Telehealth & Point of Care


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Telehealth & Point of Care

  1. 2. <ul><li>Englewood offers a wide </li></ul><ul><li>range of skilled home </li></ul><ul><li>health and hospice services. </li></ul>
  2. 3. <ul><li>Our staff provides care in a warm and compassionate manner. Almost any service which is available in the hospital can be offered at home. </li></ul>
  3. 4. <ul><li>This at-home care gives patients </li></ul><ul><li>the comfort and security of </li></ul><ul><li>healing with the presence of </li></ul><ul><li>family in familiar surroundings. </li></ul>
  4. 5. <ul><li>( USDA) – United States Department of Agriculture, Rural Development Southern Division, </li></ul><ul><li>Telecommunication Program, </li></ul><ul><li>Rural Utilities Services, </li></ul><ul><li>Distance Learning and Telemedicine Loan and Grant program </li></ul>
  5. 6. <ul><li>Identify the need </li></ul><ul><li>Identify the potential vendors </li></ul><ul><li>Thorough assessment of the cost verses benefits and use for our patients. </li></ul>
  6. 7. <ul><li>Conferred with Georgia Partnership for Telehealth </li></ul><ul><li>On-Site visit and demo by several telehealth and point of care vendors. </li></ul><ul><li>Purchased on November, 2008 twenty (20) Telehealth Monitors. </li></ul><ul><li>Final Decision </li></ul>
  7. 8. <ul><li>Referral to the USDA Rural Development 2009 Distance Learning and Telemedicine Grant application. </li></ul><ul><li>Submitted the application March 23, 2009. </li></ul><ul><li>Discussion of the application </li></ul>
  8. 9. <ul><li>Award notification was done September 29, 2009. </li></ul><ul><li>Program implementation for the Point of Care laptops were in late November, 2009. </li></ul><ul><li>Training was conducted in December, 2009 and continues thru 2010. </li></ul>
  9. 10. <ul><li>Telehealth uses </li></ul><ul><li>telecommunications devices placed in patients’ homes to take their vital signs every day, reminds the patient to take medication and answer simple questions about their condition. </li></ul>
  10. 11. <ul><li>This award-winning remote patient monitoring device is ideal for both the patient and the health care professionals. </li></ul>
  11. 12. <ul><li>Using text or voice prompts to guide patients through a series of yes/no questions that allow health care professionals to monitor and develop a thorough health assessment. </li></ul>
  12. 13. <ul><li>This three-part Life Stream ecosystem, providing cost-effective care for patients at home, includes the patient-facing Genesis DM device, software applications and service. </li></ul>
  13. 14. <ul><li>Patients suffering from a variety of chronic conditions, such as </li></ul><ul><ul><li>congestive heart failure, </li></ul></ul><ul><ul><li>chronic obstructive pulmonary disease, </li></ul></ul><ul><ul><li>coronary artery disease, </li></ul></ul><ul><ul><li>diabetes and </li></ul></ul><ul><ul><li>hypertension. </li></ul></ul>
  14. 15. <ul><ul><li>Our Telehealth home monitoring program checks the patients weight, oxygen saturation, glucose levels and blood pressure . </li></ul></ul>
  15. 16. <ul><li>We offer this FREE to high risk patients referred to us by a physician. </li></ul>
  16. 17. <ul><li>Telehealth monitoring is used to decrease avoidable acute care hospitalizations as a result of Congestive Heart Failure, COPD, High Blood Pressure, Diabetes and more </li></ul>
  17. 18. <ul><li>Honeywell Home Med Genesis DM Remote Patient Care Monitor </li></ul><ul><li>Blood Pressure </li></ul><ul><li>Blood Glucose Levels </li></ul><ul><li>Oxygen Levels </li></ul><ul><li>Weight </li></ul><ul><li>Fall Risk </li></ul><ul><li>Teaching and Education </li></ul><ul><li>Service is Free to all </li></ul><ul><li>patients who are in our </li></ul><ul><li>Care who meet specific health criteria. </li></ul>
  18. 19. <ul><li>No practitioner home or </li></ul><ul><li>office visits required </li></ul><ul><li>Assists homebound, </li></ul><ul><li>elderly, chronically ill and special needs patients </li></ul>
  19. 20. <ul><li>Simplifies practitioners' entry of care plans & medication schedules </li></ul>
  20. 21. <ul><li>Delivers practitioner-to-patient treatment reminders and instructions </li></ul>
  21. 22. <ul><li>Displays individual patients vital information in a digital format. </li></ul>
  22. 23. Displays individual patients vital information in graph format .
  23. 24. <ul><li>The easy-to-use system guides patients </li></ul><ul><li>through the simple process & provides </li></ul><ul><li>an immediate link to their care provider </li></ul><ul><li>from their home eliminating the need to </li></ul><ul><li>travel and improving care plan </li></ul><ul><li>compliance . </li></ul>
  24. 25. <ul><li>Our research and evaluation has shown Telehealth: </li></ul><ul><ul><li>Improves QUALITY - Specialist expertise at Englewood provides a more rapid and reliable assessment by using telehealth and POC. </li></ul></ul>
  25. 26. <ul><ul><li>Improves ACCESS – The nurse has the ability to quickly provide the Physician with the patients information such as weights or vital signs and is able to identify the urgency for treatment when using the telehealth monitors and POC. </li></ul></ul>
  26. 27. <ul><ul><li>Improves ACCEPTABILITY - Patients and caregivers consistently rate satisfaction with our telehealth applications very highly, often above 90%. </li></ul></ul>
  27. 28. <ul><ul><li>Decreases patient COST - The expense to patients for out-of-pocket travel costs for physicians visits outside of regularly scheduled visits can be significantly reduced by telehealth and POC. </li></ul></ul>
  28. 29. <ul><li>Telehealth is sometimes the only way that rural and isolated areas can get advanced medical care for their residents, but significant questions still remain about the value and effectiveness of the technology, according to a recent Agency for Healthcare Research Quality (AHRQ) report. </li></ul>
  29. 30. <ul><li>Taking laptops into the patients home – Some patients feel its taking time from hands-on care. Some patients feel threaten by a computer. </li></ul><ul><li>Productivity – The OASIS-C Federal Assessment instrument has lengthen indicating more detailed documentation therefore more timeconsuming. </li></ul><ul><li>Technology - For the elderly is very confusing some do not understand the concept of the new technology. </li></ul>
  30. 31. <ul><li>Individualized training and education are provided as part of the initial visit, as well as ongoing 24 hour support.  </li></ul>
  31. 32. <ul><li>The nurse continues to make scheduled visits and other visits as needed. </li></ul><ul><li>POC allows more hand-on contact and time with patient. </li></ul>
  32. 33. <ul><li>This personalized service enhances self-confidence for both the patient and the caregiver </li></ul>
  33. 34. <ul><li>Each telehealth monitor is customized per patient according to physician care plan directives.  </li></ul>
  34. 35. <ul><li>A number of vital signs can be taken from a patient including:  </li></ul><ul><ul><li>Blood Pressure, oxygen saturation, pulse rate, weight (up to 450 lbs.), peak flow and blood glucose.  </li></ul></ul>FLEXIBILITY (CONT.)
  35. 36. <ul><li>A physician can choose to have a patient’s vital signs monitored multiple times throughout the day as needed.  </li></ul>
  36. 37. <ul><li>Clinical questionnaire assessments are customized per patient based upon specific parameters.  </li></ul><ul><li>Medication reminders multiple times per day will promote patient compliance </li></ul>
  37. 38. <ul><li>Patients with a primary diagnosis of a condition like congestive heart failure </li></ul><ul><li>Patients with a recent and serious decline in their medical condition </li></ul>
  38. 39. <ul><li>Patients with a recent hospitalization and/or who have received emergent care </li></ul><ul><li>Patients faced with numerous hospital readmission </li></ul>
  39. 40. <ul><li>Patients with a limited understanding of the disease process and/or how to self-manage their treatment and recovery </li></ul><ul><li>Patients unable to apply the proper care management to enable recovery </li></ul>
  40. 41. <ul><li>Point of Care laptop in the home offers numerous advantages. </li></ul><ul><ul><li>Clinical documentation is more accurate and timely. </li></ul></ul><ul><ul><li>Provides ready access to clinical data and numerous aspects of the chart is at the nurses fingers tips. </li></ul></ul>
  41. 42. <ul><ul><li>Improves the quality and provides more time for teaching/assessment while in the home. </li></ul></ul><ul><ul><li>Allows more Q & A for our isolated patients in rural areas. </li></ul></ul><ul><ul><li>Real time analysis of changes in the patient health status, incorporated with telehealth </li></ul></ul>
  42. 43. <ul><ul><li>Patient information more </li></ul></ul><ul><ul><li>assessable at all times. </li></ul></ul><ul><ul><li>More legible with no complaints of hand writing techniques. </li></ul></ul><ul><ul><li>More productivity. </li></ul></ul>
  43. 44. <ul><li>Maximizing travel time to rural areas aiding in better collection of OASIS data collection. </li></ul><ul><li>More in-home time to actual document findings </li></ul><ul><li>Access to telemonitor life stream system with digital and graphs while in the home </li></ul>
  44. 45. <ul><li>Better real time communication and coordination with the limited number of physicians in our rural areas. </li></ul><ul><li>Reduction of re-hospitalizations by front loading skilled nurses and therapy visits and expanded use of telemonitors in the rural areas. </li></ul>
  45. 46. <ul><li>Enrolling a patient in a telehealth </li></ul><ul><li>program has consistently shown: </li></ul>
  46. 47. <ul><li>Improved quality of life scores </li></ul><ul><li>• Reduction in hospital readmissions </li></ul><ul><li>• Reduction in </li></ul><ul><li>unneeded ER visits </li></ul><ul><li>• High patient acceptance </li></ul><ul><li>levels </li></ul><ul><li>• High nurse acceptance </li></ul><ul><li>levels </li></ul><ul><li>• Improved data gathering and accuracy. </li></ul>
  48. 50. Alexander H. Vo, PhD AT&T Center for Telehealth Research and Policy Electronic Health Network University of Texas Medical Branch Galveston, Texas May 2008