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Health Resources and Services Administration

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July's Quality Improvement Grantee Spotlight

Using Telemedicine to Reduce Hospitalizations and Improve Patient Care

FirstHealth logo 

This month HRSA would like to showcase the Office of Advancement of Telehealth’s (OAT) grantee First Health Homecare Services (FirstHealth). FirstHealth demonstrates benchmark work in reducing hospitalizations, improving care coordination, and enhancing access to care through its Telehomecare program. FirstHealth’s Telehomecare program includes the use of remote patient monitoring in conjunction with standardized clinical pathways for patients with chronic illness.  Remote monitoring allows patients and providers to monitor subtle changes in a patient’s health such as: weight, heart rate, heart rhythm, blood pressure, blood oxygen or blood sugar levels. By monitoring these subtle changes, clinicians can provide appropriate interventions that can prevent a potential hospitalization or emergency care visit.

 

FirstHealth Home Care and Telehealth

FirstHealth is a not-for-profit home health agency located in the south-central region of North Carolina. Firsthealth provides comprehensive home care services to patients in six rural counties with an average daily census of 400 patients. The HRSA telehealth grant, allowed FirstHealth to develop an innovative telehomecare approach to address high rates of chronic illness in the organization’s service region.  FirstHealth focuses on reducing hospitalizations and emergency care visits while reducing the cost of healthcare, and in turn improving the patient’s quality of life. 

What is Telehealth and the Telehomecare Program?

HRSA’s OAT defines telehealth as “the use of electronic information and telecommunications technologies to support long-distance clinical health care, patient and professional health-related education, public health and health administration.” OAT provides a number of grants, including the Telehomecare Network Grant that funds providers for implementing and sustaining telehealth services for improving healthcare quality and services. 

 

FirstHealth Home Care HRSA OAT Telehomecare Network Grant Program

The objective of FirstHealth’s 2009 Telehomecare Network grant was to develop a comprehensive community network to improve the quality of care for patients with chronic illness using telehealth.  The OAT grant allowed FirstHealth to hire a full-time Telehealth Coordinator and Community Liaison– a key component to program expansion and enhancement.  In addition, because of HRSA OAT’s funding resources, FirstHealth now has 120 telemonitoring units, nearly all of which are deployed at any given time.

In reaching out to community partners, the lack of meaningful coordination and communication across the health care system, especially for complex patients with chronic illness, quickly became apparent. FirstHealth addressed this gap by establishing a telehomecare network to facilitate collaboration between the system’s hospitals, community care network, physicians, and other post acute care providers.

Since 2009, FirstHealth has served more than 1,500 patients. As a result of the telehomecare program, acute care hospitalization for this group is at 7.9% while the non-telehomecare group is at 20.1%.  In addition, patient satisfaction for the telehomecare group exceeds 90%, further evidence of the program’s success.

 Acute Care Hospitalizations Telehomecare patients vs. Non-Telehomecare patients (Risk-Adjusted Scores); Telehomecare 8%; Non- Telehomecare 20%

Beyond Telehomecare – Organizational and Community Impact

The Telehomecare program has also created some exciting and unanticipated opportunities including the development of a transitional care model that incorporates standardized clinical pathways for patients with chronic illness. Transitional care models facilitate the movement of patients across healthcare settings.  The patient is at highest risk for errors, miscommunication, and lack of coordination and follow-up during these transitions. This model allows providers to effectively manage the multiple needs of complex patients and provides the greatest opportunity to improve clinical outcomes, reduce healthcare cost and improve quality of life.

For more information, please contact Patty Upham at PUpham@firsthealth.org

For more information on HRSA’s Office of the Advancement of Telehealth and additional telehealth resources such the Telehealth Toolbox and Telehealth Glossary of Terms and Acronyms.

In addition, please see the OAT funded Telehealth Resources Centersexit disclaimer webpage for additional telehealth technical assistance resources.