Telemonitoring fails to prevent hospitalization for elderly at-risk patients

Telemonitoring, a much-ballyhooed option to reduce the cost of healthcare and improve patient outcomes by reducing patient readmissions, doesn't keep older patients out of the hospital, according to a new study published this week in the Archives of Internal Medicine.

The study, conducted by researchers from the Mayo Clinic and Purdue University, monitored 205 older adults at high risk for rehospitalization due to multiple health issues. Telemonitoring included daily biometrics of blood pressure and weight, symptom reporting and videoconferencing.

The researchers found no difference in the hospitalization, emergency department visit and hospital day rates between the telemonitored group and the patients who received usual care. In fact, the mortality rate of the telemonitoring group was higher (14.7 percent) than in the usual care group (3.9 percent).

The study somewhat contradicts several other recent studies that determined that telemonitoring can significantly reduce readmissions. A recent study by Geisinger Health Plan, for instance, found that telemonitoring using interactive voice response resulted in a 44 percent reduction in readmissions of patients with congestive heart failure; 85 percent of case managers reported that using telemonitoring helped keep patients out of the hospital, although that study was not limited to elderly patients. Geisinger was so pleased with the success of the study that it expanded its telemonitoring to patients with hypertension and diabetes.

Additionally, a British study published late last year found that remote monitoring cut emergency admissions by 20 percent and reduced mortality rates by 45 percent.

Reducing readmissions is a current priority for hospitals and the government. As required by the Affordable Care Act, beginning in 2013 Centers for Medicare & Medicaid Services will impose a 1 percent penalty in the form of reduced Medicare reimbursement on hospitals with high readmission rates for myocardial infarction, community acquired pneumonia and congestive heart failure; the penalty will increase to three percent by 2015.

To learn more:
- here's the study's abstract
- read the accompanying commentary (registration required)