Eastern Maine HomeCare Telehealth Program Lisa Harvey-McPherson RN, MBA, MPPM Vice President Continuum of Care
Seven Sites Visiting Nurses of Aroostook Fort Kent Caribou (home office for corporation) Houlton River Valley HomeCare in Fairfield Hancock County HomeCare e & Hospice ospce Blue Hill Bar Harbor Bangor Area Visiting Nurses
EMHC Overview Last year, Eastern Maine HomeCare s staff drove 1,408,143 miles to provide 78,098 visits to 3,729 patients and their families in northern, eastern and central Maine. Home care services are paid for by public and private sources, or directly by patients and their families. Services include: Nursing, Therapies, Social Work, Home Care Aides, Hospice Care AND TELEHEALTH
EMHC Telehealth Program History VNA began providing services in 1998 HCHC has had program since 2000 All EMHC sites were funded by RUS in 2004 Over the years grants have supported the purchase of equipment totaling $1.4 million Began in 1998 by using ATI two-way equipment. Began using web-based monitoring equipment in 2006
Current Status of Program Telemedicine has become a tool we use as part of our overall plan of care for qualified patients We target patients with chronic diseases and some hospice patients Telehealth is not covered by Medicare, Medicaid and private insurance *** Equipment is grant funded Program costs covered by expense reduction achieved with fewer in home visits needed.
Current Status of Program In 2006 discontinued use of video units due to age of equipment and connectivity challenges EMHC currently has 46 units Program has expanded this year Peak utilization has been 110% Several patients have asked to privately pay to keep their units after discharge from home health
Philips Telemonitors p Purchased in 2008
BASIS Each patient had one telehealth encounter/day during their LOS Patients with exacerbations had an additional encounter rather than an inhome visit The cost difference between an in-home visit and telehealth encounter is $120
Results by Diagnosis Diagnosisi Number of Patients Savings to EMHC (Reduced In Home Visits) CHF 22 $31,487 COPD 13 $16,370 Diabetes 1 $120 Cardiac 4 $4,333 Other 7 $12,759
Patient Outcomes Diagnosis # of Patients Percent of Hospitalizations 6 Months Prior to Telemed* Percent of Hospitalizations while on Telemed** Percent of ED Visits 6 Months Prior to Telemed* Percent of ED Visits while on Telemed** CHF 54 98% 20% 96% 20% COPD 20 80% 10% 95% 10% Diabetes 2 100% 0% 100% 0% Cardiac 19 79% 21% 58% 21% Other 7 57% 14% 86% 14% * Data obtained from patient interviews at time of admission to telemedicine program. Represents % of occurrence across all patients in program during time frame. ** Data represents actual hospitalizations/ed visits Data represents actual hospitalizations/ed visits occurring during patient s length of stay on home health telemedicine program. Represents % of occurrence across all patients in program during time frame.
Overall Satisfaction
Survey Results No. Question Average 1 Overall Satisfaction 4.5 2 Quality of Life 4.4 3 Better Control Over Health 4.3 4 Resolved Needs and Concerns 4.0 5 Equipment Easy to Helpful 4.6 6 Equipment was Easy to Use 4.7 7 Would Like to Continue 4.4 8 Would Recommend to Others 4.7 Grand Average 4.5
Advantages of Telehomecare Improves patient outcomes by providing daily monitoring Provides staffing relief, given the nursing shortage Provides primary care physicians and patients direct access via the internet to patient status information Baby Boomers love it!
Next Steps Never Ending Search for Grant Funding to Purchase More Units L.D. 1073 An Act To Provide for Insurance Coverage of Telemedicine Services Partner with Patient Centered Medical Home Pilots Partner with Primary Care based Care Managers EMHS Strategic Partner in Federal Healthcare Reform Bundled Payment Accountable Care Organizations Hospital Re-admission Penalties/Reduction