Transcript ATIC_Banner_Presentation_09_17_09

BANNER HOME CARE
TELEHEALTH
Objectives
• Overview of BHC Telehealth program
• Home Health and Telehealth
• Patient selection and admissions
• Results and Revisions
HOME TELEHEALTH MONITORING
• Banner Home Care offers telehealth
monitoring to patients who are on Banner
Home Care services who have a primary
diagnosis of Heart Failure, Diabetes, COPD,
Post CABG, Hyper or Hypotension, or any
other Cardio-Pulmonary condition
• There is no cost to the patient
GOAL:
• Reduction of emergency room and
hospital visits
• Reinforce to the patient, the value of self
monitoring and taking an active role in
their own disease management.
• To provide additional education for the
home care patient
• Enhance physician communication
• Better utilization of home care nursing
resources
TELEHEALTH MONITORING
• The telehealth monitoring program is
provided to the patient as an adjunct to the
skilled nursing care they are receiving
• The monitoring system includes:
– scale
– blood pressure monitor
– pulse oximeter
– telestation monitor
WEBSITE MONITORING
• The patients and caregivers are taught to
weigh and take their vital signs every day
• The telestation monitor captures the data
and sends the information via a phone
line, to a website
• The telestation also asks the patient to
answer a short series of questions
regarding their symptoms that is also sent
to the website
REVIEW OF DATA
• A Banner Home Care RN reviews the
clinical data 7 days per week
• If a patient alerts on vital signs, weight, or
symptoms, a clinical telephone
assessment will be performed
• Further interventions may be taken such
as contacting the physician, doing a home
visit, or directing the patient to the
emergency room if symptoms are severe.
CUSTOM TELESTATION
• The telestation monitor is multi-functional
– It can be customized to not only ask
assessment questions but can also send
short pieces of education to the patient on a
daily basis
• The daily information is a reinforcement of
what the RN is teaching to the patient
during the skilled nursing visit
– And an extension of what is taught in the
hospital
PATIENT SELECTION CRITERIA
• Medicare or Medicare type payor must
meet home bound criteria
• Frequent emergency room and hospital
stays
• Demonstrated difficulty in selfmanagement of their chronic conditions
• Lack of knowledge regarding their disease
process and medications
PATIENT SELECTION CRITERIA
• Teachable, motivated, able to follow
simple instructions
– either the patient or caregiver
• Land telephone line-cellular data
transmission is being added this year
Total Number of Units
• 55 units in Arizona
• 15 units in Colorado
• All patients are monitored via central
monitoring station in Arizona
• At any given time monitoring station in
Arizona is monitoring up to 70 patients
Strengths and Barriers
of Telehealth
STRENGTHS
• Consistency of staff
• Use of Best Practice
• Vendor support
• System support
• Networking and
information availability
• Custom telestation
BARRIERS
• Consistency with
discharge planning
• Reimbursement
• Cost efficiency of
marketing
• Technology
• Awareness
RESULTS
REHOSPITALIZATION RATE IN 30 DAYS
25
20
15
10
5
0
BHC (19 of
490patie nts )
National AV G for
He ar t Failur e
Open Heart Telehealth module
Categories
1. First week at home
Incision,breathing,pain,activity & nutrition,
2. Lifestyle changes
Diet, exercise, smoking cessation, stress
3. Medications
General medications, Nitro, anti-arrythmics,
**Daily feedback questions and end week quiz
Success Stories
 Depression
– Pt was delighted to
see feelings she was
having that day in the
module.
Readmission
-Improved
module by
adding questions that flag
daily action to BHC nurse.
Conclusion
New and innovative approach to healthcare
Cutting edge for telehealth program.
Aligns with our mission in the continuum of
care to make a difference in peoples’ lives
through excellent patient care.
References
1. Bradley, K.M. & Williams, D.M. (1990). A comparison of the preoperative concerns of
open heart surgery patients and their significant others. The Journal of Cardiovascular
Nursing. 5(1). P 43-53.
2. Barnason S., Zimmerman L., Nieveen J., & Hertzog M. (2006). Impact of tele-health
and recovery outcomes of elderly patients undergoing coronary artery bypass grafting.
Heart & Lung. 35(4). P 225-233.
3. Hannan, E.L., Racz, M.J., Walford, G., Ryan, T.J., Isom, O.W., Bennett, E., & Jones,
R.H. (2003). Predictors of readmission for complications of coronary artery bypass graft
surgery. Journal of the American Medical Association. 290(6). P 773-780.
4. Martin, C.G. & Turkelson, S.L. (2006). Nursing care of the patient undergoing coronary
artery bypass grafting. Journal of Cardiovascular Nursing. 21(2). P 109-117.
5. Mika, V.S., Kelly, P.J., Price, M.A., Franquiz, M., & Villarreal, R. (2005). The ABCs of
health literacy. Family and Community Health. 20(8). P 351-357.
6. Murphy-Knoll, L. (2007). Low health literacy puts patients at risk. Journal of Nursing
Quality. 22(3). P 205-209.