Page 18 Telehealth and Remote Patient Monitoring RPM for Long Termand Post Acute Care A Primer and Provider Selection Guide 2013

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hospital readmissions, especially among patients results. The first study looked at patients with mod-
with heart disease and COPD. For example, one erate to severe COPD and found that, compared to
meta-analysis of telehealth studies conducted in usual care, case managers’ use of RPM for daily
2011 found that, compared to standard care, those symptom surveillance resulted in a significant
patients with heart failure receiving telehealth had a decrease in hospital readmission rates as well as a
42% reduction in hospitalizations. Another study tendency toward fewer hospital days and outpa-
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that focused on the impact of telehealth on hospital tient visits. The second study was a retrospective
26
readmissions found there was a 60% reduction in cohort study using the Veterans Health Admin-
hospital readmissions using RPM compared with istration database of COPD patients enrolled in
standard care, and a 50% reduction compared with the CCHT program. Results indicated that 71.5%
other disease management programs that did not of the CCHT patients had a reduction in the
use RPM. This study concluded that RPM has the number of ED visits and exacerbations related to
potential to prevent between 460,000 and 627,000 COPD requiring hospitalizations after enrollment
heart failure-related hospital readmissions each in the program.
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year. 24

The Department of Veterans Affairs (VA) has 5.3 Patient Self-Efficacy, Quality of Life
made a strong commitment to telehealth among and Satisfaction
its large cohort of veterans by developing a
national program called the Care Coordination/ The use of educational materials and the delivery
Home Telehealth (CCHT) program. The pur- of disease-specific self-management tips at the
pose of CCHT is “to coordinate the care of veteran appropriate times through telehealth and RPM,
patients with chronic conditions and avoid the can increase the patient’s knowledge, engagement
unnecessary admission to long-term institutional and self-efficacy. In one study, LaFramboise ran-
care.” To that end, the VA has broadly deployed a domized 103 patients with heart failure to receive
range of RPM technologies in 50 different health (a) a telehealth intervention that included RPM,
management programs across 18 Veterans Integrat- clinician assessment, and feedback with advice or
ed Service Networks and conducted various studies encouragement; (b) the telehealth intervention plus
showing improved chronic disease management, home care; (c) home care alone; or (d) telephone
cost savings, and reduced hospital admissions and care. Patients using the telehealth intervention had
emergency department (ED) visits. Findings from increased self-efficacy, while all groups had equal
comparative studies conducted on 17,025 patients improvement in health related quality of life, the
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enrolled in the VA CCHT program in 2006 and 6-minute walk test, and depression scores. In
2007 show a 25% reduction in bed days of care, 20% addition, telehealth and RPM has the potential
reduction in numbers of admissions, and a mean to positively impact the patient’s quality of life. A
satisfaction score rating of 86%. 25 review of home telehealth found that, compared
to conventional home care or usual care, home
In addition, two studies focusing on the impact of telehealth improved access to care, patients’ medical
telehealth and RPM on COPD found promising conditions, and quality of life. 29

Telehealth and Remote Patient Monitoring for Long-Term and Post-Acute Care:
A Primer and Provider Selection Guide 2013