Much of the health information technology (HIT) today promotes patient communication to improve care and potentially lower costs. Some examples are interactive preventive health records (IPHR), e-prescribing, and electronic health records (EHR).
Emerging telehealth technologies, however, take it a step further. Telehealth allows physicians and other providers not only to communicate with patients, but to monitor their patients’ well being remotely. Such services are particularly valuable in care coordination for the chronically ill, who contribute significantly to health costs and spending for Medicare, Medicaid, and private health plans. Telehealth also has the potential to complement efforts to reduce hospital readmissions and increase care coordination, both of which have become important issues for the Centers for Medicare and Medicaid (CMS), state Medicaid agencies, and leading health plans.
Three Case Studies from Telehealth Pilot Projects
The Commonwealth Fund recently released an interesting series of three case studies about organizations that are early adopters of telehealth methods. The case studies offer some lessons for health care policy makers, providers, health plans, and other health leaders who are interested in telehealth technologies.
A quick overview of each case study:
The Veterans Health Administration
The Veterans Health Administration’s (VHA) Care Coordination/Home Telehealth (CCHT) pilot program serves 70,000 veterans at risk of needing long-term care for chronic diseases, such as diabetes, congestive heart failure, post-traumatic stress disorder (PTSD), and hypertension. The program uses monitoring devices to transmit data on symptoms and vital signs to care coordinators at VHA sites.
The telehealth program led to a 20-percent reduction in hospital admissions for patients who participated. At $1,600 per patient per year, CCHT cost less than the VHA’s home-based primary care services, which cost $13,121, and nursing home care, which the VHA estimates costs almost $78,000 per patient per year.
The VHA notes that its telehealth program could serve as a model for coordinating care for Medicare-Medicaid dual eligibles. Dual eligibles often have chronic diseases, as the VHA program’s participants did, and account for more than a third of both the Medicare budget and state Medicaid budgets.
The Veterans Health Administration, part of the Department of Veterans Affairs, operates networks of providers across the country that serve roughly 6 million veterans each year. A recent Urban Institute study found that one in 10 non-elderly veterans have neither health insurance coverage nor use VHA health services.
Click here for the full VHA case study.
Centura Health at Home
Centura Health is an integrated health system in Colorado, with 13 hospitals and more than 6,000 physicians. Centura’s telehealth program grew from attempts to reduce hospital readmissions among Medicare beneficiaries. The health system enrolled 200 patients in a program that included a 24/7 call center staffed with registered nurses, plus remote patient monitoring using a device that collected and transmitted results from health questions and vital signs.
Centura says its telehealth methods reduced 30-day rehospitalizations by 62 percent for issues related to congestive heart failure, chronic obstructive pulmonary failure, and diabetes. Emergency department visits plummeted from 283 visits in the year before the program to 21 visits in the year of the program.
Click here for the full Centura Health case study.
Partners HealthCare is an integrated health system in Boston that includes academic medical centers, long term care providers, a physicians network, and community health centers, among other providers. Partners offers a variety of health IT services, from remote monitoring, to online video consultations, to prevention and wellness tools that motivate people to keep themselves healthy.
Among the results was a significant drop in hospitalizations for heart failure patients. About 40 percent of the 1,200 heart failure patients participating in the telemonitoring program were hospitalized in the year before the program. One year after the program, only 13.3 percent of program participants were hospitalized.
Click here to read the full Partners HealthCare case study.