ACO tablet program cuts patient readmission rates

HackensackAlliance, an accountable care organization (ACO) in Hackensack, N.J., gave its patients their own 4G tablets to better coordinate and manage their care--an investment that is paying off. The tablet program is proving to help reduce readmissions in patients with chronic heart failure (CHF), chronic obstructive pulmonary disease (COPD) and diabetes, the ACO's three leading causes of readmissions, according to an article in Becker's Hospital Review.

In a pilot study, a group of Medicare patients who used the tablets had a readmission rate of only eight percent, while a control group had a 28 percent readmission rate, reports the article. That translates into big savings for the ACO. The tablet program, which currently includes 16 patients, costs the organization about $150 each month per patient, besides the initial investment in the tablets. By comparison, the average cost of a readmission is $13,200, based on statistics from the Healthcare Cost and Utilization Project. 

In addition, Medicare ACOs are measured on 33 quality metrics, which include readmission rates as well as disease-specific outcomes for COPD, diabetes and CHF. If the tablet program helps improve outcomes and prevent readmissions, ACOs can be rewarded financially for improving on those quality metrics as well, which would increase the return on investment, states the article.

Patients take their tablets home and nurse care navigators help them set the tablet up with a daily plan, including when they should eat, take medications, measure blood sugar or weigh themselves. The programmed tablets alert the patients to take medications or weigh themselves, for example, and the patients document it in their tablets. 

If patients do not document something when they are supposed to, care navigators receive a notification so they can contact the patient and identify the problem. In addition to notifying patients and providers, the tablets are also loaded with educational resources, such as medications' possible side effects or diet tips specific to patients' illnesses. 

While patients seem to be benefitting from the ACO's tablet program, a study at Riverside Methodist Hospital in Columbus, OH found that residents did not attribute high value to their Apple iPads as clinical rounding or educational tools. The hospital initiated a resident-wide iPad program in the 2011-2012 academic year. 

All 119 residents used a 16 GB iPad 2 with Wi-Fi at a cost of $499 each, of which 102 (86 percent) residents participated in the study. The aim of the study was to evaluate residents' perceptions of the iPad's clinical and educational utility, and examine differences of perceived value between medicine-based and surgical-based residents.

"Across all residency programs, the iPad received low marks for daily clinical utility (14.7 percent) and efficiency in documentation (7.8 percent)," study authors wrote. "It was most valued for sourcing articles outside the hospital (57.8 percent), and as a research tool (52 percent)."

To learn more:
- read the article in Becker's Hospital Review