Remote monitoring to cut readmissions: One year later, Beacon pilot preps for future

St. Vincent CMIO Alan Snell: 'We're finding some pretty dramatic drops in the cost of care'
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As the Central Indiana Beacon Community's pilot program, which uses remote video conferencing between nurses and discharged hospital patients in an effort to reduce readmissions, closes in on its one-year anniversary, the organization is reporting impressive results.

Alan Snell, M.D., chief medical informatics officer at Indianapolis-based St. Vincent Health (pictured), will present the full results of the pilot at this year's mHealth Summit—and then he'll talk about what's next for the Central Indiana Beacon Community remote monitoring program at a FierceMobileHealthcare-sponsored breakfast roundtable on December 4.

In the meantime, he gave FierceHealthIT a sneak peek of the results and the organization's plans to capitalize on them going forward.

The program enrolled 300 patients who were being discharged with diagnoses of congestive heart failure, chronic obstructive pulmonary disease, or both. Seven St. Vincent's hospitals and seven partner hospitals participated in the program, which was funded with $1 million out of a $16.1 million Beacon grant.

"We randomized the patients into an intervention group or control group. The intervention group received the health guide and peripherals. The nurse would videoconference with the patients a total of 10 times in a month and had daily contact with them if needed in terms of their collecting vital signs. We also had the patients answer questions and we'd give them educational materials and videos that were specific to their disease," Snell said in an interview with FierceHealthIT.

"We measured their 30 day readmissions versus the control group. The control group just received whatever that hospital does normally for a discharged patient. In many cases that's just a phone call or a follow-up—not very aggressive."

The results?

"We have a 5 percent readmission rate in the intervention group compared to 20 percent in a control group—and of course the national average is about 20 or 21 percent for those two diagnoses; so about a 75 percent reduction," Snell said.

The program also uses a patient activation measure survey from the University of Oregon that measures a patient's understanding of their disease. 

With excess capacity for devices and nursing time, the pilot expanded to include patients with other complex chronic conditions.

"We went after patients that were in capitated populations our self-insured, employed population for the hospital and their dependents so that we could establish baselines on their cost of care before and during the monitoring," he said. "We're finding some pretty dramatic drops in that cost of care."

One example: "We had a patient who had 13 admissions for congestive heart failure last year—it cost St. Vincent, because she is in our health plan, $156,000. We enrolled her at the end of December, so here we are at the end of November and she's had no admissions in almost 11 months of monitoring—a very dramatic drop," Snell said.

Want to know what happens next? At next month's mHealth Summit breakfast in Washington, D.C., Snell and his fellow panelists will talk about how the program will build on its successes, including plans for increased patient engagement and education and how it will use data analytics to identify which patients need intense monitoring and which patients don't.

Editor's note: Due to a reporter's error, this article incorrectly stated in the percentage of reduction in readmissions. The article has been edited to refect the correct number, which is 75 percent.  

To learn more:
- get more details about the event: "Using Remote Patient Monitoring to Reduce Readmissions"
- check out our panelists  
- register for the breakfast
learn more about the Central Indiana Beacon Community

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