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TeleHealth Overview

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TeleHealth Improving Clinical Outcomes, Reducing Costs and Preventing Hospital Readmissions: CMS TeleHealth Solutions
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Page 1: TeleHealth Overview

TeleHealthImproving Clinical Outcomes,

Reducing Costs and Preventing Hospital

Readmissions: CMS TeleHealth Solutions

Page 2: TeleHealth Overview

Agenda

• Introduction• Overview & Current Successes• Devices, Software & Reports• Clinical Software Demonstration• Program Development• Key Statistics & Return on Investment

Page 3: TeleHealth Overview

Optimizing Health Care for ReformReadmission Penalties:

What does it mean for hospitals?

• Hospitals will be penalized for excessive readmissions for CHF, MI, and pneumonia effective Oct. 1, 2012.

• The largest potential reduction for a hospital:– 1% in FY 2013– 2% in FY 2014– 3% in FY 2015 and every year thereafter

• Payment reduction will apply to all Medicare inpatient discharges

• Additional conditions, including COPD, will be added in 2015

Page 4: TeleHealth Overview

TeleHealth Clinical Outcomes• The premises for the Telehealth division is to

improve clinical outcomes, reduce costs and prevent hospital readmissions.

• CMS offers vital signs monitoring devices with steady scale for frail patients that can then transmit findings wirelessly to physicians who in turn can assess and diagnose the patient’s status 24/7.

Page 5: TeleHealth Overview

How we can helpHospital to Home

Page 6: TeleHealth Overview

Home Healthcare Solutions“Post Discharge Portfolio”

TeleHealth Solutions

Sleep Apnea and Respiratory Products

Medication DispensingService: 60 doses/40 days, 90% compliance

LifeLine

CMS offers in home Respironics to assess sleep apnea and other respiratory diseases.

Page 7: TeleHealth Overview

Key Products and ServicesCMS offers Lifeline products and Medication dispensing devices

CMS offers Home Cardiac monitoring devices.

Page 8: TeleHealth Overview

Remote Patient MonitoringProven Results

• Can significantly reduces the risk of death andhospitalization

• May lead to better clinical outcomes and reduced long-termhealthcare costs due to fewer hospitalizations3

• Can increase quality of life and patient satisfaction throughdaily monitoring 4

• The total number of days certain male cardiac patients spentin the hospital while on TeleHealth was reduced by nearly 80%5

• There was up to a 21% reduction of hospital admissions as aresult of chronic heart failure when patients were on remotemonitoring programs 6

• Mortality was significantly reduced for heart failure patientsrandomized to remote patient monitoring 7

Good Medicine

“We’ve had over 650patients on our programand we’ve had 26patients back in thehospital. That’s less thanthe national average, so I’d say that’s good medicine.”

‐Banner HealthTelemonitoring Manager

Page 9: TeleHealth Overview

Outcomes-Case Examples• 10/28/09

Banner Health System, Arizona noted that they have provided remote patient monitoring services to patients with heart failure and other chronic diseases since 2006 including more than 650 patients in the past three years, achieving a readmission rate of 3.8 percent for patients on monitoring versus a state average of 21% and national average of 24%.

(press release, October 29, 2009).

• 01/29/10Sentara Health System, Virginia, rated the top integrated

hospital system by Modern Healthcare in January 2010, noted in a recent national Presentation that they have been reducing hospital readmission rates by 70% or more when patients are remotely monitored in the home. Additional programs focus on “Hospital to Home” and ED models.

(World Health Congress, January 2009, National Home Care Association, July 2010)

Page 10: TeleHealth Overview

Hospital to Home InitiativeThe information noted below has been published by several TeleHealth programs

with successful results such as significant reductions in hospital readmissions.

• Patient is discharged to home from hospital and…• TeleHealth devices are installed within 24 hours• Medications are reconciled within 48 hours• Patient is assessed for risk of falls and preventative measures are put in place

within 48 hours• Patient visits primary care physician within 5 days• Onsite nurse visits are frontloaded during first 5 days

Results: Zero readmissions within 30 days post DC

Page 11: TeleHealth Overview

Vital Sign Measurements with Wireless Devices

• Award-winning wireless (RF) measurement devices, designed for patient ease-of-use.

• Steady scale available for frail Patients

• Automatic, secure transmission with cellular option (e-Device)

• Tested and proven to interoperate with CMS Lifeline (PERS) and CMS Medication Dispenser on a single phone line.

• One-button operation

• Large LCD screens, buttons and fonts

• Audible & Visual prompts

• Battery operated• Connects to ordinary

phone line or cellular signal

• Surveys in both English and Spanish

• Backlit TeleStation and manual entry of other measurements

Page 12: TeleHealth Overview

Personal Health Tablet – My WellBook:Connectivity & Communication for Patient/Person Engagement

• CMS offers Personal Health Tablet for connectivity and communication for patient/person engagement. This has specific care plans for education, tasks/reminders, feedback on vital signs, attainable goals.Specific care plans:

• Education, Tasks/Reminders, Feedback (vital signs), Attainable goals, Delivers insight for self monitoring:

“How do you feel?”Assessment Surveys

Page 13: TeleHealth Overview

SoftWare• CMS offers Dual Monitor Brackets for the Rubbermade

Healthcare Telemedicine cart which is an FDA cleared device that uses a USB connectivity panel. A facility than can use the embedded PC to access and EMR system with HIPAA compliance. This will also enable Microsoft Lync to find available physicians on line that can assist or meet on the cart or in a virtual meeting room for a 3rd party consult.

• CMS offers the Litmann Electronic Stethoscope model 3200 designed to easily fit into a practice’s workflow.

• CMS offers Horus HD Digital Scope system as a multi Integrated Imaging System.

Page 14: TeleHealth Overview

CMS Benefits• CMS offers highly specialized physicians that can interpret medical data and

submit a diagnosis and plan of care. Excellent scenario for small hospitals with no direct access to highly specialized physicians. Those hospitals can then retain their patients in their locality instead of them going to larger hospitals = increased revenue and = improved patient care.

• CMS offers primary care physicians that can interpret medical data collected by nurses of nurse practitioners and offer a plan of care at the patient’s location and thus prevent admission to a hospital. Excellent scenario for the Nursing Home industry.

• CMS offers in home Medical equipment that can then be connected wirelessly and transmit data to the designated physician for interpretation, thus being able to detect minor changes in the patient’s condition, recognize health hazards and prescribe a course of action focused on keeping the patient at home.

Page 15: TeleHealth Overview

Program Support• Defining your program goals and

metrics. Make sure we stay on track, hit goals, grow program.

• Program scheduling, operational timeline and logistics planning

• Inventory management (installation, de-installation, and cleaning processes)

• Clinical workflow and business process consulting. “Current KAM’s have been doing this for years and can share best practices”

CMS Video Cloud solutions ensures easy to use, simple dialing with bridge number, host pin and audio dial-in, state-of-the-art infrastructure,

support and top-tier bandwidth from fully managed datacenters.

Page 16: TeleHealth Overview

Resource Planning and Training

• Defining the right operational model for your program

• Online CEU courses and Telehealth resources

• Clinical staff education and training

• Patient education, user manuals, training videos

• Telehealth Certification Program

• Completely HIPAA compliant.

Page 17: TeleHealth Overview

Marketing Support• Demo devices available for

presentations to referral sources• Referral marketing collateral• Patient marketing collateral

– English and Spanish• Brochure customization at no cost• Financial ROI modeling• Remote patient monitoring clinical

outcomes and cost benefit studies• Videos• Photography

Healthy at HomeTeleHealth Improving Clinical Outcomes

Page 18: TeleHealth Overview

Key Statistics

• Target % of HHA average daily census on monitors = 20 – 25%

• Average number of patients on monitors per clinician = 100

• Average % of patients triggering an alert on any day = 25%

• Average length of patient on monitoringo Hospital-based = 30 - 45 days.o Home Health-based with disease management = 45 - 90 dayso Disease Management/Health Plans = 6 - 12+ months

Page 19: TeleHealth Overview

ROIReturn On Investment

Home Care Focus• Every 10 new referrals per month cover cost of 100 patients on

monitors• Every .75 nurse visit reduction per month covers cost of one patient

on monitor• Re certifications can be increased ‐ (tend to have higher margins)• Resumption of Care assessments are reduced (saves staff time)• More effective case load utilization (manage by exception)

Hospital Focus• Avoid non reimbursed readmissions starting in FY2012‐• Avoid global payment penalties starting in FY2013• Improve margins with bundled payment

Page 20: TeleHealth Overview

Dr. Thomas Ross, President & CEOCritical Medical Solutions, Inc.

www.cmsteleradiology.com | 1A The Pines Court, Ste C, St. Louis, MO 631419115 Bridgeport Way SW, Ste 3, Lakewood, WA 98499

800-758-5120 (O) | 636-203-5820 (O) | 636-216-0101 (F)


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