Implementing Telehealth

Home Monitoring Project

Nicole Norris

Chamberlain College of Nursing

NR 640 Informatics Nurse Specialist Practicum I

Summer 2014

Objectives

Define telemedicine and how it works Identify and describe current home monitoring practices Define what CHF is and associated complications. Identify the cost of readmission of CHF patients Describe equipment required to monitor patients from home Identify the role of the patient, Assess costs of implementing a telehealth program Identify inclusion/ exclusion criteria for selected patients Identify the project goals Identify a proposal to implement project

2

Project Goals

Improve quality of life for patients with congestive heart failure

Provide continuous care through telehealth home monitoring

Provide 24-hour technical support Document findings and make revisions to

plan as needed

Institution’s Mission

Dedicated to providing access to quality healthcare

Provided supportive environment Devoted to excellence and safety Committed to outstanding healthcare Optimizing quality of life

Vision Statement

National leader for excellence Deliver the highest healthcare Provide tailored healthcare experiences

What is Telehealth?

Tele- “at a distance”

“The use of electronic communications to exchange medical information to improve patient outcomes.”

, (American Telemedicine Association, 2014)

Telehealth Services

Remote patient monitoring Referral services Medical education Mobile health applications Biometric devices Online consults

What are the benefits?

Decrease hospital admissions Decrease healthcare costs Improve quality of life Improve patient outcomes Improve access to healthcare Decrease use of emergency department

What is CHF?

Congestive Heart Failure Most expensive chronic condition to treat Affects approximately 5.7 billion annually Leading cause of hospitalization in people

>65.

Costs of CHF

$37.2 billion annually $4,873 average daily cost for

hospitalization. Length of stay approximately 4.76 days $17.4 billion for readmissions within 30

days

Telehealth Solutions

The project is intended to utilize telehealth home monitoring for patients with chronic CHF on an out-patient basis.

Successful implementation of this project will encompass tremendous benefits.

Telehealth Solution

Home monitoring program

Cost effective Wireless monitoring Monitors weight, blood pressure, pulse ox

How much does it cost?

Budget InformationIT Technical Support Staff $15,000 ($60,000/year, $5k/month x 3 months)

Equipment Installation Fee $3,750 ($150 x 25)

Telemonitoring Landline unit with b/p

$5,775.00 ($79.00/month x 25 x 3 months)

Weight Scale $1,496.25 ($19.95/month x 25 x 3 months)

Blood Glucose $1,496.25 ($19.95/month x 25 x 3 months)

Training $700 ($28/hour x 25)

Total Estimated Budget $28,218

Inclusion/ Exclusion Criteria

Inclusion Diagnosis of CHF Ambulatory Able to provide self-care Willingness to participate EJF <40%

Exclusion Diagnosis of

comorbidities such as renal failure or liver disease

Non-ambulatory Refuse consent to

treatment Alcohol use Smoker

Participate Training

Train participates prior to discharge Arrange a date for home visit prior to

discharge Provide simulation set-up prior to

discharge Provide 24-hour phone support for 1st

month

Critical Success Factors (CSF)

Stakeholder support Referral mechanisms and protocols Effective communication between stakeholders Necessary resources Support government regulation and policies Demonstrate the effectiveness of telehealth for

selected patients.

How It Works

Daily monitoring sessions Questionnaire Prompted to call physician Advise given via phone to treatment plan Follow-up 6 months after trial

Staff Training

All staff of Cardiac Wellness center ED nurses Quick 10 minute in-service training while

at work

Proposal

Select trial group of 25 patients from St. Louis Medical Center in Second Life

Monitor patients via telehealth home monitoring x 3 months

Provide 24-hour technical support Document findings and make revisions to

plan as needed

End of Project

Healthier Patients Happier Staff Decreased Cost Decreased Emergency Visits Increased Revenue

Let’s Get Started!!

Let’s get ready to make SLMC the best by being the first hospital to implement a successful telehealth home monitoring program!!

Special Thanks

Dr. Hebda Paul Woodcock Dr. Sipes St. Louis Medical Center Staff Classmates Phillips Home Monitoring Company Sunita Wadell INS, PG Community Hospital

References

Desai, A. and Stevenson, L. (2012). Rehospitalization for Heart Failure: Predict or prevent? American Heart

Association publication, Circulation. Retrieved from http://circ.ahajournals.org/content/126/4/501.full

 

American Telemedicine Association (ATA), (2014). Retrieved from

http://www.americantelemed.org/abouttelemedicine/what-is-telemedicine#.U3g2XP1OWM8

 

Center for Disease Control and Prevention (CDC, 2014). Retrieved from

 

http://www.cdc.gov/dhdsp/data_statistics/fact_sheets/fs_heart_failure.htm

Seibert, P., Whitmore, T., Patterson, C., Parker, P., Otto, C., Basom, J., Whitener, N. and Zimmerman, C. (2008).

Telemedicine Facilitates CHF Home Health Care for those with Systolic Dysfunction. Retrieved from:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2274890/