Remote care management program to be rolled out nationwide

Building on the success of a two-year study that determined that videoconferencing significantly reduced hospital readmissions, Indianapolis-based St. Vincent Health has partnered with its parent organization, Ascension Health Alliance, to form a joint venture that officially will launch a remote care management program next month with the goal of scaling the program on a national level.

The 2010 federally-funded ARRA Beacon Community Grant study wrapped up in December 2012, successfully demonstrating that remote monitoring reduced the 30-day readmission rate for patients discharged with congestive heart failure and chronic obstructive pulmonary disease. In the intervention group, which consisted of 75 patients, there was a mere 4 percent readmission rate and in the control group of 94 patients there was an 11 percent readmission rate--both rates are far below the national average of 21 percent.

However, Alan Snell, M.D. (right), Chief Medical Informatics Officer for St. Vincent Health, told FierceMobileHealthcare that the two organizations are not resting on their laurels.  

"One of the requirements for the Beacon grant program was to have a sustainability plan, as a result we have created a joint venture company between St. Vincent Health and Ascension Health Alliance," Snell said. "The advantage of doing this joint venture with Ascension is that Indiana will be the test sites and then they plan on rolling this model out across Ascension as well to their other sites nationally."

St. Vincent Health is an integrated healthcare organization based in Indianapolis with 20,000 associates, and 22 hospital sites. Ascension Health is the nation's largest Catholic and non-profit health system, employing more than 121,000 associates serving in more than 1,400 locations in 21 states and the District of Columbia. Ascension Health Alliance is the for-profit arm of Ascension Health.

"By this time next year, our goal is to have around 500 patients being monitored on any given day," Snell said. "Depending on their acuity level, we'll use varying degrees of monitoring, technology and nurse interaction to help them transition out of the hospital. We plan to monitor these recently discharged patients for 60 days. We felt the 30 days we monitored patients in the clinical trial was too short to educate them for better self-care management after their monitoring was discontinued."

Snell said that for the scale-up, they will be changing the software platform and device, as well as some of the peripherals. For instance, he said they will adopt a more portable tablet form factor than the large, bulky device previously used, and will incorporate more analytics and structured documentation.  

For the pilot, patients were given an electronic health guide to place in their home to help monitor and manage their health. On a daily basis, patients interacted with the wireless mobile device to answer questions and provide additional requested information based on their responses. Patients also measured their vitals using a Bluetooth scale and a blood pressure cuff and some were asked to use a Bluetooth pulse oximeter.

"A lot has changed, not just the hardware but also the software, from when we began originally," Snell said. "The cost is also dropping rather dramatically."

For the launch of the new St. Vincent-Ascension Health Alliance remote care management program, more nurses will be utilized starting next month to perform scheduled video conference calls with patients to address questions and enable them to evaluate how the patients are doing.

"With a limited number of patients, we were able to handle it with just one nurse," Snell said. "Now, we're going to be scaling up. We're also going to be developing a risk assessment and then protocols. We didn't use tools upfront for risk assessment during the grant."

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