Page 8 Case Studies in Telehealth Adoption Scaling Telehealth Program sLessons from Early Adopters

8 The commonweALTh Fund

Exhibit 3. The Impact of Integrated Telehealth on 30-Day Readmission Rates at
Centura Health at Home

Pre-project Post-intervention readmission
Facility and condition: readmission rates rates achieved*
St. Anthony’s Central
• Congestive heart failure 13.8% 4.2%
• Chronic obstructive pulmonary disease 14.1% 6.7%
• Diabetes 14.7% 0.0%

Porter Adventist Hospital
• Congestive heart failure 17.7% 9.5%
• Chronic obstructive pulmonary disease 12.5% 2.7%
• Diabetes 9.5% 0.0%

* About one-quarter of the 200 patients used telephonic telehealth, while the majority used remote patient monitoring and had access to the clinical call center.
Source: Data provided by Centura Health at Home, reporting outcomes to the Center for Technology and Aging.

restructured in the hospital to incorporate tele- during their hospital stay required additional train-
health-based care. Case managers have been ing for effective communication techniques to
trained to identify patient eligibility and enrollment emphasize the value of the program to patients.
criteria for patients being discharged without home Clinical call center nurses also benefited from
care. Introduction to the telehealth intervention effective communication training as well as disease
takes place before discharge. Within 48 hours of management education to bolster confidence in
patient discharge, a personalized telehealth algo- clinical decision-making processes to actively man-
rithm is created for RPM patients, and telehealth age patients in response to issues raised during calls.
technicians install and train patients to use the • Selecting technology that scales with the pro-
device within their homes. gram and its needs. As a result of increasing the

• Introducing patients to the program through a volume of patients served through the integrated
trusted clinician. Introducing the program during telehealth program, CHAH made a decision to
the hospital stay by a home care nurse or physician change vendors to support more cost-effective
or by a primary care physician during a scheduled scaling of the program while meeting the broader
office visit after discharge increased the likelihood patient population’s needs. The new platform
that a patient would enroll in the telehealth program. offers the ability to monitor only those patients

• Providing staff training on effective commu- who fall outside established parameters, thereby
nication techniques. Home service coordination placing the emphasis on those patients needing
nurses who introduced patients to the program immediate attention.

The organizations profiled in our Case Studies in Telehealth Adoption series include the Veterans Health
Administration’s Care Coordination/Home Telehealth program, Partners HealthCare’s Connected Cardiac
Care Program, and Centura Health’s Centura Health at Home program. To read the profiles, visit our website at
http://www.commonwealthfund.org/Publications/Case-Studies/2013/Jan/Telehealth-Synthesis.aspx.