The Collaborative Forum » 30 Day Readmissions

Remote Patient Monitoring Plays a Large Role in Successful Outcomes

Randy Williams — Tue, 17 Aug 2010 00:22:42 +0000

It seems more and more often lately, I’ve been reading about remote patient monitoring (RPM) and how different segments of the healthcare industry are turning to these technologies as an effective and cost-efficient means of reducing hospital readmissions. The lead sentence of a recent WSJ article read: “Technology that aims to keep congestive heart failure patients out of the hospital is gaining traction.”

This is a good thing. We at Pharos have been using behavior change technology and RPM as a very effective tool for keeping heart failure patients healthier for the past 14 years. Providers and home care agencies have been embracing and using it for years.

The WSJ article cites some examples of payers who are turning to RPM, too. We are encouraged by the growth we are seeing in that segment of the healthcare market – growth that clearly indicates that these types of technologies are becoming more broadly valued and accepted as a critical element in cost containment and improved health outcomes. (more…)

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What Constitutes an Effective Hospital Readmission Program?

Randy Williams — Wed, 07 Jul 2010 22:17:49 +0000

I am sure you have seen the reports, including the 2009 article in the New England Journal of Medicine (Jenks, et al), that highlight the cost and prevalence of 30, 60 and 90 day hospital readmissions. I think it’s safe to say that we all agree that this is a major issue that our healthcare system needs to address.

Where we don’t all agree is how to get there. Organizations across the country are looking for effective initiatives and innovations to reduce these costs. In their quest, some organizations are looking for easy solutions, such as the simple scheduling of follow-up visits post discharge. However, as detailed in a new study from the Mayo Clinic, published in the Archives of Internal Medicine, siloed, quick-fix initiatives, while very important, alone will not provide the true behavior change needed for measurable reductions in avoidable hospital admissions and readmissions. (more…)

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Emergency Department Visits Drive Up Readmission Rates Far Higher than Originally Presumed

Randy Williams — Thu, 03 Jun 2010 21:14:17 +0000

Another article caught my attention last week. It was an article in HealthLeaders on a report issued as part of the Agency for Healthcare Research and Quality’s (AHRQ) Healthcare Cost and Utilization Project, which covered 12 states including Arizona, California, Florida, Hawaii, Massachusetts, Missouri, Nebraska, New Hampshire, New York, South Carolina, Tennessee, and Utah.

The key finding of the report was that the problem of readmissions and use of emergency room resources is more problematic than originally presumed.

According to the AHRQ report, “most readmission studies only report information on patients who have multiple hospital inpatient stays,” and in so doing exclude patients who seek care in the emergency department (ED). Once the researchers included ED visits, the rate of multiple visits jumped by more than one-third—from an average of 1.5 to 2.1 acute care hospital visits per patient. (more…)

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Quality Can Be Improved and Measured Meaningfully

Randy Williams — Thu, 27 May 2010 03:16:42 +0000

I’ve been in the healthcare field for over 20 years now, and I still believe that the vast majority of those involved—whether on the payer or provider side—truly want what’s best for their patients or members. After all, healthcare quality and cost affects everyone.

In an editorial published earlier this week in the New York Times entitled “The Gaming Begins,” the editors point out the difficult struggle over how to calculate medical loss ratio under the new healthcare law and discussed concerns that insurers could “game” medical loss ratio by spending money on administrative costs, rather than on meaningful measures to improve quality.

Beginning in 2011, the new law requires health insurers to spend 80-85 percent of the premiums they collect on medical services or activities that improve the quality of care (the medical loss ratio). Insurers can then use the remainder of the premiums for things such as marketing, overhead, salaries, and profit. (more…)

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Accountability for Patients and for Care Organizations…

Randy Williams — Wed, 02 Dec 2009 14:42:30 +0000

Just a few weeks ago, the American Heart Association (AHA) released a scientific statement, State of the Science: Promoting Self-Care in Persons with Heart Failure: A Scientific Statement from the American Heart Association, that discusses the importance of patient self-care (PSC) and provides evidence-based recommendations to clinicians to promote self-care in their heart failure (HF) patients. The AHA placed significant emphasis on teaching patients how to recognize condition symptoms and what to do with that information, how to make appropriate behavior changes and the importance of transitions of care and depression screening. In addition, the statement acknowledged that systems of care, such as care coordination and telehealth, hold promise for improving the self-care abilities of persons with HF.

Clearly, this set of recommendations resonates with us at Pharos Innovations. These recommendations are directly aligned with the paradigm of physician- and patient-centric care coordination that we created with Tel-Assurance^®. The AHA recommendations are all about accountability: the patient’s as well as the physician’s. Accountability brings better results with healthier patients and reduced hospital readmission rates—both which on the face of it, are great things.

Unfortunately, our healthcare delivery system, as currently designed, is not set up to maximize patient and physician accountability. Specifically, in the way healthcare providers are currently incented for the quantity of care, not the quality. The good news is that this is changing. (more…)

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Making Healthcare Better

Randy Williams — Tue, 10 Nov 2009 21:00:12 +0000

I read an interesting article on Sunday, in The New York Times Magazine, Making Healthcare Better. The article discusses Dr. Brent James of Utah’s Intermountain Healthcare and the results that he and his team are producing with their patients. The Intermountain team has been improving healthcare and reducing costs by following treatment protocols and estimates indicate that the data-driven changes they’ve made at Intermountain have saved thousands of lives a year. In total, Intermountain has developed protocols for 50 clinical conditions, which accounts for more than half of their patients.

There are plenty in the medical field who are skeptical of Dr. James and his approach—and the balanced article includes them—but the results speak for themselves. In the end, what Dr. James and his team at Intermountain have done, is take a different approach to practicing medicine. They’ve looked at the way things were done, and effectively disrupted the intuitive approach to medicine. By providing protocols as a guideline, their doctors have saved thousands of lives.

Disruptive innovation—a theory of Clayton Christensen—discusses that the way to affect real change, is to disrupt the way things have been done. Disruptive innovation can have characteristics that traditional segments may not want (protocols vs. intuitive medicine). In fact, I founded Pharos Innovations and developed Tel-Assurance® based on Christensen’s notion of disruptive innovation. (more…)

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