Page 3 Case Studies in Telehealth Adoption Scaling Telehealth Program sLessons from Early Adopters

ScALing TeLeheALTh ProgrAmS: LeSSonS From eArLy AdoPTerS 3

• Barriers to patient participation need to be low. and improvement in care quality and reduced cost or
To minimize any potential barriers to maximizing responses to health care and payment reforms.
enrollment, patient participation should be at no Each program has sought to enhance patient
or little financial cost and enrollment should be activation and engagement in care, as well as the
automatic for all eligible patients. The VHA has remote monitoring of data for the early detection of
recently announced that it will waive copayments complications. These shared program features are
for patients receiving its telehealth services. fundamental to facilitating behavior change and ensur-

• Telehealth data can empower all stakehold- ing timely, interactive care interventions that prevent
ers. Telehealth data can have a positive impact on unnecessary hospitalizations. In all organizations,
patient care when placed in the hands of motivated organizational culture, human factors, and social pro-
clinicians and patients. The real-time transmission cesses that promote support from executive leadership,
of monitoring data, for example, allows nurses to clinical staff, and patients and their families have been
provide patients with just-in-time care and educa- key elements to ensure the realization of successful
tion. The use of personal health data can help edu- program outcomes.
cate and motivate patients to make necessary life-
style changes and realize better clinical outcomes. Veterans Health Administration: Taking
Home Telehealth to Scale Nationally
• Program evaluations need to incorporate non- The Veterans Health Administration (VHA) is the most
standard measures. Program evaluations need to notable example of a home telehealth service taken
recognize the importance of nonstandard measures to scale. The VHA piloted, evaluated, and deployed
and the role they contribute to improved clinical home telehealth in a continuing process of learning
and financial outcomes. These may include patient and improvement, and found that an enterprise-wide
experience and staff satisfaction, for instance. implementation can be achieved and can lead to cost-

• Successful programs can take time to scale suc- effective, quality outcomes for chronic care patients.
cessfully. It takes time to integrate technology into The organization’s Care Coordination/Home Telehealth
care delivery and to allow staff to adapt. Structure, (CCHT) program uses Group Health’s Chronic Care
coordination, planning, and setting goals and Model as a framework, with the patient’s home the pre-
expectations are critical. Aligning program goals ferred site of care wherever possible and appropriate.
with broader organizational strategic initiatives to Promoting patient activation and self-management has
improve performance and deliver more account- been key to CCHT’s success in preventing unnecessary
able care can facilitate progress. hospital admissions or emergency department visits.
First introduced in 2003, CCHT is now a
LEARNING FROM THE VETERANS HEALTH routine service that uses home telehealth and disease
ADMINISTRATION, PARTNERS HEALTHCARE, management technologies in the remote care manage-
AND CENTURA HEALTH AT HOME ment of chronically ill patients at risk for long-term
Each organization has established practices for scal- institutional care. CCHT has demonstrated successful
ing telehealth based on its needs and objectives. The outcomes including patient satisfaction and reduc-
strategic objectives used by these organizations to tions in bed days of care and hospital admissions.
guide the introduction of telehealth programs into Through the end of fiscal year 2010, veterans reported
practice are often in alignment with larger strategic patient satisfaction levels greater than 85 percent for
initiatives. These may include performance improve- home telehealth services offered through CCHT, and
ment initiatives that seek to achieve clinical excellence reductions in bed days of care in excess of 40 percent
on preenrollment figures for the CCHT population