APT Conference 2014

1. Remote Patient Monitoring
Ways to Control Costs, Improve Outcomes,
Avoid Readmissions & Modify Patient Behavior

2. Long Ago, People Danced @ Concerts,
Now They Video / Click / Share / Tweet
Source: Left image – 123RF.com. Right image – amadarose.co.uk.

3. Smart Home

4. Telehealth & RPM in Coordinated Care

5. Why is Telehealth/RPM important?
National/ State Challenges
Health Care Workforce
• Shortage
• CME/EBP
• Lack of Coordination
Hospital Viability
• Financial crisis
• Pay for Performance
• Penalties
Poor Health Status
• High consumers, high cost
• Half $ spent on 5%
population
• Patient disengaged

6. Patient-Centric Approach

7. Transforming Healthcare

8. Bringing the Health Care Team
to the Patient

9. Telehealth in Mississippi

10. • 165 telehealth sites of service (non-affiliated)
• 34 medical specialties
• 8 types of locations
• 7,669 telehealth encounters/month
• Continued growth in primary & specialty care services
Community based partnerships have led to our success
UMMC Center for Telehealth
(September, 2014)

11. • Analytics
• Bringing the health care team to the patient
– Specialty consults, ancillary services…
• Remote Patient Monitoring
– Chronic disease management
– Care at Home
– Avoid Readmissions
– Avoid ER visits
• Personalized Health
– Wellness
– Wearables
Health IT in Care Coordination

12. Tiered Health IT Approach
Tier 1 Tier 2 Tier 3
Post Discharge
Acute Setting
Remote Patient Monitoring
Acute or Outpt Setting
RPM, Med Adherence and
Video Home Visits
IVR, RPM IVR, RPM IVR, Med Adherence, RPM,
video visits
Readmission Prevention
Avoid ER
Reactive
Readmission Prevention
Avoid ER
Proactive/Reactive
Chronic disease mgt,
^ follow-up/monitoring
Readmission Prevention
Avoid ER
Proactive/Reactive
Post D/C Pilot Diabetes RPM Pilot Population Health
Personalized Health Care

13. Post Discharge Pilot Program
• 180 patients enrolled in IVR program (3 month period)
• 364 alerts (308 resolved by nurse)
• 56 (15.4%) alerted with intervention required
• 45 non-urgent
• 11 urgent
• Cost avoidance from 11 urgent alerts resolved
• ~$98,791 (based on $8,981 average admission)
• As readmission penalties increase, cost avoidance and
savings increase

14. • Improved Quality, Efficiency, Safety in hospital
• Safety in Transitions of care
• Improved outcomes-
– early recognition
– earlier intervention
– minimized complications
– decreased LOS
• Better Coordination of Care
• Improved Patient Management at Home to prevent
readmission/ER visits
• Patient Empowerment
What does RPM offer?

15. Population Health
Diabetes Project in Mississippi

16. Access to Health Care, Education & Support
Improve access to care for
Mississippian’s with Diabetes
• Limited Access to Diabetes Specialists
• Limited Access to education/support for community
physicians in the treatment of Diabetes
• Inconsistent use of evidence-based treatment guidelines
• Limited access for patient and family support

17. Population Health
Diabetes Project in Mississippi

18. Integration of RPM, Telehealth & Care Coordination

19. How can we engage patients?

20. How does it work?
Acute
Physiologica
l
Monitoring
Phase 1
Adherence
Phase 2
Behavior
Change
Phase 3
Transition to
Self-Management
Phase 4
Phase 1 Monitoring signs and symptoms Phase 3 Disease process education
Identify resources needed Support for changing behavior
Phase 2 Learn new medical regimen Phase 4 Learn and model self-management behaviors
Medication management; adherence to orders Demonstrate self-monitoring and response

21. Individualized Patient Care

22. Population Health
Diabetes Project in Mississippi
Using a remote care management (RCM)
platform, participants have remote access
to education and a team of specialists
over a 12 month period.
•Daily Health Sessions
•Personalized Interventions
•Targeted Education
•Health Coaching
•Behavior Modification
•Patient Empowerment

23. Care Innovations™ Guide Virtual Care Suite – Population Stratified by Risk

24. Empowering Patients

25. Mississippi Diabetes Telehealth Network
10-10-2014
Current Number
of Enrolled
Current Number
of Active Guide
Tablets
Current Number of Scheduled
Enrollments
24 19 6
Number of Scheduled
Health Sessions
Number of Health Sessions
Completed
592 569
Number of
ER visit
Number of
Hospitalizations
Impacts
0 0 (1) A1C
Down
8.8 to
8.0
% 96
Compliance
3-Eyes Identified
with Retinopathy

26. Population Health
• Predictive Modeling
• Risk Stratification to customize care management service
• Target high impact patients
• Personalized care plans, interventions, and patient education
Prevention
Well
Members
Prevention &
Disease
Management
Low Risk
Members
Disease
Management
Moderate
Risk
Members
Episodic
Case
Management
High Risk
Multiple
Disease
States
Complex
Care
Inpatient
LTC

27. If you focus only on risk and cost, many
individuals will look “the same”.
Ruth
50 years old
diabetes and hypertension
Forecasted Annual Cost of Care:
$15,245
3 inpatient days
1 ER Visit
$1,528 for medications
Maria
50 years old
diabetes and hypertension
Forecasted Annual Cost of Care:
$14,993
3 inpatient days
1 ER Visit
$1,568 for medications

28. Predictions empower you to see each patient as
an individual in terms of risks.

30. The Whole Picture
• EMR – Health Information
Network/Exchange
• Pharmacy data
• Claims Data
• Remote Monitoring devices
• “Wearable” data
• Patient Reported data

31. Translate to Meaningful
and Actionable Data
Intervention

33. mHealth on the Rise
The global mHealth
market is poised
to exceed
$49.1 billion
by 2020.
Source: Healthcare IT News, mHealth
Market scales to new heights based
On a market report, March 4, 2104

34. Mobile technology – Key to
widespread adoption…
• Studies show that people
check their phones more
than75 times a day*
• Leverage the addictive nature
of smartphones and
technology as a tool to engage
people in their health and
outcomes.
Kleiner Perkins Caufield & Byers’s annual Internet Trends report. 5/29/2013

35. Future Innovation
Ideas
• Wearable
technology –
Wellness initiatives
will be the key and
wearable
technology can
assist us in
managing
population health
Wearable Technology

36. Home-based connected health to overtake hospital-based by 2019
By: Aditi Pai | Oct 14, 2014
The telemedicine market, which according to BCC Research is comprised of “telehospital”
and “telehome” technologies, is expected to reach $43.4 billion by 2019 with a compound
annual growth rate of 17.7 percent, according to a recent report from the firm.

37. Patient Testimony

38. ?
Bridging the gaps in quality healthcare