Improving Patient Care through Remote Patient Monitoring A Collaborative Approach Between Olmsted Medical Center Rochester, MN and The Evangelical Lutheran Good Samaritan Society LivingWell@Home Sioux Falls, SD
Olmsted Medical Center (OMC) Rochester, MN A not-for-profit organization. Southeastern Minnesota s hometown healthcare provider for over 65 years. 165 clinicians with 1,000 healthcare professionals 18 locations, including a Level IV trauma hospital, a sports medicine facility, retail clinics, and 10 community branch clinics more than 20 specialities represented Our mission is the delivery of exceptional patient care focusing on caring, quality, safety, and service. -2-
OMC Locations -3-
The Evangelical Lutheran Good Samaritan Society (GSS) Sioux Falls, SD Largest not-for-profit provider of senior care and services in the USA. Our mission is to share God s love in word and deed by providing shelter and supportive services to those in need, believing that In Christ s Love, Everyone is Someone. LivingWell@Home is the Society s remote patient monitoring service that enhances healthcare homes and primary care providers service deliveries by helping manage chronic disease populations through nurse monitoring. -4-
The Evangelical Lutheran Good Samaritan Society -5-
Implementation OMC primary care physicians are certified under the MN Department of Health, Healthcare Home (HCH) initiative. OMC has approximately 300 patients enrolled in their HCH. OMC and GSS collaborated to offer in-home, remote monitoring, and sensor technology services to OMC s HCH patients. -6-
Monitoring Options Monitoring includes blood pressure, pulse, weight, oxygen saturation, and glucose levels. Sensor Technology includes sleep quality and quantity, sleep habits, bathroom usage, movement trends, and door opening and closing. -7-
Patient Enrollment 135 patients referred for in-home remote monitoring 87 are currently installed 14% declined the service 16% discontinued (moved out of town, moved to a care center, or deceased) Age of Participants Payer Class 20-39 40-49 50-64 65-79 >79 Self-Pay Private Insurance Medicaid Medicare 0% 20% 40% 60% 80% 100% 0% 20% 40% 60% 80% 100% -8-
Provide value through: Improving patient care Goals Increase patient and family engagement through participation Shorten time to interventions Allow participation without clinic visits Providing more care at home Reducing overall care costs Improve care coordination without increasing nursing time Reduce unnecessary patient visits (clinic visits, ED visits, hospitalizations) -9-
Process Patient is recommended by OMC Primary Care Provider (PCP). OMC Healthcare Home (HCH) staff call patient to review monitoring benefits, and a referral is processed for LW@H. LW@H contacts the patient to place the equipment. Monitoring begins and is conducted 7 days a week. LW@H staff monitor/review for concerning changes in movement or measurements. LW@H validates the change with the patient. If concerning, LW@H contacts OMC to contact patient for next steps. -10-
Health Care Home & LivingWell@Home -11-
Subjective Results Patient A: Improved BP control, blood sugars improved, not missing PM meds anymore due to reminders. Patient B: More engaged in care, takes monitoring with him out of state. Better control of BP and fluid retention. Patient C: Very high BP episode. Through triage, patient was sent to ER quickly. Patient states I almost died - you saved me. Patient D: Less anxious, fewer phone calls as she has monitoring in place. Patient E: Blood sugars information sent to Endocrinology every two weeks for improved ongoing management and intervention. -12-
LivingWell@Home is a comfort, it really is! We would ve lost Mom... You gave me my mom for another Mother s Day. You have kept my mom at home for another 4 years. The system has already saved my life, -13-
Number of Healthcare Home Patients (Total HCH Patients Capped at 300) 300 250 200 Non-LW@Home 150 100 LW@Home 50 0-14-
Medical Complexity by Tier 45% 40% 35% 30% 25% 20% 15% 10% 5% 0% Tier Level 1 Tier Level 2 Tier Level 3 Tier Level 4 Lowest complexity Highest Complexity -15-
Mar-15 Apr-15 May-15 Jun-15 Jul-15 Aug-15 Sep-15 Oct-15 Nov-15 Dec-15 Jan-16 Mar 2015 Apr 2015 May 2015 Jun 2015 Jul 2015 Aug 2015 Sep 2015 Oct 2015 Nov 2015 Dec 2015 Jan 2016 Medical Results Blood Pressure at Goal A1c Below 8% Health Care Home LW@Home 100% 90% 80% 70% OMC 60% 50% -16-
Stabilizing Vital Signs Patient: 75 years old Diagnosis: Diabetes, congestive heart failure Time period: June 1, 2015, through September 9, 2015 Diastolic -17-
Mar 2015 Apr 2015 May 2015 Jun 2015 Jul 2015 Aug 2015 Sep 2015 Oct 2015 Nov 2015 Dec 2015 Jan 2016 Mar 2015 Apr 2015 May 2015 Jun 2015 Jul 2015 Aug 2015 Sep 2015 Oct 2015 Nov 2015 Dec 2015 Jan 2016 OMC Healthcare Home Phone Calls per Patient Appointments per Patient Non LW pt LW@Home pt -18-
Outcomes/Summary Decreased patient clinic visits, but increased phone calls. Over time, the phone call volume dropped. Clinical outcomes hard to evaluate but both A1c and BP are better in the OMC general population. Patients and families are happy with the service. The complexity of tracking ED use and hospitalizations was unexpectedly difficult. Cost of service ranges from $100-$200 per month, depending upon technologies used. Reimbursement through Medicare does not exist today in MN. In some states Medicaid Waiver covers cost of remote patient monitoring. -19-
Presenters Sherrie Petersen, BSW, MBA Director, Living Well@Home The Evangelical Lutheran Good Samaritan Society speter13@good-sam.com Lois Till-Tarara, MHA, CMPE Vice President Clinical Operations Olmsted Medical Center ltill-tarara@olmmed.org Linda Williams, MD, MHA Chief Medical Information Officer Olmsted Medical Center lwilliams@olmmed.org -20-