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Top 3 insider tips to raise quality while lowering cost

Are you focusing on quality or cost? Don’t choose one—optimize both
with these three insider tips.

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Quality in healthcare has always been the primary focus, but in today’s environment, cost efficiency cannot be overlooked for a moment. Yet with so much of COPD care practices already optimized to streamline spending and drive revenue, what more can providers do?


Read on to learn 3 ways to ensure your team is functioning efficiently and effectively

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Take full advantage of telehealth and telemonitoring technologies


Advances in Information and Communications Technologies (ICT) such as telehealth and telemonitoring are enabling the delivery of remote, interactive healthcare services to patients and their caregivers. But the benefits go far beyond the operational.


Christine Cunningham

Christine Cunningham, RRT

Director of Clinical Services

CHI Health at Home

Brian Carlin

Brian Carlin, MD, FCCP, FAARC

Pulmonary and Critical Care Physician

Altoona Regional Health System

Jennifer Anderson

Jennifer Anderson, MBA, RRT, AE-C

Administrative Director of Respiratory Care Services and Pulmonary Function Laboratories

AU Medical Center

Information and Communication Technologies will enable us to not only monitor patients, but also apply predictive analytics to alert us earlier when there is a problem.”

Christine Cunningham, RRT

Director of Clinical Services

CHI Health at Home

TeleMedicine, TeleCare, TeleMonitoring, TelePulmonology, and TeleHealth. What’s the Difference?4


The terms used to describe information and communications technologies are often used interchangeably, but in fact, have different meanings. According to Connect2Health, a task force founded by the Federal Communications Commission, here is how the phrases are defined:

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Telecommunications technologies to support the delivery of various medical, diagnostic and treatment-related services—usually by physicians.

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Technologies that enable patients to stay safe and independent in their own homes.

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Technologies that enable providers to capture previously inaccessible in-home patient data, such as vital signs and symptoms.

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An implementation of telemedicine that could support general practitioners in interpreting spirometry results. In telepulmonology, a GP digitally consults a pulmonologist to gain support in diagnosing patients or to gain treatment advice.5

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Includes a wider variety of remote healthcare services such as health education, social support, and medication adherence typically provided by physicians, nurses, pharmacists or social workers.

Technology enables us to determine patients who
do not require a visit and those who need to be seen right away. This helps ensure better utilization of resources.” 

Jennifer Anderson

Administrative Director of Respiratory Care Services and Pulmonary Function Laboratories AU Medical Center

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Engage and empower caregivers6


Caregivers—whether full-time or assistive—can play a critical role in decreasing healthcare costs and the need for resources, while maintaining or increasing the quality of COPD care. This can be especially true for chronically ill patients during the post-hospitalization transition, when patients are most vulnerable.


According to John Piette, et al., in a paper published in the Journal of Clinical Trial Results, caregivers can help patients:


  • Follow self-management plans
  • Identify early warning signs of acute illness
  • Remember and understand self-care information
  • Navigate the health system
  • Cope emotionally with a chronic illness


These benefits can help patients maximize the effectiveness of their care plan

and maintain wellness to a great extent.


Piette reports however, that while assistive caregivers are often an important

member of the care team, there may not be a system in place to maximize

their abilities.

Maximizing caregiver support


Don’t assume that caregivers are automatically equipped to make a significant difference. You are a key player in transferring information and co-creating plans/programs to help them do their best work. Keep these tactics top of mind:

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Co-create clearly defined roles and responsibilities

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Inform caregivers by keeping them in the communication loop

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Develop education programs specifically for caregivers versus for the patient and caregiver as a dyad

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Increasing focus on the needs of the caregiver

Described as ‘potential agents of change that can facilitate and enhance adherence of COPD management behaviors,’ the unmet needs of the caregivers themselves are becoming a focus for some researchers. In fact, according to Morag Farquhar, et al. in a paper published in Chronic Respiratory Disease Healthcare, informal caregivers of patients with COPD have both generic and disease­specific needs.7


 Farquhar goes on to explain that it is rare for clinical and supportive interventions to be made on a patient’s behalf without prior assessment—and that the same should be true for caregivers.

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Key considerations when assessing caregiver needs

A Single Assessment Process out of the United Kingdom is said to include 7 key issues to consider when evaluating the needs of the caregiver:7 


  1. The nature of the caregiver’s needs
  2. The significance of the caregiver’s needs, and which they would like to prioritize
  3. The length of time the prioritized need has been experienced
  4. Recent life events experienced by the caregiver
  5. Potential solutions identified by the caregiver
  6. Perceptions of family members and of the patient
  7. Potential solutions agreed upon by the caregiver and healthcare professional

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Extend care team roles and responsibilities


With greater need to drive the return on investimate (ROI) of care delivery, identify ways to drive the ROI of your care team members. One key approach is to extend care team member roles beyond their traditional application. This approach is accelerating in uptake, as was recently confirmed in an article published in Leadership+, a newsletter sponsored by the Healthcare Financial Management Association (HFMA).8


Extending roles helps care teams create more value with their current resources and meet the needs of efficient, effective care. Here are two examples.

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Extending the RT role9

According to Timothy Meyers, MBA, RRT-NPS, FAARC, in his article, Thinking Outside the Box: Moving the Respiratory Care Profession Beyond the Hospital Walls, there is a need for respiratory therapists to extend their specialized clinical skills beyond the traditional acute care setting:


  • Consult patients on wellness and prevention
  • Become the knowledge hub on disease management practices and principles
  • Coach on smoking cessation
  • Inform about the managed care approach
  • Be highly involved in home health settings

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Extending the nurse role8

Bobbie Berkowitz, PhD, RN, NEA-BC, FAAN, Dean, Columbia University School of Nursing, says, “The use of advanced practice registered nurses, such as nurse practitioners, can help relieve the shortage of primary care physicians.


Utilizing nurse practitioners to the full scope of their license can improve patient outcomes and optimize the healthcare workforce.” 

We need to find ways of repositioning the use of
resources from the acute care environment into the home environment.” 

Brian Carlin, MD, FCCP, FAARC

Pulmonary and Critical Care Physician

Altoona Regional Health System

Meeting the needs of healthcare today


As care teams face greater demand to do more with less, they’ll need to innovate or be left behind.


Help your care team deliver efficient, effective care by identifying new ways to leverage telehealth technologies, empowering caregivers, and extending the roles and responsibilities of members of the team.

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1.2015 Benchmarks Telehealth and Telemedicine. Health Intelligence Network. Accessed July 1, 2018.

2.Thomas, K.  Improvements in COPD Outcomes Through Telehealth.  Advanced TeleHealth Solutions. Accessed July 1, 2018.

3.Deschenes S. 5 ways telemedicine is reducing the cost of healthcare. Healthcare Finance News. July 12, 2012. Accessed July 1, 2018. 

4.Federal Communications Commission. Accessed June 2018.

5.Thijssing L.Telepulmonology: Effect on quality and

efficiency of care. Respiratory Medicine (2014) 108, 314e318.

6.Piette JD, Striplin D, Marinec N, Chen J, Gregory LA, et al. (2015) Improving Post-Hospitalization Transition Outcomes through Accessible Health Information Technology and Caregiver Support: Protocol for a Randomized Controlled Trial. J Clin Trials 5:240. doi:10.4172/2167-0870.1000240

7.Farquhar M. Assessing carer needs in chronic obstructive pulmonary disease. 

Chron Respir Dis. 2018 Feb; 15(1): 26–35. Accessed June 20, 2018. 

Accessed March 15, 2018.

8.Wagner K. Preparing the Healthcare Workforce for Value. Leadership +.May 17, 2017. 

Accessed July 1, 2018. 

9.Myers T., Thinking Outside the Box: Moving the Respiratory Care Profession Beyond the Hospital Walls. Respiratory Care.

All content on this site is for informational and educational purposes only and is not a substitute for medical advice of your doctor or other health care professional. Always seek the advice of your physician or other health care provider with any questions you may have about any medical condition.  Refer to the Terms of Use for additional information.

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