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Barbie Oliver - University of South AL Telehealth
- 1. 2ND ALABAMA RURAL HEALTH & TELEHEATH SUMMIT 2013 Remote Bio-Monitoring Program October 18, 2013 Barbie Oliver, CRNP University of South Alabama
- 2. THREE STATE AGENCY COLLABORATION Center for Strategic Health Innovation
- 3. RMEDETM Uses Interactive Voice Response (IVR) technology Detects threshold violation readings for Blood Pressure, Blood Glucose and Weight Generates threshold violation reports in real time and/or periodic graphs Provides link to ADPH Nurse for Medicaid Patient 1st patients Monitors Congestive Heart Failure, Hypertension, Diabetes for M/C Patient 1st
- 4. POTENTIAL BENEFITS FOR PROVIDERS: Earlier intervention for uncontrolled disease Reduced need for alternate provider visits Reduced need for Emergency Department visits If admitted to hospital, shorter length of stay Improved compliance with the provider’s plan of care Increased patient satisfaction
- 5. POTENTIAL BENEFITS FOR PATIENTS: Potential for improved outcomes Lowered healthcare-related expenses Improved compliance with provider’s plan of care Education and reinforcement of healthy behavior changes Increased satisfaction with care
- 6. SAMPLE REPORTS: BIOMONITORING DATA GRAPHS
- 8. GENDER DIAGNOSIS 1 AND AVERAGE MONTHS OF ENROLLMENT
- 10. RACE DIAGNOSIS 1 & 2
- 12. AGE /DIAGNOSIS 1-2 /NUMBER OF PATIENTS
- 13. HOME TELEHEALTH TECHNOLOGIES These applications can extend the vision of the clinician to facilitate quicker assessment and proactive intervention for many populations living with chronic and acute healthcare problems to improve quality of life.
- 14. Questions ???? Barbara (Barbie) Oliver, CRNP (251) 414-8152 boliver@southalabama.edu
Notas del editor
- CSHI works closely with Alabama Medicaid Agency and the Alabama Department of Public Health Nurses to provide an innovative Interactive Voice Response system for Medicaid patients with the chronic diseases, Diabetes, Hypertension and Congestive Heart Failure. RMEDETM is used by the ADPH Nurses in managing these chronically ill patients. There are currently over 727 Medicaid patients in Alabama that are actively transmitting home monitoring information into RMEDETM.
- Realtime Medical Electronic Data Exchange System (RMEDETM), developed in house by the USA’s Center for Strategic Health Innovation (CSHI) is a secure web-based life-state management system including in-home monitoring of patients with chronic disease and an interventional informatics reporting system. TheRMEDETMInteractive Voice Response (IVR) Data Collection System Allows a patient to use any telephone (or computer), including cell phones, to dial a toll-free phone number and input their physiologic measures as ordered by their physician. When the patient dials in, an automated voice asks the patient to enter their unique 4 digit number followed by their zip code for verification. It then asks for patient specific physiologic parameters such as weight, blood pressure, etc. After each data element is input, the patient is asked to verify the data and is given an opportunity to make corrections. The call typically takes less than one minute. The data are then viewable through RMEDETM in both tabular and graphical format by the patient’s physician and ADPH Nurse.
- How the Program Works:Referral:ADPHNurse receives referral and provider-set data limits for the monitoring measuresEnrollment:ADPHNurse contacts the patient to set up a home visit to place equipment and provide instruction (USA CSHI provides a speaker telephone, blood pressure monitor and scale as needed, patients use their ownglucometer and strips) Alerts:Readings outside of provider-set parameters produce a threshold violation and an alert is automatically e-mailed from RMEDETM to the ADPH Nurse. The nurse then follows up as needed; making contact with the patient, evaluating what action is needed and providing education, reassurance and/or referral. Reports can be faxed to the provider directly from RMEDETM Reports:Periodic graph reports of patient data are faxed to the Provider Ongoing Contact: ADPHNurse makes contact with patient at least monthly Renewal:Provider orders are renewed yearly
- age groupcountunder 20….1220-29………1730-39……….6040-49……….14350-59……….29760-69……….20070-79……….2over 80…….0 Total 731
- Male……. 179Female…551
- racecountAfrican American…………………………..…463American Native or Alaskan Native……4Asian or Pacific Islander …………………..1Caucasian………………………………………..260Hispanic………………………………………….3Total……731
- main diagnosiscountCHF………………………………6Diabetes………………………..357Hypertension…………………368 TOTAL………..731
- Achievement of control is the main goal of treatment, and has been shown to reduce the onset of complications, with increased survival and better quality of life. Actively using self monitoring to inform therapy (i.e., to adjust therapy dosages or amend nutrition recommendations) requires frequent interaction between providers and patients, which is time and resource consuming for both entities. Real-time tele-monitoring of status, with immediate automated alerts to the nurse and subsequent phone feedback to the patient circumvents the need for many face-to-face interactions – a significant challenge in health disparate populations. This can allow providers to quickly adjust therapy, foster patient accountability, and foster compliance with treatment through immediate feedback.