Page 10 Case Studies in Telehealth Adoption Partners Health Care Connecting Heart Failure Patients to Through Monitoring

10 The commonweAlTh Fund

Data Can Motivate and Empower IMPLICATIONS FOR U.S. HEALTH CARE
Clinicians and Patients ORGANIZATIONS
Outcomes in controlled trials, as well as in before- Being in an integrated delivery network that owns a
and-after studies, have consistently demonstrated an home care service business has allowed Partners to be
approximate 50 percent drop in cardiac-related read- ahead on the adoption curve with telehealth relative
missions for patients enrolled in CCCP. One drive of to other health systems. Organizations—particularly
that outcome is patients learning self-management ones lower on the adoption curve—that are considering
skills and receiving constant feedback about how life- technology-enabled solutions will need to address the
style factors affect health outcomes. Another is just-in- following issues: establishing acceptance that the tech-
time care, whereby remote monitoring and intervention nology can clinically make a difference, identifying the
by nurses sends a strong message to patients that they method by which the organization will implement and
are accountable. CCH’s commitment to research allows integrate the technology, determining whether a one-
the organization access to the data and studies to coun- size-fits-all approach will be feasible across the net-
ter resistance and arguments from clinicians about the work or system, and evaluating whether the prevailing
impact on quality and patient experience. CCH is also financial system can support an economical approach
able to prepare the business case and concomitant cost- to scaling.
savings argument. But the traditional business case From an organizational readiness perspec-
approach cannot convey the full impact that other fac- tive, it is critical to recognize the role of champions
tors, such as patient experience and staff satisfaction, who understand workflow and also to understand the
have on improved health outcomes and higher quality requirements for successfully integrating solutions into
of care. practice. To gain buy-in from staff, it is important to
put the data in the hands of motivated individuals, like
New Technology-Enabled Solutions Do Not clinicians who want to help their patients. It is also
Fit Old Policy Frameworks important to aggregate external data, integrate it with
CCH faces challenges in optimizing the impact of clinical health information systems, and communicate
connected health programs on care outcomes. The cur- it to patients and providers alike. Data cannot be main-
rent fee-for-service environment can present a mental tained in separate data silos and must be placed in the
barrier for clinicians, and pilots involving financial EHR to be meaningful and useful in clinical decision
incentives that reward provider engagement have not support. Patients need access to the patient portal, with
led to significant behavior change. Many doctors view the ability to retrieve clinical information and perform
the move toward a patient-centered medical home as administrative functions. CCH has invested significant
requiring more staff, such as nurses and pharmacists, resources in developing a platform to support the inte-
rather than an opportunity for leveraging technology gration and management of data, which will also serve
in support of fewer staff. While the widespread use as a platform for the development and implementation
of connected health solutions will require structural of other applications.
changes in the form of reimbursement and new care However, recognizing that not all systems are
models like the patient-centered medical home, a sig- equal in the U.S. health care delivery system, CCH’s
nificant amount of work remains to be done in promot- experience also points to common pitfalls to avoid
ing the use of technology to leverage existing staff rather than just best practices to adopt. A common
across more patients. mistake is attempting to shoehorn a connected health
program into the traditional care model. Technologies
such as telemonitoring can be disruptive to workflow
and represent a change in the way care is delivered.