Telehealth Best Practices CP320.01 5/4/2015
Goal and Objectives Goal: Provide health care organizations with best practices for implementing a telehealth program. Objectives: • Understand the importance of leadership’s role in running a successful telehealth program • Clearly define the goals for the program • Analyze the patient population to determine monitoring needs • Track results for sustained success
Best Practices for Creating a Telehealth Program • Top-Down Leadership Commitment • Build an Innovative Culture • Establish Financial Objectives • Identify Program Goals • Establish Model of Care and Resource Allocation • Develop a Targeted Implementation Plan • Integrate Standards and Plan for Scalability • Develop a Targeted Marketing Strategy
Golden Rule: Leadership Commitment
Leadership Commitment Commitment from C-Level is critical to success Strategy • Create the vision through your model of care • Drive cultural shift with defined staff roles/responsibilities • Develop a business plan • Establish realistic goals • Hold staff accountable for implementing and managing the program Tactics Integrate telehealth into the care management of the patient
Innovative Culture The Power of Visiondrives cultural change within your organization The vision identifies where you want to be, rather than where you are today • Fosters commitment and energizes people • Establishes standards • Creates a bridge between the present and future
Remote Monitoring Value • Increased Access Increased Volume • Improved Communication Improved outcomes and care coordination • Presence in Remote Community Competitive Edge • Driver of Ancillary Services Private pay, mPERS
What are Your Financial Objectives? • Increase Other Services • Cost Avoidance • Revenue Generation • Expense Reduction • Business Development • Test New Markets
Hospital readmission rates are measured for October 1, 2011 Medicare patients with: CHF, AMI and Pneumonia The worst performing hospitals (bottom 25%) will lose 1% of total Medicare payments with the October 1, 2012 following disease added: COPD, CABG, PTCA and post - surgical vascular conditions Hospital readmission rates are reassessed for all 7 diseases and worst performing hospitals Oct 1, 2013 (bottom 25%) are penalized 1% of Medicare payments Percentage of Medicare payments lost to the October 1, 2017 worst performers will rise to 2% Why Measure Your Program Results? Be a star referral source for hospitals CMS Penalties for Low Performers
Cost Per Visit Visit Type Time Cost / Visit Traditional (HHA , MD office, ED) 48 minutes (cost/encounter) Genesis Touch: Video 20 minutes (cost/encounter) Tele-triage (phone call/assessment after VS acquisition) 5-10 minutes (cost/encounter) Savings: XX minutes $XX.XX
Clearly Identified Program Goals Develop Goals consistent with the Telehealth Vision: Improving Outcomes Achieve stakeholder satisfaction Financial ROI • Reduce re-hospitalizations • Improve care management • Patient • Clinical Provider • Payer • Increase referrals • Increase market share • Partner with providers
Example Program Goals Example Goals Key Performance Indicators (KPI) Realize a x% improvement in the acute care hospitalization rate within 6 months from the start of the telehealth program when x% of the average daily census is using telehealth. Achieve a high satisfaction rate based upon survey results from physicians and patients each quarter. Reduce cost per visit, increase nursing efficiencies, reduce LUPA’s, reduce re-hospitalizations within 60 days. Improving Outcomes Achieve stakeholder satisfaction Financial ROI
Measurement Criteria How to measure outcomes: • Analyze a geographic subset of your patient population • Establish baseline measurements for the subset • Number of monitors vs. average daily census • Current rehospitalization rates • Number of nursing visits per episode • Number of monitored days per episode • Utilize the above measurements as a benchmark for comparison after telehealth is implemented Checkpoint: Do you have enough monitors on enough patients to positively impact outcomes?
Data Analysis Measure results against goals • Patient Management: • Management and triage of patient health data • Care management and the coordination of care • Clinical interventions • Clinical Efficiency • Allocation of clinical resources to meet the needs of the patient • Clinical documentation practices which outline a consistent plan of care • Utilization of best practice product and process tools • Predetermined product capabilities and best practice supported workflow • Program Effectiveness • Alignment of resources/roles/responsibilities to support processes and procedures Data analysis is the most critical, yet most overlooked practice.
Establish Model of Care and Resource Allocation
Telehealth Delivery Model Considerations: • Share leadership vision and goals • Evaluate your resources and determine program roles / responsibilities • Outline expectations for nursing practice and expectations for success • Create a workflow processes: • Case Management • Triage • Equipment Management • Data collection and analysis • Awareness of increased consumerism within our healthcare system
Case Management – Care Coordination A process for managing patient data should be Implemented to provide oversight 7 days a week, holidays and weekends. The ideal candidate to oversee the program is your strongest clinician.
Stratify the Patient Population Monitor Placement: Which patients should be monitored? Disease state: Review the patient’s current condition(s) High-risk populations: Polypharmacy Number of nursing visits per episode: Can the number of visits be reduced through the introduction of telemonitoring? Number of monitored days per episode: Recertify if patient hasn’t fully recovered
Develop a Targeted Implementation Plan
Rollout Program Implement your model of care with a small segment of your patient and nurse population before rolling out more widely Review results to:
Program Evaluation Review all aspects of your initial targeted program: • Revise your model of care to suit agency needs • Identify your long-term telehealth champions • Develop a contingency plan to maintain the program in the event of employee turnover Every agency is different and will find a model that best suits them
Peer Review Utilize information gained from the program participants: • How could we manage the patient more effectively? • Could we have prevented the hospitalization? • Did we miss the signs of deterioration? • What are the key takeaways from installing and utilizing the monitor with patients?
Integrate Standards and Plan for Scalability
Integrate Standards • Document the processes and procedures you created for your telehealth program • Communicate them to your team to ensure that every patient who is placed on a monitor receives consistent care
Plan for Scalability • Develop a plan to expand the program within your current agency location • If you have multiple branches, identify a strategy for incorporating telehealth within each location and a timetable for deployment
Develop a Targeted Marketing Strategy
Marketing and Wide-Scale Deployment Marketing is a great resource and provides much needed referrals in a competitive environment Marketing Materials Grow Your Census • Create a Solution Overview that communicates your value • Develop a case study based on your initial targeted implementation • Seek co-branded marketing opportunities • Contact referral sources, including hospitals and physicians • Contact current patients to educate them about your telehealth program Look for 3rd party validation of your program results
Conclusion Telehealth can provide tremendous value to patients and care providers when a thorough strategy is developed. Telehealth is like a garden, it requires constant care and attention in order to flourish!
Learn More Get in Touch with Me at: Anne.Evans@Honeywell.com Reach out to your regional representative or call 1-888-353-5440 Learn More about Honeywell Life Care Solutions online: www.honeywelllifecare.com Select Services Reduce costs and improve care coordination with Honeywell’s telehealth monitoring services. We help remove the complexity associated with offering telehealth by monitoring your patients from our nurse call center headquarters. https://www.honeywelllifecare.com/SelectServices