Monthly Archives: April 2015

Telemedicine: A $428 Million Silver Bullet?

TV as a Dr cartoonWhen I was a small child watching Saturday morning cartoons on our 300-pound console television set in my living room, I imagined what the year 2015 might bring while watching the Jetson’s. I looked forward to the flying car that came out of a briefcase, “Rosey” the robot maid and the talking interactive TV set with Mr. Spacely yammering at George all the time. What I haven’t seen so far in 2015 is the flying car…”Rosey” is called a “Rumba” (okay, kind of a stretch but somewhat a help in the maid department,) and that talking TV…video conferencing at its finest!  Here is how that talking box is making health care a bit easier to swallow with all these new laws going into effect.

Our US hospitals will be fined an estimated $428 million by the federal government in 2015. It is all a part of the Affordable Care Act (ACA) called the Hospital Readmissions Reduction Program (HRRP). An alarming 2,610 of our 3,369 US hospitals, (over 77%), will be fined under the HRRP in 2015.

The stated goal of the HRRP is to reduce the number of unnecessary hospital readmissions and increase quality of care while reducing the overall cost. Others, like Dr. Peter Pronovost, director at Johns Hopkins Medicine, refer to the HRRP as “a mechanism to reduce payment rather than improve quality.”

Many hospitals just can’t afford to do that follow up in a traditional manner under the current cost and pay structure. The Wall Street Journal states that “small and financially struggling hospitals lack the resources to effectively manage their discharged patients at home. Attempting to reduce readmissions could create greater financial difficulties for them.” Many worry that the HRRP’s requirement for reduced admissions actually flies in the face of the best medical science and jeopardizes the health of patients.” That would be a disastrous unintended consequence and one everyone wants to avoid.

There is a silver lining on the readmissions cloud however. Telemedicine.

Technology is reducing the cost of home-based follow up care to proactively reduce readmissions. Progressive health care systems like the Mayo Clinic are working hard to develop and define telemedicine best practices and policies. These efforts have saved the Mayo Clinic an estimated $35,000 to $75,000 a year in fines so far.

It seems that the embrace of new video conferencing and connected sensor technologies in our modern hospitals may just be the answer to the HRRP’s call to action and an affordable way for hospitals to reduce readmissions.

Telemedicine reduces readmissions.

Despite some claims that only 25% of readmissions are unavoidable, one study on readmissions of patients with congestive heart failure showed that using telemedicine cut readmissions in those cases by 38-44%.

Telemedicine investments have positive ROI.

The Pennsylvania hospital system Geisinger Health Plan tracked 541 patients using the telemedicine system for 4 years. The net result? A return on investment of $3.30 for every dollar spent on the program.

Telemedicine can relate real-time data.

A telemedicine system can do more than allow real-time, face-to-face interaction between a patient and their care team. A telemedicine system can also utilize internet connected sensors to relate everything form heart rate, to blood pressure, blood sugar, and weight to help the care team respond to warning signs in a timely manner.

In fact, for telemedicine to be a viable option and one that can be covered for reimbursement, the Department of Health and Human Services requires that “you must use an interactive audio and video telecommunications system that permits real-time communication between you, at the distant site, and the beneficiary, at the originating site.”

Given all this, it seems a wise investment in telemedicine today may be the answer to providing better care, reducing readmissions, and ultimately avoiding costly fines in the future.

For more than 20 years Avidex AV has provided innovative technologies that drive business outcomes for our clients. Is your organization looking for a new kind of technology partner? Connect with one of our Account Executives today to learn more.

Resources:

#1: http://healthblog.ncpa.org/400-additional-hospitals-face-obamacare-readmission-penalties-totaling-428-million-in-fiscal-2015/

#2: https://www.healthcatalyst.com/healthcare-data-warehouse-hospital-readmissions-reduction

#3: http://healthblog.ncpa.org/medicare-advantage-telemonitoring-cuts-hospital-readmissions-44-percent-roi-3-30-per-dollar/

#4: http://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/downloads/telehealthsrvcsfctsht.pdf

#5: http://www.wsj.com/articles/SB10001424127887323741004578418993777612184

#6: http://www.mayoclinic.org/healthy-living/consumer-health/in-depth/telehealth/art-20044878

Bob Higginbotham

About Bob Higginbotham

Bob Higginbotham, CTS-I, CTS-D, is the Avidex National Manager of Healthcare AV. Bob has spent his 30 year career in leadership positions in the AV industry including extensive design and build work in healthcare facilities. He owned and operated a successful AV business in Texas with multiple offices in several cities where he managed a staff of over 100 employees. Bob has served as a technical consultant for a major AV manufacturer, led the technical sales team for a national video conferencing provider and provided technology auditing services for several private education facilities. He has a unique working knowledge of audiovisual technology as well as multiple certifications in audio engineering, acoustics, AV design, CQT system commissioning and video transmission systems. Bob holds a BA in communications and has recently served as board chair for a large private school. He brings his years of technical knowledge and leadership experience to Avidex where he leads the national healthcare AV team. Contact Bob at bobh@avidexav.com

The Wait is Over- Technology and the Continuum of Care

vectorstock_2226919Imagine you aren’t feeling well.  You call your doctor to get an appointment.  You are lucky and are able to get an appointment within a week due to a cancellation.  You have to schedule a couple hours off of work to travel to the doctor’s office and conduct the appointment.  A week later you leave work and get to the doctor’s office at the scheduled time.  It takes 30 minutes for you to be called back to an examination room by the nurse.  He conducts a brief precursory check of your vitals and then says the doctor will be with you shortly.  Another 20 minutes pass and the doctor comes into the room.  She asks a few questions and you answer.  After about 11 minutes she gives you a prescription and sends you on your way.  You return to work late and are greeted by a stern glance from your boss.  Hopefully the pills do the trick, because there is no way you want to do this again any time soon.

The story above details the typical American experience in seeing the doctor and is the reason why there is a major problem in America today.

People are voluntarily delaying essential healthcare.

A great number of people find getting healthcare difficult based on the time it takes to see a doctor.  In fact, 33% of people report some type of problem in seeing their Primary Care Physician (PCP) and nearly 25% report issues with getting time away from work for doctor’s appointments. “I have to wait too long” even made the list of 5 Reasons People Don’t Like Their Doctor.

The result is an undue burden on the urgent care and emergency room systems, with 55% of those visits not being urgent or emergencies. Studies also show that 46% of the time these visits could have been handled by a PCP.

The American Medical Association goes on to state that an estimated 70% of all doctor’s visits could in fact be handled…over the telephone.

A hurdle to that however is that few patients are confident that the telephone is effective in diagnosis of their medical needs. However, when asked about video-conferencing, the majority of patients are at least somewhat likely to meet that way. Over 36 million Americans have utilized some type of telemedicine service because of the convenience and time savings. So how does telemedicine help solve some of these problems?

Physicians are tasked with seeing more patients.

It’s the sad truth. One of the most limited resources in the healthcare system is a physician’s time. Physicians are being tasked with seeing more patients. The net result is that the average time a patient spends with a doctor during a visit is 11 minutes, and the patient usually only gets 4 of those minutes to talk. The average telemedicine appointment last 15 minutes or more, and does not require the patient to spend additional time traveling to the doctor’s office or waiting in the waiting room.

Telemedicine is more convenient.

Over 25% of people report trouble getting time off of work to see a doctor. That is because if you include travel to and from the doctor’s office and the time spent waiting to actually see the doctor, that 11 minutes of face time may easily take up 90 minutes of a patient’s day. It may be difficult to get 90 minutes off of work, especially if repeat visits are required. However, taking a 15 minute break to have a video conference with a physician at your desk or on your phone is very easy.

Continuum of Care

In today’s world of bits and bytes, medical charts have gone from analog paper to digital electronic health records (EHRs). EHRs make telemedicine even more feasible, as any physician can access the digital records given they have the proper permissions. EHRs are also stored and protected according to federal HIPPA guidelines to assure privacy. This allows a patients records to easily be passed form a physician to a specialist or accessed for follow up appointments or questions after an initial appointment.

The idea of telemedicine has been around for some time, however it is poised to accelerate in acceptance today. The continued consumer acceptance of videoconferencing, increased access to teleconferencing applications through computers, tablets, and phones, as well as the federal emphasis on the privacy of EHRs and continued support of telemedicine programs in the Affordable Care Act (ACA) are all strong indicators that telemedicine is indeed a major component of the future of healthcare.

For more than 20 years Avidex AV has provided innovative technologies that drive business outcomes for our clients. Is your organization looking for a new kind of technology partner? Connect with one of our Account Executives today to learn more.

 

Resources:

#1: http://www.huffingtonpost.com/richard-c-senelick-md/5-reasons-people-dont-lik_b_779950.html?

#2: http://www.ncpa.org/sub/dpd/index.php?Article_ID=24196

#3: http://www.corpsyn.com/knowledgecenter/articles/telemedicine.html#.VRlUmfnF9vk

#4: http://www.healthitoutcomes.com/doc/patients-accepting-of-telehealth-0001

Bob Higginbotham

About Bob Higginbotham

Bob Higginbotham, CTS-I, CTS-D, is the Avidex National Manager of Healthcare AV. Bob has spent his 30 year career in leadership positions in the AV industry including extensive design and build work in healthcare facilities. He owned and operated a successful AV business in Texas with multiple offices in several cities where he managed a staff of over 100 employees. Bob has served as a technical consultant for a major AV manufacturer, led the technical sales team for a national video conferencing provider and provided technology auditing services for several private education facilities. He has a unique working knowledge of audiovisual technology as well as multiple certifications in audio engineering, acoustics, AV design, CQT system commissioning and video transmission systems. Bob holds a BA in communications and has recently served as board chair for a large private school. He brings his years of technical knowledge and leadership experience to Avidex where he leads the national healthcare AV team. Contact Bob at bobh@avidexav.com

Patient Tracking Systems: Reducing the Cost of Healthcare and Waiting Room Anxiety

operating roomTake a moment to think about all of the departments within a modern day hospital.  There is the emergency room (ER), the intensive care unit (ICU), the neonatal intensive care unit (NICU), radiology, oncology, the operating room, neurology, obstetrics, cardiology, etc.  Some hospitals like Seattle Children’s have over a hundred different departments, clinics, and programs.  Now consider that patients may need to visit various departments during their hospital visit and you may start to get an idea of how challenging it can be to keep track of where a patient is at any given time.

Enter patient tracking systems, a combination of software and integrated hardware used to effectively communicate a patient’s critical information and location within a hospital.

Reducing the Cost of Care

A patient tracking system relies on a series of screens and computers that allow hospital staff to continually track and display the status and location of patients throughout the hospital.  It eliminates the need to have physical access to the patient’s chart, as if the patient has moved from one area to another, that chart typically moves with them.  This can create some confusion for staff who are trying to locate the patient for a procedure, for laboratory tests, or even to bring them their selected meal from the cafeteria.

Because these are PC based systems, they allow interoperability with other systems that may need to be accessed to retrieve other essential information needed for care.  They are also easily referenced by the hospital staff, as the individual lines are color-coded to provide a quick reference as to the status of each patient.

To quote Anna-Marie Merchant, GH Patient Care Manager, their patient tracking system

“…provides us with a clear picture of what is happening in the entire surgical department. It has certainly improved communication amongst various surgical areas at GH. The number of phone calls to and from departments and with family has significantly decreased.”

The net result is a reduction in the average patient stay, a reduced cost of providing care, and a reduction in the amount of staff that needs to be added to increase patient throughput.  There is a great whitepaper by the California Health Foundation here if you’d like to see the full study.

Next generation patient tracking systems are even more highly integrated with technology to reduce the amount of input by the hospital staff and to mitigate any human error in those entries.  These systems rely on an RFID tag on the patients’ hospital bracelets and RFID readers that automatically pick up the patient as they reach key locations.

We’ve all seen a multitude of screens used within the hospital environment.  Every patient room typically has a screen installed for patient entertainment and education.  Waiting areas throughout the hospital have screens installed as well, either for way finding or for a way to keep patients’ families and friends entertained.  But what if there was a way to leverage the same patient tracking system to reduce the anxiety of waiting?  Well, there is!

Reducing Waiting Room Anxiety

An added benefit of a patient tracking system is the ability to push the same data into waiting room environments so that loved ones can keep informed on the status of patients as well.  If you’re worried about privacy, you need not be.

These systems allow the information to be customized to each screen the data is being sent to.  To comply with HIPPA regulations for patient privacy, each patient is given a unique numeric ID.  This is given to the family so that they can check the status of their loved one on the screen, without disclosing their names and procedures to the rest of the waiting public.

Studies have been done on everything from music to aromatherapy being used to reduce anxiety in waiting rooms.  However, one sure fire way to help reduce this anxiety is to provide easy access to the status of each patient.

“Keeping our patients’ families updated about their loved one’s whereabouts, alleviates a lot of their anxiety and provides a more patient/ family focused experience,” notes Jan Dziepak, MDH Patient Care Manager.

For those who are not present in the waiting room, there are even virtual portals for other family members to use to keep in tune with their loved ones progress.  Launch an internet browser, select the proper facility, enter the patient ID and then the patient’s progress is shown on the screen.   To see an example, click here.

Of course there are some considerations to installing screens in the correct areas, as well as configuring the computers at each screen. This assures that each display presents the relevant information to either inform the staff or to comply with HIPPA and protect the privacy of patients.  Handled correctly however, the system can reduce the cost of care and provide a value added service that reduces the anxiety of those waiting in the hospital as well.  So if you are a hospital looking to increase efficiency and reduce the cost of providing amazing health care, integrating a patient tracking system into your facility is most likely a good start.

At Avidex AV, we are leveraging over 20 years of experience with innovative technology to drive positive business outcomes in healthcare.  Is your organization looking for a new kind of technology partner? Connect with one of our Account Executives today to learn more.

 

Resources:

#1: http://www.seattlechildrens.org/clinics-programs/a-z/

#2: http://www.ncbi.nlm.nih.gov/pubmed/19050663

#3:http://www.chcf.org/~/media/MEDIA%20LIBRARY%20Files/PDF/U/PDF%20UsingPatientTrackingToolsInHospitals.pdf

#4: https://www.haltonhealthcare.on.ca/newsletter/2014/august/smartrack.html

#5: http://www.peacehealth.org/apps/SmarTrack/

#6: http://www.zenginehq.com/patient-navigator?gclid=CJvT_oWy0cQCFQuMaQodgIsAMQ

Jeff Miller

About Jeff Miller

Jeff has been working in the professional AV integration industry for over twenty years. During that time he has served as Designer, Project Manager and/or Account Executive for hundreds of projects. As an Account Executive at Avidex, he specializes in Medical, Education, and Control Rooms. He can be reached at jmiller@avidex.com