most