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K. Ghaney



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    OS29 - e-Health Solutions for Patient Self Management (ID 47)

    • Event: e-Health 2018 Virtual Meeting
    • Type: Oral Session
    • Track: Clinical Delivery
    • Presentations: 1
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      OS29.02 - Feasibility of Remote Patient Monitoring for COPD and Heart FailureĀ  (ID 294)

      K. Ghaney, Remote Patient Monitoring Program - HTDM, Eastern Health; St. John's/CA

      • Abstract
      • Slides

      Purpose/Objectives: 1. Describe strategies used for initiation and modification of remote patient monitoring/telehomecare. 2. Describe lessons learned from feasibility period to sustainability and scalabilty. 3. Promote patient success stories and outcomes. The Remote Patient Monitoring Program focused initially on Congestive Heart Failure (CHF) and Chronic Obstructive Pulmonary Disease (COPD) patient populations, whose chronic conditions lead them to frequent emergency departments and multiple hospital admissions. Management of Diabetes Type II was included in recent months. Technology is used as a platform to deliver healthcare outside the conventional setting in the patient's own home. Patient data is electronically transmitted (e.g., symptoms, vital signs, outcomes) from the home to the clinical team with a goal to identify evidence-based care interventions, provide education, support, and health and wellness coaching that improves patient self-management. Early evidence shows that expected benefits of: reduced length of stay, emergency department visit and acute admission reductions will be realized. High satisfaction rates with the patient care experience with this healthcare delivery model have been demonstrated. Over 700 patients have been enrolled in the program to date with numbers expected to double in the next 12 months - improving access. Patient success stories and outcomes will be shared to demonstrate the impact remote patient monitoring/telehomecare can have - especially in remote locations.

      Methodology/Approach: Patient identification was competed using electronic data examination and direct patient referral. Health session kit (iPad and peripheral devices) were delivered using in-home assisted installation and through a self-install (direct ship to patient) model. These methods were analyzed for efficiency and cost. Referrals received via fax, email or by telephone Eligible patients are contacted either by phone and/or letter Patients who accept are consented and enrolled for a 4 - 6 month period iPad mini, BP cuff, pulse oximeter, and weigh scale delivered to the home Biometric data and symptom question responses are delivered remotely to the RPM dashboard daily to be monitored by RN. RNs contact the patient when pre-established individualized thresholds are surpassed. Advice, coaching and intervention is provided as required. Pre-scheduled coaching calls are completed for goal setting, action planning, self-management support and behaviour modification

      Finding/Results: Direct patient referral is more efficient but requires increased focus on clinician engagement. Self-install model (direct ship) is more cost efficient but requires more technical support via phone and clinician. Technology is the enabler. Clinical self-management support, education, and intervention are considered most valuable to patients. ER visits and acute admissions will be examined in the 12 month period before enrollment in the RPM program and 12 months after enrollment Patient surveys are administered on enrollment, completion of the program and 4 months after disenrollment A benefits analysis report will be completed by December 2017

      Conclusion/Implications/Recommendations: Audience will hear results of the program: - enrollment and equipment feasibility anlysis - findings in efficiencies and cost reductions - learnings for scalability and expansion - outcomes for patients and efficiencies for organizations - patients related stories of success

      140 Character Summary: RPM empowers and engages patients to be experts in their own care. Self-management support and education using technology is key to success in achieving outcomes.

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