Addressing the cost and access to care through telehealth
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Home › Our Approach › Perspectives › Addressing the cost and access to care through telehealth
Skyrocketing healthcare costs and a shortage of experienced professionals strain the care delivery system, particularly for the critically and chronically ill. Coordinated telehealth solutions can help. Whether it's reaching into the patient’s home, or out to short-staffed ICUs – telehealth, or the application of technology assisted remote care, is being applied with exceptional results.
From hospital to home
Telehealth is a coordinated and comprehensive methodology for health systems to manage people and patients across the care continuum – from hospital to home.
Integrated telehealth solutions are helping to reduce costs and improve patient outcomes. Whether a commercial hospital or VA or DoD hospital, many organizations must do more with less, yet improve the quality and access to care. Telehealth innovations can leverage current workforce skills by reaching critically and chronically ill patients through technology assisted remote care.
Telehealth puts state-of-the-art technology to work to leverage the skills of overburdened healthcare professionals.
Telehealth is the use of remote sensors, communications, and data processing technologies that focus on the patient/person and involves dynamic interaction with providers in real-time or near real-time, resulting in improved clinical outcomes, lower costs, and greater satisfaction. Telehealth technologies include bidirectional audio/video, physiologic and behavioral monitoring, engagement prompts, and point-of-care testing. Tailored programs utilize remote teams of physicians, nurses, pharmacists, social workers, and health coaches supported by enabling technology to provide the highest quality healthcare.
Government agencies are early adopters
Many clinical innovations that gain acceptance in the commercial sector have been driven by early adoption through government agencies such as the Department of Defense and the Department of Veteran Affairs Veterans Health Administration. The implementation of telehealth solutions is a prime example. The VHA has had extensive experience working with telehealth technology to improve access to care.
These types of coordinated telehealth programs can often be cost-effective ways to systematically manage patient populations with ongoing needs, particularly those with medically complex and/or chronic conditions.
Telehealth in the ICU
A recent study examined the impact of Philips remote intensive care unit (eICU) in 32 hospitals, across 56 intensive care units with nearly 120,000 patients, over a five-year period, and demonstrated significant reductions in both mortality and length of stay.
Compared to patients receiving traditional ICU care, patients who received care from the eICU program were:
26% more likely to survive the ICU
Discharged from the ICU 20% faster
16% more likely to survive hospitalization and be discharged
Discharged from the hospital 15% faster
Telehealth at home
Newly released data from an intensive ambulatory care (eIAC) program at Banner Health (Phoenix, AZ) documents the effectiveness of this “high tech/high touch” system of managing patients with multiple chronic conditions.
Results indicate that this approach has the potential to influence cost reductions in the range of 27% for acute care and 32% for long-term care, in addition to reductions in hospitalization in the range of 45%.
Telehealth in the future
With the recent Ebola outbreak fresh on the minds of many, telehealth could be an important solution in the government’s arsenal of tools to quickly and effectively manage a unified and coordinated response to any communicable disease crisis.
Keeping caregivers out of harm’s way as much as humanly possible may reduce the risk of local epidemic complications. We’re working with a well-respected university hospital, which was named HHS partner for education/training in communicable diseases, to help build-out a 3-5 bed communicable disease unit that will include remote control of medication infusion pumps and Philips ventilators. If this type of unit could be established at each of the over 400 hospitals monitored today by eICU centers, the potential impact could be significant.
The likely benefits of these units could be to:
Minimize caregiver/patient interaction, thereby reducing the chance for disease transmission
Shorten time that caregivers must wear hot and dehydrating protective clothing to reduce the chance for errors
Use cameras in the ante-room to observe isolation precautions to ensure that staff use proper technique
Ability to enable loved ones and non-suited personnel to communicate with patients in isolation
Ability to collect data in near real-time across all isolation units for direct transmission to CDC/NIH
Provide CDC/NIH remote access into all isolation rooms
We believe that creation of a country-wide set of isolation beds in major metropolitan areas for care of patients with pandemic/epidemic communicable diseases could help aid in the government’s ability to deal with future communicable situations and provide distributed surge capacity for these events.
The opportunities for telehealth are expanding.
by Dr. Brian Rosenfeld, Chief Medical Officer, Philips Healthcare, Telehealth
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1 Dahl, D., Khurana MD, H. (2015). Impact of an intensive ambulatory program on both financial and clinical outcomes in Banner Health. Unpublished internal study. Results are specific to the institution where they were obtained and may not reflect the results achievable at other institutions.
2 Several articles point to increased access for patients. For example, Telemedicine and e-Health. May 2012, 18(4): A-1-A-146. doi:10.1089/tmj.2012.9994. Accessed 15-Dec-15. Another example, “Survey: Telehealth Increases Access to Care, Continuity”
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