Problem of hospital readmissions, benefits of telemedicine hit home




No matter what region of the U.S. you live in, we all want access to quality healthcare. We can all agree that it's comforting when a local hospital receives high marks in a national ranking. However, I recently read a report in which my hometown of Buffalo, N.Y., was found to be one of the worst performing areas of the country when it comes to certain quality healthcare measures.

As we all know, hospitals now face penalties from Medicare for readmission of patients who return within 30 days of discharge. Medicare is also penalizing or rewarding hospitals based on their performance on basic quality measures and patient satisfaction surveys. Unfortunately, a disproportionate number of Buffalo hospitals have been penalized and not enough rewarded using this criteria.

On average, 48 percent of hospitals received a penalty and 52 percent a bonus in recent Medicare surveys, as reported in the Buffalo News article. Nevertheless, a whopping 92 percent of hospitals in Buffalo received a penalty and only 8 percent got a bonus. I can't help but feel that these results might be different if these hospitals implemented remote monitoring, video conferencing and other telemedicine services to combat the problem of readmissions.

In 2012, the American Telemedicine Association estimates that more than 10 million Americans directly benefited from telemedicine services, more than double the number just three years ago. Currently, more than one million Americans receive remote cardiac monitoring, an important application given the high number of hospital readmissions for heart failure which often occur within 30 days of discharge, are largely preventable, and cost Medicare $6 billion annually. 

Indianapolis-based St. Vincent Health successfully conducted a pilot program in which remote video conferencing between nurses and discharged patients with congestive heart failure and chronic obstructive pulmonary disease helped to reduce readmissions by an astonishing 75 percent. In addition, a Department of Veterans Affairs national home telehealth program demonstrated a 25 percent reduction in the number of days of bed care and a 19 percent reduction in hospital admissions.

Buffalo hospitals can also find inspiration from Cleveland, our Lake Erie neighbor just a three hour drive away. Cleveland's Case Western Reserve University is conducting a pilot to test next generation high-definition, multipoint video conferencing for homebound patients. Currently, the system is being studied in two Cleveland neighborhoods equipped with high speed bandwidth, allowing clinicians to keep in contact with patients at home and to evaluate their conditions on an ongoing basis. 

If Cleveland can do it, so can Buffalo. As someone who follows the growing adoption of mHealth and telemedicine, my attention is often focused on healthcare in other parts of the country. Yet, it appears there is just as great a need for technological change in my own backyard. - Greg (@Slabodkin)