CMS Telehealth
    Service Presentation
    Telehealth Integrated Systems
     for Personalized Patient Care
             ...
Presenting CMS Telehealth
    •   CMS Telehealth Introduction and Background
    •   The Health Management Situation
    •...
CMS Telehealth--Principals
    – Healthcare executive management and consulting for full
      spectrum of healthcare: hos...
The Situation—Diseases & Chronic Illness
      Chronic Illness = 45% (125 million) of Americans—
        and 75% over 65—h...
The Situation-Care Providers
    • Compliance with CMS policies such as 30 day
      readmissions
    • Financial implicat...
The Situation-Readmissions
    • Research has shown that hospital readmissions are reducing
      the quality of health ca...
Solutions
    • Encourage patient self-monitoring, education and care
      plan adherence for patients and their families...
Why CMS Telehealth Was Created

    CMS Telehealth solutions
    • Allow patients, especially seniors, the underserved, th...
About CMS Telehealth
    • A NY/NJ based marketer and distributor of integrated
      follow-up and monitoring systems for...
How CMS Telehealth Works with You
     • Our team meets with each client to determine what the best solution is
       for...
Our services connect you to the patient
                           Collect information post-discharge over phone
        ...
How it works




12
Uses phone or internet to collect patient post-discharge status
       information
        – Outbound live agent call to a...
Setup is easy by patient



      Select category or
     group characteristic

     Set start/end dates
           and ti...
Compile a series of
     questions and alerts

     The CaringTouch template
     has over 400 questions to
     choose fr...
Set alerts for CHF survey
     Set thresholds and alert
     frequency




                                 Clinicians def...
Alerts
       When a threshold is
           crossed
       An alert is emailed
       to the designated
         care pro...
Survey as
     completed
     • Takes minutes
     • Secure entry into
       CaringTouch
       database for review
     ...
Trending report




19
Trending report




20
Trending report




21
Trending report




22
CaringTouch™ Benefits
     • Control, power, simplicity, security
        –   Provider controls scheduling and alert thres...
How it works




24
Transmits patient self-testing directly to care provider
        – Access via secure websites for reports--no additional s...
‘Healthcare Anywhere’
     •Highly portable
     •Cellular connectivity
     without the phone
     •Monitors connect by c...
Other RVSPM Solutions

     •   Hub connects to 50+ monitoring devices
     •   Data transfer by phone or PC
     •   Inte...
Benefits

     • Integrated home health monitoring
       – With Caring Touch, a ‘double check’ on patient status
        ...
Telehealth Effectiveness and Results
            Clinical studies of telehealth use combined with coordinated
            ...
Telehealth Effectiveness
                                                                                                 ...
Effectiveness and
                                Results
     Home health agency users:
     • Advocate Home Health (IL):...
Effectiveness and Results
     Connector hub to monitors




     Also: Whittier Institute for Diabetes, Community Health ...
Effectiveness and Results
     Research and pilots:
     • MedApps: Meridian Health, Baptist Home Health Network
     • In...
Questions
     •   What are the hospitals' strengths by clinical services-inpatient and outpatient? Please
         priori...
Next Steps




35
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CMST presentation revised Palisades

  1. 1. CMS Telehealth Service Presentation Telehealth Integrated Systems for Personalized Patient Care Palisades Medical Center May 13, 2010 1
  2. 2. Presenting CMS Telehealth • CMS Telehealth Introduction and Background • The Health Management Situation • How We Work with You • Telehealth Services • Telehealth’s Effectiveness and Results • Questions and Next Steps 2
  3. 3. CMS Telehealth--Principals – Healthcare executive management and consulting for full spectrum of healthcare: hospitals, physician practice management, home healthcare, DMEs and insurance – Founder, IT consulting firm; computer systems, software and networking integration expertise for HIT and manufacturing – Marketing for telecare, telehealth and technology companies serving older adults; advisory services for eHealth companies – Sales, account management and implementation strategies for imaging and electronics companies 3
  4. 4. The Situation—Diseases & Chronic Illness Chronic Illness = 45% (125 million) of Americans— and 75% over 65—have at least one chronic illness • 76% of Medicare spending is on patients with one or more chronic diseases • 75% of all healthcare costs Congestive Heart Failure = 5.3 million • 47% of the patients are likely to be readmitted within 4-6 months • Estimated cost (2008): $34.8 billion Hypertension = 73 million Americans, 1 in 3 • 35.1% have their blood pressure under control --64.9% do not • Estimated cost (2008): $69.4 billion Health and Human Services—AHRQ; Deloitte ‘Connected Care’ 2009 citing ‘Health Affairs; American Heart Association, 2008 4
  5. 5. The Situation-Care Providers • Compliance with CMS policies such as 30 day readmissions • Financial implications of – post-discharge readmissions by diagnosis and payor – unnecessary ER admissions by payor • Discharge planning, case management and homecare • Better utilization of clinical time for patient care, where non-clinical personnel can be used 5
  6. 6. The Situation-Readmissions • Research has shown that hospital readmissions are reducing the quality of health care while increasing hospital costs (July 9, 2009, CMS Office of Public Affairs) • Hospital comparative data show that for patients admitted to a hospital: – Heart attack treatment--19.9% will return to the hospital within 30 days – 24.5% of patients admitted for heart failure will return to the hospital within 30 days – 18.2% of patients admitted for pneumonia will return to the hospital within 30 days • Good discharge plans can help reduce the rate of unplanned readmissions by – giving patients the care instructions they need after a hospital stay – helping patients recognize symptoms that may require immediate medical attention 6
  7. 7. Solutions • Encourage patient self-monitoring, education and care plan adherence for patients and their families in order to improve better longer-term outcomes for patients with chronic diseases • Improve patient compliance • Reduce unnecessary hospital readmissions and ER visits • Proactively identify changes in conditions • Attract new patients • Improve staff productivity • Integrate valuable information into EMR and PHR systems 7
  8. 8. Why CMS Telehealth Was Created CMS Telehealth solutions • Allow patients, especially seniors, the underserved, those living in rural areas and patients with chronic conditions – to receive convenient and immediate healthcare, and to live independently – by utilizing affordable systems that allow for remotely managing health and wellness • Enable care providers to more effectively, efficiently reach and treat patients for better outcomes 8
  9. 9. About CMS Telehealth • A NY/NJ based marketer and distributor of integrated follow-up and monitoring systems for healthcare providers • We connect care providers and patients for better post-discharge and chronic condition management • We work to assist you in improving outcomes via patient self-monitoring and education – Reducing 30 day readmissions – Providing information in between office visits – Help determine the right care at the right time 9
  10. 10. How CMS Telehealth Works with You • Our team meets with each client to determine what the best solution is for them based upon the specific needs of their patients • Our comprehensive and service/product solutions are robust, scalable, and customized for each individual client and their patient needs • CMS Telehealth does its own marketing, distribution, installation and maintenance of our products and services • The technology solutions and services we provide are – Through established relationships with companies which have a proven track record in telehealth technology, often members of the Continua Health Alliance (which sets standards in device interoperability) – Designed to be compatible with your IT requirements • Our team continuously researches the newest technology that can be beneficial to clients and their patients • A management member of our team is always available to our clients and their patients CMS Telehealth combines the best of hands-on healthcare experience in all phases of healthcare operations, technology and customer service 10
  11. 11. Our services connect you to the patient  Collect information post-discharge over phone or internet  Survey questions assess condition  Customize questions and parameters  Data is stored for review, trending and analysis  Generates alerts when needed  Transmits patient self-testing directly  Technologies utilize commonly used monitors  Review secured website for status and trends  Data is stored for review, trending and analysis …and to better patient outcomes 11
  12. 12. How it works 12
  13. 13. Uses phone or internet to collect patient post-discharge status information – Outbound live agent call to answer questions and receive information – Or--direct patient input via Interactive Voice Response (IVR) or the internet – Contact method and frequency for patient set by client – Compiles trending reports for documentation CaringTouch database includes template patient surveys by profile: COPD, CHF, cardiac, diabetes, rehab, more Software runs on standard PC workstations and telephones no capital investment Software and database fully maintained by CMS Telehealth 13
  14. 14. Setup is easy by patient Select category or group characteristic Set start/end dates and time Select custom question Set frequency series for each group 14
  15. 15. Compile a series of questions and alerts The CaringTouch template has over 400 questions to choose from— or add your own Utilizes ‘branching logic’ 15
  16. 16. Set alerts for CHF survey Set thresholds and alert frequency Clinicians define thresholds Thresholds automatically monitored by CaringTouch 16
  17. 17. Alerts When a threshold is crossed An alert is emailed to the designated care provider The email specifies the question and response that triggered the alert Alternatively: phone call and text/SMS message 17
  18. 18. Survey as completed • Takes minutes • Secure entry into CaringTouch database for review and documentation • Access 24/7 • HIPAA compliant 18
  19. 19. Trending report 19
  20. 20. Trending report 20
  21. 21. Trending report 21
  22. 22. Trending report 22
  23. 23. CaringTouch™ Benefits • Control, power, simplicity, security – Provider controls scheduling and alert thresholds – Real time reporting – Alerts are generated automatically – CMST maintains application and secure database • Flexibility and ease – Deployment: outbound calls, IVR, internet self-reporting – Use own staff to call or contract with CMS Telehealth – Comprehensive questions, templated and customized • CMS Telehealth installs, maintains and trains staff on how to use software, calls and follow up – Hosting, customer updates, system updates, alerts all included 23
  24. 24. How it works 24
  25. 25. Transmits patient self-testing directly to care provider – Access via secure websites for reports--no additional software needed – Information transmitted to PHRs (Google Health, MS HealthVault) and EMRs (where available) Remote monitoring devices connect to a wide variety of leading, commonly used vital signs monitors – Weight scales, blood pressure cuffs, blood glucose meters, pulse oximeters Patient management tools permit checking and trending of information above and beyond verbal reporting – A second level of accuracy and education 25
  26. 26. ‘Healthcare Anywhere’ •Highly portable •Cellular connectivity without the phone •Monitors connect by cable or Bluetooth •FDA 510(k) cleared;ISO 13485:2003, ISO 9001:2008 certified •Integrates to popular PHRs and enterprise level EMRs 26
  27. 27. Other RVSPM Solutions • Hub connects to 50+ monitoring devices • Data transfer by phone or PC • Integrates data with health management systems and PHRs • FDA 510(k) cleared; ISO 13485:2003 certified • Works with standard phone or Ethernet connectivity • Data entered manually to questions (push button prompts) or recorded via monitoring devices • Multiple language queries 27
  28. 28. Benefits • Integrated home health monitoring – With Caring Touch, a ‘double check’ on patient status and vital signs over time • Monitoring systems fully compatible with widely available ‘off the shelf’ devices • Systems encourage compliance longer-term • Enables information sharing with physicians, medical home care, family, PHRs and EMRs • ‘One stop shopping’—CMS Telehealth single point of contact for sales, service and training 28
  29. 29. Telehealth Effectiveness and Results Clinical studies of telehealth use combined with coordinated care show: • Improvement of health outcomes through better ongoing assessment • Improved patient experience in self-management of care • Enhances follow up and records for regulatory compliance • Complements service offerings • Targets the right care at the right time • 40% reduction in ER visits • 63% reduction in hospital admissions • 60% reduction in hospital bed days of care, with similar results in nursing homes • 14% - 55% reduction in all cause hospitalizations • 29% - 43% reduction in heart failure hospitalizations • 80% reduction in readmission for CHF patients (12% reduced to 2%) 1-3: Letan, Better Health Care Together, Home Health News, January 2010 4-5: Chaudhry survey of 9 studies, cited by Institute for Healthcare Improvement, March 2009 6: Creason, CHF Telemanagement Clinic, cited by Institute for Healthcare Improvement, March 2009 29
  30. 30. Telehealth Effectiveness and Results Cleveland Clinic study 2009 (N=250, ages 20-60s) 68% with hypertension, 26% diabetes, 6% heart failure Average # of days between doctor’s office visits • Increased (less frequent visits) – Diabetes: 71% — Hypertension 26% • Decreased (more frequent visits) – Heart failure: 27% "What we were really testing was the ability to care for a patient who has a chronic disease in a more continuous fashion, rather than the episodic model we have today, of seeing a patient once every 90 to 120 days. The promise of this new model of delivery is that we can manage patients in a more timely fashion to achieve better outcomes -- at an effective cost.” Dr. C. Martin Harris, CIO, Cleveland Clinic “Cleveland Clinic program linking chronic disease patients directly to doctors online shows success,” The Plain Dealer, March 16, 2010; Medical Device Daily, March 26, 2010 30
  31. 31. Effectiveness and Results Home health agency users: • Advocate Home Health (IL): integrated into sleep apnea, COPD and DME programs • Partnership with Kentucky Home Health Association to offer system to membership • Almost Family Home Health (CT): 40 offices 31
  32. 32. Effectiveness and Results Connector hub to monitors Also: Whittier Institute for Diabetes, Community Health System- University of California, University College London Hospitals (NHS) 32
  33. 33. Effectiveness and Results Research and pilots: • MedApps: Meridian Health, Baptist Home Health Network • In-home data communicator and medical device hub – Montefiore Medical Center (subsidiary CMO-The Care Management Company) test with 6600 seniors and disabled adults. Funded by Centers for Medicare and Medicaid Services (Care Management for High-Cost Beneficiaries Demonstration. • Earlier tests in Wenatchee, WA and Bend, OR – VHA (30,000 units total): • Four years of data from the VHA’s telehealth program: 19% percent reduction in hospitalizations and 25% reduction in “bed days of care” for participating patients • Veterans Administration of Central California Health Care System recently added to promote better medication adherence in chronically ill veterans 33
  34. 34. Questions • What are the hospitals' strengths by clinical services-inpatient and outpatient? Please prioritize on a scale of 1-5, with 1 being the greatest strength. • Areas of concern to the team as it relates to post-discharge readmissions by diagnosis and payor? Please prioritize on a scale of 1-5, with 1 being the most important area to address. What are the approximate financial implications of each area of concern? • Areas of concern to the team for unnecessary ER admissions by payor that can better be handled in a more efficient manner? Please identify on a scale of 1-5, with 1 being the most important area to address. What are the approximate financial implications? • In the areas of discharge planning, case management and home care, what areas would the clinical staff like to see their clinical time reduced that can be handled by non-clinical personnel so that more clinical time can be spent with a patient? Please prioritize on a scale of 1-5, with 1 being the most important area to reduce. What would the financial implications be? • Geographic areas that you are looking to attract new patients from? Please prioritize. • Who are your immediate competitors and in what areas of services)? 34
  35. 35. Next Steps 35

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