3. RMEDETM
Uses Interactive Voice Response (IVR) technology
Detects threshold violation readings for Blood Pressure, Blood Glucose
and
Weight
Generates threshold violation reports in real time and/or periodic graphs
Provides link to ADPH Nurse for Medicaid Patient 1st patients
Monitors Congestive Heart Failure, Hypertension, Diabetes for M/C
Patient 1st
4. POTENTIAL BENEFITS FOR PROVIDERS:
Earlier intervention for uncontrolled disease
Reduced need for alternate provider visits
Reduced need for Emergency Department visits
If admitted to hospital, shorter length of stay
Improved compliance with the provider’s plan of
care
Increased patient satisfaction
5. POTENTIAL BENEFITS FOR PATIENTS:
Potential for improved outcomes
Lowered healthcare-related expenses
Improved compliance with provider’s plan
of care
Education and reinforcement of
healthy behavior changes
Increased satisfaction with care
13. HOME TELEHEALTH TECHNOLOGIES
These applications can extend the
vision
of the clinician to facilitate quicker
assessment and proactive intervention
for
many populations living with chronic
and
acute healthcare problems to
improve quality of life.
CSHI works closely with Alabama Medicaid Agency and the Alabama Department of Public Health Nurses to provide an innovative Interactive Voice Response system for Medicaid patients with the chronic diseases, Diabetes, Hypertension and Congestive Heart Failure. RMEDETM is used by the ADPH Nurses in managing these chronically ill patients. There are currently over 727 Medicaid patients in Alabama that are actively transmitting home monitoring information into RMEDETM.
Realtime Medical Electronic Data Exchange System (RMEDETM), developed in house by the USA’s Center for Strategic Health Innovation (CSHI) is a secure web-based life-state management system including in-home monitoring of patients with chronic disease and an interventional informatics reporting system. TheRMEDETMInteractive Voice Response (IVR) Data Collection System Allows a patient to use any telephone (or computer), including cell phones, to dial a toll-free phone number and input their physiologic measures as ordered by their physician. When the patient dials in, an automated voice asks the patient to enter their unique 4 digit number followed by their zip code for verification. It then asks for patient specific physiologic parameters such as weight, blood pressure, etc. After each data element is input, the patient is asked to verify the data and is given an opportunity to make corrections. The call typically takes less than one minute. The data are then viewable through RMEDETM in both tabular and graphical format by the patient’s physician and ADPH Nurse.
How the Program Works:Referral:ADPHNurse receives referral and provider-set data limits for the monitoring measuresEnrollment:ADPHNurse contacts the patient to set up a home visit to place equipment and provide instruction (USA CSHI provides a speaker telephone, blood pressure monitor and scale as needed, patients use their ownglucometer and strips) Alerts:Readings outside of provider-set parameters produce a threshold violation and an alert is automatically e-mailed from RMEDETM to the ADPH Nurse. The nurse then follows up as needed; making contact with the patient, evaluating what action is needed and providing education, reassurance and/or referral. Reports can be faxed to the provider directly from RMEDETM Reports:Periodic graph reports of patient data are faxed to the Provider Ongoing Contact: ADPHNurse makes contact with patient at least monthly Renewal:Provider orders are renewed yearly
age groupcountunder 20….1220-29………1730-39……….6040-49……….14350-59……….29760-69……….20070-79……….2over 80…….0 Total 731
Male……. 179Female…551
racecountAfrican American…………………………..…463American Native or Alaskan Native……4Asian or Pacific Islander …………………..1Caucasian………………………………………..260Hispanic………………………………………….3Total……731
main diagnosiscountCHF………………………………6Diabetes………………………..357Hypertension…………………368 TOTAL………..731
Achievement of control is the main goal of treatment, and has been shown to reduce the onset of complications, with increased survival and better quality of life. Actively using self monitoring to inform therapy (i.e., to adjust therapy dosages or amend nutrition recommendations) requires frequent interaction between providers and patients, which is time and resource consuming for both entities. Real-time tele-monitoring of status, with immediate automated alerts to the nurse and subsequent phone feedback to the patient circumvents the need for many face-to-face interactions – a significant challenge in health disparate populations. This can allow providers to quickly adjust therapy, foster patient accountability, and foster compliance with treatment through immediate feedback.
