Page 5 Case Studies in Telehealth Adoption Scaling Telehealth Program sLessons from Early Adopters

ScALing TeLeheALTh ProgrAmS: LeSSonS From eArLy AdoPTerS 5

as the program has been taken to scale. As the Partners HealthCare: Connecting Heart
program has grown, the evidence has reinforced Failure Patients Through RPM
the benefits to patients and has made a strong clini- Partners HealthCare is an integrated health system
cal and business case that facilitates buy-in from in Boston. Partners’ programs in home telehealth
clinicians and managers. The dissemination of have been driven in large part by the Center for
findings broadly throughout the system has rein- Connected Health (CCH), Partners’ research center
forced the continuous cycle of learning within the for the development, testing, and implementation of
organization. patient-centered technology solutions for health care

• Standardizing core program elements. With delivery. Being one of only a handful of research cen-
systemized clinical, technology, and business pro- ters of its type in the world, CCH plays a unique role
cesses, as well as national policies and operational in the integrated delivery system’s development of
procedures for contracting with vendors and a ded- technology-enabled approaches to delivering quality,
icated program office and training center, CCHT cost-effective, patient-centered care. The Connected
care is consistent across time and place throughout Cardiac Care Program (CCCP), which provides home
the VHA system. telemonitoring and education for heart failure patients,
is among a number of CCH programs that have been
• Balancing system with local needs. Successful successfully piloted at Partners and scaled across the
implementation of the program has relied on the network.
VHA’s ability to balance top–down guidance on A 2006 pilot study of CCCP with 150 heart
standardizing approaches to clinical protocols, failure patients showed reductions in heart failure–
workforce training, and business processes with related and all-cause readmissions as well as in emer-
bottom–up innovation to meet the needs of patients gency room visits. While these results were not statisti-
at the local level. cally significant, they provided evidence to Partners’

• Investing in an enabling technology infrastruc- leadership that led to its support for the expansion of
ture. The enterprise-wide health information CCCP. Additional benefits included a reduction in the
technology infrastructure and use of algorithms to need for nurse visits for patients receiving skilled nurs-
match patients with appropriate telehealth tech- ing care from a home care provider, and participants’
nology have contributed to the consistency in the high satisfaction levels and greater confidence to self-
systemwide implementation of home telehealth. manage diseases. To date, more than 1,200 patients
Although beneficial to the program, they are have been enrolled in CCCP. The program has consis-
not necessarily required for a program to work tently experienced an approximate 50 percent reduction
successfully. in heart failure–related readmission rates for enrolled

• Dedicating resources to staff training and devel- patients. Non–heart failure readmissions have declined
by 44 percent. CCH’s in-house analysis estimates that
opment. Establishing a national training center to the program has generated total cost savings of more
deliver online training programs has ensured a tele- than $10 million since 2006 for the more than 1,200
health-competent workforce to deliver efficient and enrolled patients (Exhibit 2).
effective care at scale. Program staff and graduates In Partners’ experience, the role of human
of the training program have been critical in help- factors and social processes in supporting technology
ing solve programmatic issues at the local level deployment has been as important as the technology
and in serving as ambassadors for promoting the itself in ensuring the successful introduction of con-
program throughout the organization.
nected health solutions into workflow and patient
care. The impact that the technology has on patient