While the nation’s healthcare costs continue to drain the economy, several forward thinking provider organizations are finding ways to turn the situation around with carefully thought out telemed programs. A recent report from the Commonwealth Fund highlights the cost effective approaches used by three “model citizens.”
The report looked at remote patient monitoring programs spearheaded by the Veterans Health Administration (VHA), Partners Healthcare in Boston and Centura Health at Home in Colorado. The programs used monitoring devices such as the Health Buddy system to capture and transmit biometric data, including blood pressure, heart rate, blood glucose and body weight to their clinicians, who then evaluated the data and coordinated care to reduce patients’ risk of deteriorating. The Health Buddy is four-button device that connects patients to their provider through a web-based application that reads the biometric data submitted by the end users.
At VHA, the organization’s Care Coordination/Home Telehealth (CCHT) program was able to reduce bed days of care by 40 percent, when compared to bed days before patients were enrolled in the program. Andrew Broderick from the Public Health Institute, a health research organization, said the “the cost of CCHT, at $1,600 per patient per year, compared favorably with the cost of the Veteran Health Administration’s usual home-based program of $13,121 per patient per year.” The telehealth cost savings were even more impressive when looked at in the context of commercially available nursing homes, where the average price tag is $77,745 per patient per year.
Put another way, between 2004 and 2007 the VHA remote monitoring program reduced the use of healthcare resources by more than 20 percent for 8,954 patients with diabetes, by 30.3 percent for more than 7,000 patients with hypertension and by 25.9 percent for more than 4,000 patients with congestive heart failure.
At Partners Healthcare, the integrated health system developed a Connected Cardiac Care Program (CCCP) that uses telemonitoring and education to help heart failure patients. The program has enrolled more than 1,200 patients and “consistently experienced an approximate 50% reduction in heart-failure related readmissions,” according to the Commonwealth Fund report. According to Partners’ in-house analysis, the program has saved more than $10 million since 2006.
The Commonwealth Report report broke down those numbers as follows: The telemonitoring program costs about $1,500 per patient. That included the cost of marketing, referral management, nurse support and technology; it saved $9,656 per patient in fewer hospitalizations. Total net savings: $8,155 per patient.
Joseph Kvedar, MD, director of the Center for Connected Health and a physician at Partners Healthcare, explained that CCCP involved the collection of vital signs and interaction with a home care nurse via technology tools. “It’s all about keeping patients out of the hospital. The 50 percent reduction in hospitalization has downstream consequences. It reduces the costs that go along with admissions. It also keeps people out of the emergency room, another high-cost environment. [The program] keeps their illness better managed in the home, which sometimes translates into fewer doctor visits.” Kvedar also pointed to more efficient use of medication and imaging tests. “All of those expenses are cut back when you keep someone healthy in their home.”
Lastly, Centura Health at Home combined remote patient telemonitoring with a long-standing clinical call center-based program. The combined service targeted patients with congestive heart failure, chronic obstructive pulmonary disease and diabetes with the goal of reducing 30-day hospital readmissions and home nursing visits. A one-year pilot project conducted in 2010 and 2011 was able to reduce readmissions by 62 percent for the three patient populations, with a cost savings of $1,000 to $1,500 per patient.