In 2016, nearly 2.3 million Medicare beneficiaries we discharged from the hospital with home health referrals, yet only 54% ever utilized home health services¹. For the patients who do not use such services, after returning home, they often feel fine until their condition deteriorates, resulting in readmission, institutionalization, or even death. Several factors contribute to the underutilization of home health, such as incorrect or incomplete data, lack of patient education on the difference between non-medical and home health care services, or the distrust of an unfamiliar person in their home. 

Despite patients failing to receive home healthcare, it significantly reduces readmissions and improves patient outcomes, especially when coupled with digital health tools like telehealth and remote patient monitoring. In 2012, the Independence at Home program was designed to test the effectiveness of home-based primary care, which led to beneficiaries having fewer readmissions, hospitalizations, and emergency department visits within a 30-day period². The program also demonstrated the significant ability to improve the quality of care across all areas while improving the quality of life and comfort for patients. Traditional fee-for-service models have often limited the availability of such services, as providers would be able to see more patients in a day when conducting office visits. However, increased support and adoption of value-based care are improving access to home health options. 

Digital health tools like telehealth and remote patient monitoring are also contributing successfully to the success of home health programs. In rural areas where patients may otherwise lack access to healthcare services required to care for their conditions, telehealth and RPM bridge the gap to ensure that all patients can receive continuous, quality care needed to improve outcomes³. In addition, digital tools can expand health education to previously underserved communities.

Before the pandemic, digital health tools were in play. However, they were infrequently and inconsistently applied. COVID-19 drove healthcare professionals to employ digital solutions rapidly to keep patients safe. With traditional, hospital-based care, patients often successfully maintain treatment regimens under the guidance of a healthcare provider but fail to maintain healthcare plans when they return to their home environments⁴. RPM addresses this concern by providing patients with a mechanism to receive consistent, quality health guidance as providers can monitor the patients’ health outside of regular visits. Patients are supported through self-management of their conditions, improving outcomes, and patient engagement.

While mainstream support for RPM tools was generated throughout the pandemic, many providers are looking to continue using digital health tools to meet the needs of patients⁵. Acute care can be more effectively delivered in a home setting, reducing overcrowding in hospitals and readmissions to improve patient outcomes and satisfaction with their healthcare. This empowers patients to remain at home longer by receiving quality care in the comfort of their home environment. In the future, advances in technology like artificial intelligence and machine learning will continue to improve the services available to patients at home, from monitoring their conditions to the diagnosis of new ones, to improve health and quality of life.

https://homehealthcarenews.com/2020/10/half-of-patients-referred-to-home-health-dont-receive-services-but-providers-can-change-that/

https://www.healthaffairs.org/do/10.1377/hblog20191003.276602/full/

https://www.healthcareitnews.com/news/benefits-and-future-remote-patient-monitoring

https://www.homecaremag.com/february-2021/rpm-reduce-unnecessary-hospitalizations

https://mhealthintelligence.com/features/how-covid-19-affects-the-telehealth-remote-patient-monitoring-landscape

The post Improving Patient Outcomes Through Health at Home appeared first on Health at Home.

In 2020, the number of individuals over 60 surpassed the number of children under five for the first time in history^[1]as lifespans increase to over 70 in many countries. In the US, people live longer, with an average life expectancy of 77.8 years in 2020^[2]predicted to increase to 85.6 by 2060^[3]. As of 2020, 56 million US people were ages 65 or older, expected to increase to 84 million people by 2040^[4].

Chronic conditions are already prevalent in the US, with more than 85% of seniors over 65 having at least one chronic condition^[5]. At the same time, nearly half of all US people have at least one chronic condition, and 30 million people have five or more^[6]. The likelihood of developing chronic conditions only increases with age, making chronic care management a significant portion of the nation’s healthcare expenditures. 84% of healthcare costs are estimated to be directly related to chronic care management, which will only increase with diagnosed patients. 99% of Medicare spending goes towards chronic care management.

Seniors have already expressed their preference for home health care, with 90% reporting that they wish to stay at home as they age^[7]. Increased technology makes this possible, ensuring that patients receive hospital-quality care in the comfort of their own homes. Skilled home health providers enable patients to receive therapies and treatments at home, in addition to services that help them with daily activities.

The myth that often persists with home care is that it caters to younger, generally healthier patients. However, this is untrue, with patients over 85 accounting for one-fourth of home health visits while they only account for slightly more than one-tenth of the total Medicare population^[8]. In addition, nearly half of all home health patients have five or more chronic conditions, while this population makes up less than one-quarter of all Medicare beneficiaries. With the demand anticipated to continue, the home health industry is expected to reach $225 billion by 2024, more than double its market value in 2016⁴.

These demands can be met by the evolving hospital-at-home model, for which CMS expanded flexibilities in late 2020^[9]. Hospital at home programs have already seen success across the country, so this expansion will only serve to improve the availability and affordability of these home health services. The program requires healthcare providers to screen patients for medical and non-medical factors and conduct an in-person evaluation before beginning home health care. In addition, remote patient monitoring will also be a significant component of home healthcare, enabling providers to monitor for changes in vitals or symptoms that may indicate worsening conditions.

Home healthcare helps to achieve two goals: improving patient outcomes while reducing the cost of care. Studies have shown that at-home care is, on average, less expensive than traditional care at a skilled nursing facility. In addition, patients benefit from lower rates of readmissions and other hospitalizations^[10]. Fewer patients in emergency departments and fewer admitted to the hospital will increase the capacity and ability of physicians to treat higher-acuity ED presentations.

By making home health care widely available, patients with chronic conditions can receive quality care in the comfort of their homes and benefit from improved patient outcomes. This will be especially valuable as the number of patients with chronic conditions continues to rise, reducing the burden it would place on healthcare systems. Instead, patients get to remain home longer while still accessing the care they need to enjoy their senior lives.

[1] https://www.weforum.org/agenda/2021/03/what-is-the-biggest-benefit-technology-ageing-longevity-global-future-council-tech-for-good/

[2] https://www.cdc.gov/nchs/data/vsrr/VSRR10-508.pdf

[3] https://www.census.gov/content/dam/Census/library/publications/2020/demo/p25-1145.pdf

[4] https://www.mcknightsseniorliving.com/home/news/home-care-daily-news/should-home-healthcare-be-a-new-focus-for-medicare-advantage/

[5]  https://www.cdc.gov/nchs/health_policy/adult_chronic_conditions.htm

[6] https://www.americanactionforum.org/research/chronic-disease-in-the-united-states-a-worsening-health-and-economic-crisis/

[7] https://www.mcknightsseniorliving.com/home/news/home-care-daily-news/should-home-healthcare-be-a-new-focus-for-medicare-advantage/

[8] https://homehealthcarenews.com/2021/01/top-home-health-trends-for-2021/

[9] https://homehealthcarenews.com/2020/11/cms-launches-unprecedented-hospital-at-home-strategy-to-manage-latest-covid-19-surge/

[10] https://www.ajmc.com/view/improved-cost-and-utilization-among-medicare-beneficiaries-dispositioned-from-the-ed-to-receive-home-health-care-compared-with-inpatient-hospitalization

The post Chronic Disease Prevalence is Increasing Home Health Demands appeared first on Health at Home.

By July 2020, 80% of healthcare providers had conducted telehealth visits^[1], yet the majority of patients seen were under the age of 65^[2]. Much of this is likely because, unlike the 65+ population, younger individuals are typically more technologically adept and able to navigate the devices and applications needed for a telehealth visit. The elderly population, while they stand to benefit significantly from telehealth (they are more susceptible to COVID-19, and 85.6% have at least one chronic condition^[3]), they need additional support from healthcare providers to effectively make use of telehealth technology.

Trends suggest that older populations are becoming more familiar with technology; in 2019, 73% of people 65 and older versus only 14% in 2000^[4]. Similarly, the start of the century saw limited numbers of smartphones used across all demographics, increasing to just over half of people over 65 nearly two decades later. Despite the growing ownership of devices amongst the senior population, only 26% report feeling very confident in the ability to use the device^[5], with 73% reporting that they need assistance setting-up new devices.

To overcome telehealth barriers, physicians must recognize the disparity and implement solutions that can prove to enhance the senior population’s access to telehealth. Numerous healthcare providers have already devised strategies to assist their senior patients in accessing telehealth^[6].

Some healthcare organizations have begun supplying them to patients without the means to afford the necessary devices to enable telehealth. One provider has repurposed the vans used to pick up and drop off patients from appointments to delivery vehicles that bring tablets right to the homes of elderly patients. The drivers also serve as aids to help the patient log in and navigate their way to the telehealth visit.

Other patients face physical limitations, such as vision and hearing loss that makes telehealth challenging. In cases such as these, providers are using family members and caregivers as an interpreter, relaying messages between the patient and the provider. When a family member or caregiver is unavailable, the provider can see the patient in person, often at their own home.

For patients who have the necessary technology yet lack the skills to use it effectively, providers have started introducing “practice visits,” designed to provide the patient with the training needed to use their device correctly. Providers implementing this strategy found that both they and their patients have more successful telehealth visits.

In addition, some providers choose to provide high-risk patient monitoring devices, like scales and blood pressure cuffs, teaching them and their caregivers how to use and report data accurately. For patients who would typically have frequent in-person visits, this data collection allows providers to detect irregularities in the patient’s vitals that could signal a worsening of their condition and require urgent care.

Such strategies are proving effective at increasing senior access to telehealth. By providing support and resources to actively use telehealth, seniors can enjoy more time at home, increased independence, and enjoy better health outcomes. As technology continues to evolve and new demographics age, it will be interesting to see how long-term telehealth takes shape.

^[1] https://www.fiercehealthcare.com/practices/rush-to-embrace-telehealth-many-physicians-still-have-concerns-about-quality-care-survey

^[2] https://www.cdc.gov/mmwr/volumes/69/wr/mm6943a3.htm

^[3] https://www.cdc.gov/nchs/health_policy/adult_chronic_conditions.htm

^[4] https://www.pewresearch.org/fact-tank/2019/06/18/americans-60-and-older-are-spending-more-time-in-front-of-their-screens-than-a-decade-ago/

^[5] https://www.pewresearch.org/internet/2017/05/17/barriers-to-adoption-and-attitudes-towards-technology/

^[6] https://www.pewresearch.org/internet/2017/05/17/technology-use-among-seniors/

The post How Providers Can Improve Seniors’ Access to Telehealth appeared first on Health at Home.

When the pandemic began, many healthcare providers made the switch from in-person care to telehealth to reduce disease exposure. This was not a problem for many patients, especially when they had the means to facilitate virtual visits. Other patient demographics, like seniors, may be underrepresented by telehealth visits, however.

It is startling to consider that half of people older than 65 living alone do not have the financial ability to cover essentials, let alone new devices or internet access needed for a telehealth visit^[1]. Plus, more than one in three households lead by senior citizens lacked access to a computer, and more than half do not have a smartphone^[2]. Without the same access to technology as higher-income counterparts, low-income seniors are significantly less prepared to make the transition to telehealth.

With doctor’s offices canceling in-person visits in favor of socially distanced alternatives, low-income seniors are at risk of missing out on crucial access to healthcare. While programs like social security have been effective at raising people out of poverty, 9.7% of people over 65 remain impoverished even with social security assistance^[3]. A study found that nearly one in five people with the lowest incomes reported not knowing how to use devices that enable telehealth^[4]. Not knowing how to use telehealth-enabling devices stems from the lack of accessibility to low-income populations.

Access to care is further hindered as many rural communities lack the high-speed internet connectivity required to facilitate telehealth visits. In areas with low broadband access, patients made 34% fewer telehealth visits^[6]. Similar initiatives are trying to expand internet access to rural residents as well.

While improvements to internet infrastructure will not be immediate or address the concerns of patients unable to afford it in the first place, healthcare providers should look to implement outreach programs to lower-income patients. Even providing telehealth options without video can improve access to patients without a smartphone, tablet, or computer with a camera. While patients using audio-only options will not benefit from the face-to-face interaction with a provider, they can still speak with their provider to address any questions or concerns they may have.

While telehealth has tremendous potential to serve previously underserved populations, providers must keep in mind the limitations that some of their patients may experience. Especially with vulnerable populations such as the elderly, challenges with internet access, low income, and device accessibility can limit the adoption of telehealth to meet their needs. Addressing these challenges will help patients benefit from a more equitable ability to access telehealth opportunities.

^[1] https://khn.org/news/technology-divide-between-senior-haves-and-have-nots-roils-pandemic-response/

^[2] https://www.healthaffairs.org/do/10.1377/hblog20200505.591306/full/

^[3] https://www.cbpp.org/research/social-security/social-security-lifts-more-americans-above-poverty-than-any-other-program

^[4] https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2772162

^[5] https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2739054

^[6] https://www.govtech.com/health/growth-of-telemedicine-slowed-by-internet-access-challenges.html

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Remote patient monitoring (RPM) is poised to change the way healthcare is delivered. Rather than physicians being provided with a limited snapshot into the health of their patients, RPM enables them to monitor health and symptoms continuously, even when the patient has left their office or been discharged after a hospital visit. While many healthcare specialties can benefit from the technology and insight into a patient’s condition that RPM provides, the public health crisis has enabled RPM to demonstrate its effectiveness in delivering wound care and improving health outcomes.

Every year, Medicare estimates that between $28.1 billion and $96.8 million is spent directly on wound care, including non-healing wounds, postoperative wounds, and diabetic foot ulcers (DFS)¹. Furthermore, it is predicted that up to 2.5 million seniors may require wound care throughout the pandemic. However, patients in need of wound care primarily overlap with those who are most susceptible to COVID-19 infection: those ages 65 and up, nursing home residents, individuals with heart conditions, severely obese individuals, and individuals with diabetes¹.

While seniors are increasingly choosing to age at home, the pandemic has caused issues such as isolation and a reluctance to attend in-person doctor appointments. Without applying technology to these situations, it would be difficult for patients to receive the care needed to properly care for their wounds. When it comes to wound care, telehealth and RPM is positioned to deliver more effective care to patients while they remain in the comfort of their home.

In a recent study, a year-long prevention program for patients with healed diabetic foot ulcers was followed². In the study group, patients were provided with a foot temperature monitoring mat allowing them to measure their foot temperatures daily while remaining at home. The results showed complete elimination of major amputations and a 52% reduction in all hospital admissions. The patients participating also reduced the recurrence of foot ulcers, emergency room visits, and outpatient visits. The success in this trial of RPM in improving patient outcomes with DFUs will lead to its expanded use in the treatment of diabetes, such as remote glucose monitors and reminders for the patients to take their insulin at prescribed times.

RPM can also be used to care for wounds that are the result of operations or injuries. Before the pandemic, patients would receive help caring for wounds from specialists that would visit nursing homes or from home care agencies during home visits³. However, these patients are still in need of assistance when caring for wounds. Healthcare providers can monitor the condition of a patient’s wound virtually, examining it for signs of infection, changes in dressing, or ointments that may help the healing process. Plus, virtual tools can help providers teach the family members of patients to properly dress the wound when needed.

This enables providers to receive the insight needed to monitor the condition of the wound while avoiding exposing patients to COVID and empowering patients to receive needed, quality care from home. Tools such as RPM will only become more useful as patients undergo elective surgical procedures that they put off during the pandemic. Healthcare providers will be able to more efficiently monitor wound healing progress, changes in symptoms, or any worsening condition that may require immediate care.

RPM in wound care is only one application in which it is seeing success, and its value is being recognized by healthcare agencies and providers across the country. Even before the public health crisis, Medicare had expanded its coverage of RPM, allowing more providers to receive compensation for remotely monitoring patients⁴. Across its applications, RPM has decreased readmission rates up to 40% and emergency room visits by up to 92%⁴. As RPM continues to be successfully implemented throughout the healthcare agency, it will change the way care is delivered and how patients expect to be cared for.

Sources:

1 https://www.mcknights.com/marketplace/marketplace-experts/an-answer-to-wound-care-in-the-senior-living-community/
2 https://www.podiatrytoday.com/study-suggests-remote-patient-monitoring-decreases-dfu-recurrence-and-health-care-costs
3 https://www.homecaremag.com/october-2020/technology-care-at-home
4 https://www.medicaleconomics.com/view/your-doctor-will-remotely-see-you-now

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Each year, $3.8 trillion is spent on healthcare services, with 90% of the cost attributable to the care of chronic conditions¹. Of the national health expenditure, 21% or $799.4 billion was spent by Medicare alone². This number is only anticipated to grow as “baby boomers” age and increase Medicare enrollment to more than 73 million individuals by 2030³. The increase in a senior population creates more than just budgetary challenges, it will drastically increase the demand for specialized services that treat and manage chronic conditions that affect nearly 80% of older adults⁴.

However, as the public health crisis has demonstrated, physicians and patients need alternatives to in-office visits that may pose health risks. In April 2020, 25% of patients with chronic conditions expressed fears of going into a doctor’s office or hospital⁵. This fear is understandable, as 73% of patients hospitalized with COVID-19 had a preexisting condition⁶, making it essential for patients with chronic conditions to appropriately mitigate the risk they have for contracting such an illness. COVID-19 has only accelerated existing trends, like telehealth and remote patient monitoring (RPM), to deliver quality, effective care to a patient in the comfort and safety of their home.

Even before the public health crisis, Medicare made steps forward when they announced reimbursement for RPM in January 2019⁶. This allowed physicians to receive reimbursement for remotely reviewing a patient’s biometric data. It was further expanded in January 2020, allowing physicians to bill Medicare for additional time spent reviewing data and allowing more diverse practice staff to participate. Additionally, the Quality Payment Program and Hospital Readmission Reduction Program provide further incentives for physicians to improve patient outcomes through RPM⁷. RPM has been successful in both lowering emergency room visits and readmission rates by up to 92% and 40%, respectively⁶.

Rather than collecting health data from patients at infrequent office visits, RPM works by providing patients with the tools to measure data such as blood pressure, heart rate, blood oxygen, or glucose levels at home. The data is then recorded and shared with their healthcare providers, who can remotely monitor patient status. This enables physicians to assess the health of their patients more frequently and before something goes wrong. Rather than reactively treating a patient, RPM allows physicians to take a preventive health approach to reduce emergency room visits, readmissions, and health complications. Especially when it comes to patients with high-risk and chronic conditions, deterioration in their health can be detected far sooner than if they had waited for significant symptoms to appear or an in-office visit to alert the doctor of any changes in their health. Patients benefit from improved outcomes, while physicians can deliver better care, and payers are faced with reduced costs.

Many RPM devices currently available integrate with sophisticated mobile apps that share data in near real-time or sync with apps like Apple Health so that both patients and physicians can easily view the data. By making patients an active part of the healthcare process, they become more engaged and understand what is needed to improve their chronic conditions. RPM facilitates collaboration between healthcare providers and patients to avoid preventable deterioration. By avoiding hospitalizations and managing symptoms of their chronic conditions, patients are provided with a higher quality of life.

Sources:

1. https://www.cdc.gov/chronicdisease/about/costs/index.htm
2. https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/NationalHealthExpendData/NHE-Fact-Sheet
3. https://www.forbes.com/sites/howardgleckman/2019/02/22/what-really-is-happening-to-medicare-spending/?sh=1cf2bfeb6d2f
4. https://www.ncoa.org/article/get-the-facts-on-chronic-disease-self-management
5. https://healthpayerintelligence.com/news/how-coronavirus-influenced-medicare-chronic-disease-management
6. https://www.medicaleconomics.com/view/your-doctor-will-remotely-see-you-now
7. https://medcitynews.com/2021/03/why-the-next-generation-of-remote-patient-monitoring-holds-the-key-to-a-new-model-of-care-delivery/?rf=1

The post Improving Chronic Care Through Remote Patient Monitoring (RPM) appeared first on Health at Home.

Americans living in rural areas are disproportionately affected by the lack of quality healthcare service. With higher rates of preventable diseases and worse health outcomes than the 57 million Americans living in urban areas¹. At the same time, rural physicians are challenged by workplace shortages and thin margins. To further compound this prevalent issue, in the past decade, 120 rural hospitals have closed. Of these, 39 were designated critical access hospitals, intended to keep essential services in rural areas³. These persistent issues can be solved through technology and the increase in home health.

If COVID-19 has demonstrated anything, it was the healthcare community’s ability to rapidly implement telehealth alternatives. In the last week of March 2020, telehealth visits increased by 154%⁴. For Medicare beneficiaries, nearly half of all primary care visitors in April were a direct result of COVID⁵. The use of telehealth services was further supported by emergency presidential declarations lifting the Centers of Medicare and Medicaid Services’ geographic or site of service requirements. With this change, CMS was able to add 135 services to their telehealth services list. This increase in telehealth adoption shows the openness to telehealth options, previously not seen.

In rural settings, telehealth is a particularly attractive solution to the challenges healthcare faces. As rural communities lose healthcare providers, telehealth is uniquely positioned to supplement limited resources⁶. Telehealth also opens the door to more efficient home healthcare and remote patient monitoring, which increases favorable patient outcomes.

With remote patient monitoring (RPM), a patient’s condition can be monitored outside of the hospital through telehealth and digital devices to facilitate patient engagement and inform better treatment decisions. Physicians receive continuous data on patient conditions and can encourage patients to modify behaviors and take ownership of their healthcare journey⁷. Typically, patients can make positive behavioral changes while under hospital care but fail to maintain a health care plan when they return home. Using telehealth in combination with RPM can significantly improve a patient’s quality of life and reduce the risk for future hospitalizations.

Before the public health crisis, home-based care delivery was in stages of experimentation but lacked consensus about what was reimbursable at home⁸. This changed as payers, providers, and patients became aligned in favor of home-based care. While not all changes have been permanent, it will give providers the ability to strategize how care is delivered in a post-COVID environment⁸.

The widespread adoption and support of telehealth and RPM measures have shown that effective, efficient care can still be delivered in a home care setting. Not only does it make healthcare more effective, but it also makes it more accessible to the rural communities desperately in need of healthcare resources.

Sources:

1. https://www.cms.gov/newsroom/press-releases/trump-administration-announces-initiative-transform-rural-health
2. https://www.chartis.com/forum/wp-content/uploads/2020/02/CCRH_Vulnerability-Research_FiNAL-02.14.20.pdf
3. https://www.ruralhealthinfo.org/topics/critical-access-hospitals
4. https://www.cdc.gov/mmwr/volumes/69/wr/mm6943a3.htm
5. https://www.hhs.gov/about/news/2020/07/28/hhs-issues-new-report-highlighting-dramatic-trends-in-medicare-beneficiary-telehealth-utilization-amid-covid-19.html
6. https://www.chcs.org/news/telehealth-in-rural-america-disruptive-innovation-for-the-long-term/
7. https://www.homecaremag.com/february-2021/rpm-reduce-unnecessary-hospitalizations
8. https://medcitynews.com/2021/01/the-home-health-landrush-getting-ahead-in-a-complex-market/?rf=1

The post Telehealth Aids Rural Healthcare appeared first on Health at Home.

COVID-19 imposed many challenges for the healthcare sector. Fears of contracting the virus led many patients to cancel in-person visits, generating large demand for telehealth and virtual care. While telehealth technologies are not new, they have long been discussed. However, the pandemic forced providers to quickly implement virtual care options to support the patient demand, advancing the use of this technology “seven years in the last seven months”¹. This especially makes access to care easier for the older population that may prefer to receive care at home.

In a study, 60% of patients report the desire to continue receiving healthcare through telehealth methods, citing the care felt more personal, convenient, and timely². Rather than need to travel into the doctor’s office, patients were happy with the ability to revive quality care in an environment they feel most comfortable in. Plus, 90% report that the level of care they received was as good or even better than traditional in-person care. With the overwhelmingly positive response to telehealth, the technology will continue to be an asset and change the way people receive care far into the future.

As telehealth adoption rapidly grew, remote patient monitoring (RPM) technologies were implemented to monitor patients at home. With RPM, continuous monitoring and frequent check-ins allow physicians to intervene early when necessary. This created a fundamental shift, patients are incentivized to stay healthy, and with real-time monitoring, patients are evaluated more than at 3, 6, 9, or 12-month intervals. Continuous data, like blood pressure, weight, or blood sugar levels, give physicians the data they need to understand the patient’s health.

Beyond meeting the patients’ needs, the combination of telehealth and RPM will decrease inefficiencies experienced by home health providers. Rather than having set home health visits, patients can be seen only when necessary since these tools allow for constant and effective communication between patients and providers. Sick patients can be seen as soon as they begin to display signs of illness, while healthy patients can forgo seeing a physician. When a home visit is necessary, RPM enables providers to have all necessary documentation needed to justify the visit³.

On top of the healthcare industry and patients realizing the value of telehealth and RPM, government agencies are getting on board as well. The USDA is investing $42.3 million to 86 programs, many of which include “connected health programs”⁴. These programs are designed to expand and support many healthcare programs, a major of which deliver telehealth to rural and underserved communities. At a critical time in the development of these programs, funding is imperative to continue to positive momentum and expand care to serve more patients.

Despite the challenges of the pandemic, telehealth and RPM rose to meet the changing demands of patients around the country. Through more effective and efficient care, patient health is encouraged, and physicians can more easily collect the data needed for support. Rapid innovation and implementation of telehealth have already generated positive results, so it will be interesting to see where this technology leads in the future.

Sources:

1. https://validic.com/on-demand-2021-state-of-healthcare-the-rise-of-virtual-care/
2. https://www.fiercehealthcare.com/practices/patients-want-to-keep-using-virtual-care-after-covid-19-pandemic-ends-survey-finds
3. https://news.careinnovations.com/blog/how-home-health-and-rpm-benefit-one-another
4. https://mhealthintelligence.com/news/usda-announces-latest-round-of-telemedicine-distance-learning-grants

The post The Rise in Virtual Care Visits appeared first on Health at Home.

As we mark American Heart Month this February, a combination of virtual care and monitoring technology enables CHF patients to stay connected to care in the comfort and safety of their own homes.

Home is where the heart is – it’s also the place we usually feel most comfortable, which can be a boon to the healing process. And being at home instead of the hospital reduces the risk of infections and dramatically reduces cost.

Linking Home and Hospital

At the University of Pittsburgh Medical Center (UPMC), a team of physicians has been working with remote patient monitoring and telehealth to help CHF patients heal at home and prevent ER visits and hospital readmissions.

Patients’ smartphones, laptops, and even landlines become the eyes and ears of their care team. When connected wirelessly to scales and blood pressure cuffs, for example, the devices can transmit vital signs back to the hospital, where they can be analyzed and interpreted.

If data received indicates a problem, the patient is contacted via phone or video call and given instructions to perhaps amend their medication or pay closer attention to their diet or make an appointment to see their doctor. Small issues can often be treated before they can trigger a hospital admission.

Empowering Patients with Information and Guidance

The initiative has also helped CHF patients better understand their condition and learn how to effectively care for themselves at home, according to Kimberly Armahizer, clinical supervisor for innovative homecare solutions at UPMC.

“The programs are for 60 or 90 days, and afterward, patients are more aware of their symptoms and can better assess themselves daily.”[1]

A program piloted at two Kaiser Permanente locations in California experimented with a telemonitoring program for their CHF patients that provided in-home training in the use of a device that measures weight, blood pressure, heart rate, and blood glucose for those patients who are also diabetic.

Via modem, patients transmit daily readings to a call center monitored by nurse case managers. Software sorts and ranks the data, allowing nurses to see at a glance who most urgently needs contact. Careful daily monitoring helps patients stay on track with their care plan and learn more about which symptoms need immediate attention.

Philip Madvig, MD, Associate Medical Director of The Permanente Medical Group in Oakland, California, reports that their remote monitoring program has cut the rate of hospitalization and readmission for CHF patients to about a third of the average rate system-wide. “This was not a controlled experiment, the patients weren’t randomized, but there is nothing else to explain this dramatic change,” says Madvig.[2]

Remote Monitoring Provides Reassurance

Recently discharged CHF patients have plenty to process and integrate into their new home routine. Being connected daily with their doctor’s office can reduce their anxiety and give them confidence, knowing a qualified medical professional regularly sees their vitals.

[1] https://healthtechmagazine.net/article/2020/04/how-remote-patient-monitoring-programs-are-beneficial

[2] http://www.ihi.org/resources/Pages/ImprovementStories/GoodHeartFailureCareFollowsPatientsHome.aspx

The post How Technology is Helping CHF Patients Get Better in Their Own Homes appeared first on Health at Home.

Getting a diagnosis of congestive heart failure (CHF) is difficult and often alarming, but the good news is that people can live happy, fulfilling lives in spite of it.

If you’re bringing home a family member who’s been discharged from the hospital after a CHF diagnosis, it can feel like a huge responsibility to take on. But you’re not alone. Over 5 million people live with CHF, many of whom are able to be at home relying on family members as caregivers.

And with the procedures doctors have honed over time, combined with new technologies like remote patient monitoring and video or telehealth calls, even heart failure patients living alone can take care of themselves.

Either way, the experience is likely to spark questions. Below are some of the most common. But be sure to contact your doctor if you need further help. It’s not unusual for patients to feel they are bothering their physician, but that’s what they’re there for.

What does it mean to have congestive heart failure?

CHF is a bit of a misnomer since your heart has not actually stopped working but has slowed down. As a result, it’s unable to pump enough blood into all areas of your body. Veins can get backed up, with blood creating congestion that causes swelling in the lungs, stomach, legs, and ankles.

This congestion in body tissues can cause a number of symptoms, including:

• Shortness of breath
• Persistent cough or wheezing
• Trouble breathing while lying down
• Nausea or complete lack of appetite
• Recent fluid build-up

How do I treat heart failure at home?

When CHF patients are discharged from the hospital, their families can feel overwhelmed by the requirements of their care. Home care can be especially difficult when the patient suffers from multiple chronic conditions.

And while it’s true CHF can create serious problems if the condition is not treated on a daily basis, these treatments are manageable at home. They include:

• Checking vital signs daily. Weight and blood pressure readings help patients, and their doctors stay abreast of changes that could signal a treatable decline.

Weight gain can indicate a build-up of fluid, in which case you should contact your doctor immediately.

And high blood pressure puts a strain on your heart. Your doctor can recommend an easy-to-use blood pressure monitor.

In some cases, doctors recommend remote patient monitoring, which allows you to input your daily vitals check into a computer app. This app automatically transmits the data to your provider’s office, where staff continuously monitor their patients’ status.

• Closely following your doctor’s instructions with medications. Be sure to take your medicine exactly as directed every day.

A simple regimen of reminders, either in your calendar, in the form of a note on the refrigerator, or setting an alarm on your phone, can help. Remote patient monitoring programs can also be programmed to automatically remind you.

• Incorporating healthy lifestyle changes. Simple modifications to your daily routines support better circulation, minimize additional health risks, and help reduce symptoms.

For example, dressing in loose clothing reduces the restriction in blood flow that can cause clots. This is especially important in your extremities. For that reason, avoiding socks with a tight band at the top is important. Also, wearing layers that can be easily added or removed helps avoid extremes in body temperature.

Adopting a heart-healthy diet is another key lifestyle change. That means reducing salt-intake and eating a variety of fruits and vegetables. Other heart-healthy options include whole grains, nuts, legumes, low-fat dairy products, and skinless poultry and fish.

• Managing your stress. The American Heart Association notes the value of meditation and managing anger by counting to 10 before responding to a situation.

Good sleep habits are another key stress reduction strategy. Since CHF is linked to sleep-disordered breathing, it’s important to keep track of snoring and report problems to your doctor.

Where can I get help?

Your doctor’s office will provide a thorough treatment plan that will get you off to a good start. It will guide you through the various health conditions or problems your may encounter, along with a corresponding list of actions to take. Of course, never hesitate to contact your physician if you are unsure about any aspect of at-home care.

For patients with multiple chronic conditions, there’s a lot to manage. This was the case for Elena C., a CHF patient in her 60s who also needed to manage her diabetes and HIV. On her doctor’s recommendation, she began working with a home health care agency. Clinicians followed up with her regularly, explaining how to detect the difference between warning signs that require an ER visit and symptoms that just need a phone call follow-up from her doctor.

As a result, Elena and her family get daily reassurance and confidence that she is getting the care she needs at home.

While heart failure can’t be cured, an effective home health care program that supports a more active lifestyle, positive dietary changes, stress management, and careful attention to your doctor’s treatment plan can slow the progress of the disease and allow you to enjoy life at home.

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