Testing Technology vs. Enabling a System of Chronic Care – Results of the NIH Tele-HF Trial

Randy Williams — Tue, 16 Nov 2010 21:53:59 +0000

The results from the National Institutes of Health (NIH)-sponsored Tele-HF trial are in, and the findings are worth considering . The results are counter to most of the findings of other studies examining telemonitoring for heart failure and at face value are disappointing to us, and the industry. Upon closer examination, however, this study offers us an excellent opportunity for further innovation, refinement of solutions and continuous improvement. It also provides a snapshot of how significant the challenges remain in transforming U.S. healthcare – from a system that is episodic, reactive, acute care based to a system of care that incorporates proactive, interactive, continuum-based chronic care management.

The genesis for this study stretches back nearly 10 years, from conceptualization to the results we see reported today. This randomized, controlled multi-centered trial was designed to compare an automated, daily symptom and self-reported weight monitoring technology with “usual care” in reducing hospital readmissions and mortality among patients recently hospitalized with decompensated heart failure. The boldness of vision should not be underrepresented: Tele-HF is the largest study of a non-pharmacological intervention for heart failure ever conducted.

At a high level, the results showed “no significant differences” between the group receiving usual care and the group randomized to receive telemonitoring. I cannot say that these are the results we were hoping for. However, I urge those in our industry and other key stakeholders to take a closer, more informed view, and to reach their own conclusions and insights.

The Details

First, I want to thank and acknowledge the great work of the investigators, study sites and everyone involved in this trial. It was a long process and everyone worked with the utmost integrity and professionalism. We were privileged to have been selected for participation. I also want to acknowledge the value of conducting large, multi-centered, randomized, controlled trials in terms of advancing medical science.

The patient interventions in this study took place in 2006-09 and omit many of the processes and techniques Pharos uses today to achieve the necessary critical mass of physician and patient involvement. Here are the limitations of this particular study – from my perspective: (more…)

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Post tags: Care management, Disease management, Remote Patient Monitoring

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Setting the Record Straight: Chronic Care Management CAN be Successful

Randy Williams — Wed, 10 Feb 2010 14:58:45 +0000

Clearly, the need to reduce healthcare costs without affecting the quality of healthcare delivered is at the center of our country’s healthcare debate. However, a recent BusinessWeek article of February 4, 2010, by Chad Terhune and Arlene Weintraub, makes the mistake of lumping together all disease management programs and then goes on to cite examples in which particular programs have demonstrated no cost-savings nor any apparent increase in the health of patients.

That is not, however, true of all programs that aim to manage chronic disease and demonstrate reduced costs.

As a cardiologist and CEO of Pharos Innovations, a company that focuses on managing chronic disease while demonstrating real reductions in avoidable hospital admissions and overall healthcare costs for Medicaid, Medicare, the VA, commercial health plans and provider systems, I think it’s important to set the record straight. There ARE well-proven ways to reduce costs AND keep patients healthier. (more…)

© Randy for The Collaborative Forum, 2010. | Permalink | No comment | Add to del.icio.us
Post tags: Care management, CMS, Disease management, Health plan, Medicaid, Medicare, Population Health, Remote Patient Monitoring

Tags: Care management, CMS, Disease management, Health plan, Medicaid, Medicare, Population Health, Remote Patient Monitoring

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The Collaborative Forum » Disease management

Testing Technology vs. Enabling a System of Chronic Care – Results of the NIH Tele-HF Trial

Setting the Record Straight: Chronic Care Management CAN be Successful