Telehealth and Triple Aim Are a Strong Match

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Karen Utterback By Karen Utterback 
Former Vice President, Product Marketing and Strategy, McKesson (Retired)

Telehealth Helps Support the Triple AimOver the last several years, telehealth systems have become steadily accepted among homecare agencies as a way to improve care, especially for the sickest patients. The Affordable Care Act’s focus is on lowering readmission rates, offering agencies a chance to take telehealth to a whole new level.

At the McKesson Homecare and Hospice 2013 National Users’ Conference session on measuring the impact of telehealth, William Broderick suggested that agencies should be gearing up to help hospitals and ACOs understand how telehealth fits with Triple Aim. Broderick is Director of Marketing and Outcomes Research at Robert Bosch Healthcare Systems Inc.

As hospitals look to lower readmission rates and ACOs pursue efficiencies, especially around chronic disease care, Broderick says agencies should prepare to show the enormous benefits of telehealth, including:

  • Improved clinical care
  • Lower mortality rates due to patient engagement
  • Improved patient satisfaction due to quality of life enhancements
  • Better staffing efficiencies
  • Fewer ER visits and readmissions

“One challenge to measuring telehealth outcomes, is making sure you understand the statistics the various stakeholders are interested in,” says Broderick. “For example, hospitals are mainly looking for ways to lower readmissions while ACOs may be more interested in improving care for chronic disease patients.”

The second challenge is making sure your outcomes can be correctly compared with other benchmarks, he notes. Because home health agencies tend to use telehealth to monitor the sickest patients, and readmission rates are higher for those patients, it can be tricky to show telehealth’s real benefits with regard to outcomes.

At the least, Broderick recommends tracking readmissions rates for patients who have had a heart attack, heart failure, pneumonia and COPD. The first three on the CMS list result in a 1% Medicare reduction for hospitals with readmission rates higher than the norm (going up to 3% over the next three years), and COPD will be added to the list next year. He notes that the rule of thumb is to have data from 100 patients before releasing comparison figures or using them in marketing materials.

After adjusting for variables such as age and sex, agencies can compare their readmissions rates with both the national average and their local hospitals and use those figures in their discussions with key partners. Data on other conditions may also be useful in the next few years, Broderick says, as telehealth’s benefits to less sick (but still at risk) patients become apparent

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