Page 2 Case Studies in Telehealth Adoption Partners Health Care Connecting Heart Failure Patients to Through Monitoring

2 The commonweAlTh Fund

and patient-focused orientation. These include deter- BACKGROUND
mining how technology can contribute toward improv- Boston-based Partners HealthCare is an integrated
ing care quality and cost-effectiveness and identifying health system. In addition to the two academic
strategies for their successful introduction into practice. medical centers, Brigham and Women’s Hospital and
A key strategic priority at Partners has been Massachusetts General Hospital, the Partners’ system
to reduce 30-day readmissions to improve quality of includes community and specialty hospitals, commu-
care and patient satisfaction, and to minimize Partners’ nity health centers, a physician network, home health
financial risk for potential reductions in Medicare pay- and long-term care services, and other health-related
ments. Initiatives that work toward meeting those goals entities. The spectrum of care offered at Partners
include: providing patients with critical information at includes prevention and primary care, hospital and
discharge to promote safer transitions, using transitions specialty care, rehabilitation, and home care services.
teams and health coaches, participating in the Center As one of the nation’s leading medical research orga-
for Medicare and Medicaid Services’ care coordina- nizations and a principal teaching affiliate of Harvard
tion pilot demonstrations, and programs that connect Medical School, the nonprofit organization employs
chronic care patients with specialized outpatient care more than 50,000 physicians, nurses, scientists, and
services. Health information technologies, including caregivers.
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patient-centered telehealth technologies, serve as a Partners’ mission includes a commitment to its
strategic tool across many of these process improve- community and the recognition that increasing value
ment initiatives. In the future, widespread use of con- and continuously improving quality are essential to
nected health solutions at Partners will be driven by maintaining operational excellence. Partners is also
structural changes like new reimbursement models and dedicated to enhancing patient care, teaching, and
the introduction of patient-centered medical homes. research and to taking a leadership role as an integrated
Partners’ Center for Connected Health (CCH) health care system. The organization also prizes tech-
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leads the development of patient-centered telehealth nology adoption and innovation to drive improvements
solutions and remote health services for a variety in operations, productivity, and patient care. Its success
of chronic health conditions, potentially leading to to date in the large-scale adoption of electronic health
reductions in preventable readmissions. The shared record (EHR) and computerized physician order entry
goal of these telehealth solutions is to improve outpa- (CPOE) systems attests to the organizational culture of
tient care management. Partners’ experience with the openness, preparedness, and ability to adapt to change.
implementation of technology into workflow and care Such attributes have helped to ensure that the rollout of
management practices indicates that the technology new technologies is minimally disruptive and seamless
has a positive impact on patient activation and engage- to workflow.
ment in self-care and plays a critical role in realizing Partners has launched efficient care redesign
better clinical outcomes. This evidence is critical in efforts for five conditions—diabetes, acute myocardial
demonstrating to providers that this new program sup- infarction, coronary artery bypass graft surgery, stroke,
ports behavior changes that lead to improved care and and colorectal cancer—that reflect its shift toward
quality outcomes. However, Partners’ experience indi- longitudinal, condition-, and patient-focused orienta-
cates that organizations must be prepared for potential tion in care. The care redesign initiative is being led by
implementation delays imposed by the current fee-for- Partners Community HealthCare (PCH), the manage-
service environment’s adverse impact on staff behav- ment services organization for the Partners’ network of
ior. To overcome workforce resistance, organizations physicians and hospitals. PCH encompasses more than
must demonstrate to clinicians and other staff that new 5,500 employed and affiliated physicians and seven
programs will support care and quality outcomes. acute care hospitals within the system. If opportunities