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Fairview Homecare and Hospice Telemonitoring: Development of a Tool for Information Exchange IPHIE 28 June 2010 Mike Grove, Shaji Khan, Julie Cragg, Tami Schmidt. Goals. “To identify, capture, and report data to tell the story of Telemonitoring at Fairview Home Care & Hospice” Grow the program
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Fairview Homecare and Hospice Telemonitoring: Development of a Tool for Information ExchangeIPHIE28 June 2010Mike Grove, Shaji Khan, Julie Cragg, Tami Schmidt
Goals • “To identify, capture, and report data to tell the story of Telemonitoring at Fairview Home Care & Hospice” • Grow the program • Streamline processes • Ongoing effort
Telemonitoring (TM)Defined • “…an automated process for the transmission of data on a patient’s health status from home to the respective health care setting” (Paré, et al. JAMIA 2007). • Congestive Heart Failure, Cardio-Pulmonary Diseases, Asthma, Diabetes, other chronic conditions • Weight, blood pressure, O2-saturation levels, heart rate • Continuous or intermittent (patient-triggered)
Methodology • Telemonitoring literature review • Fairview process review • Telemonitoring information tool design & process recommendations • Conclusions & next steps
Literature Review • Studies show that Telemonitoring (TM) in treating chronically ill patients can: • Increase perceived levels of comfort by patients • Result in timely medical interventions • Reduce severity of healthcare encounters • Provide cost containment • Prolong life
Telemonitoring Literature Gaps Challenges More randomized controlled studies needed regarding patient outcomes and financial impact to healthcare systems
Current EHR Systems - Overview • Fairview Hospitals EHR • Fairview Home Care & Hospice EHR • Fairview Telemonitoring information system
“TM Tracker” Reports Analytics “Connected” via Patient ID TM Tracker (UM) Manual
Proposed Tool – “TM Tracker” • TM Patient Metric capture Re-hospitalizations Length of Stay ER Visits Other Encounters w/ HC TM Tracker TM Patient Process
Tool & Process Solution - 1 Technology (TM Tracker) • Removes barriers to TM information • Fills need not met by current systems • Reports performance metrics • Ultimately tells TM “story”
Tool & Process Solution - 2 Processes • Interoperability intersection of technology and process • Educate physicians and nurses on telemonitoring efficacy • Establish clearly defined parameters for TM data informed by best practices and patient history • Document process improvements
Roadmap for Growth • TM Tracker implementation • Reporting TM data • Documenting & optimizing current processes • New TM vendor (underway) • Systems alignment (optimal) • “TM Tracker” is a bridge to optimal solution but will “tell the story” in the interim
Acknowledgements • Campbell, Kassie. Homecare Nurse, Fairview Home Care & Hospice. • Haraldson, Sylvia. Specialty Programs Manager and Infection Control, Fairview Home Care & Hospice. • Lewis, Ann, RN, BSN. Telemonitoring Coordinator, Fairview Home Care & Hospice. • Murphy, Becky. Finance Director, Fairview Home Care & Hospice.
References Cleland, John GF. The Trans-European Network - Home-Care Management System (TEN-HMS) Study: An Investigation of the Effect of Telemedicine on Outcomes in Europe. Disease Management and Health Outcomes. 14: 2006. Pare, Guy, PHD, Mirou Jaana, PHD, Claude Sicotte, PHD. Systematic Review of Home Telemonitoring for Chronic Diseases: The Evidence Base. Journal of the American Medical Informatics Association. 14: 3, May/June 2007. Schmidt, Silke, Andreas Schuchert, Thomas Krieg, and Michael Oeff. Home Telemonitoring in Patients With Chronic Heart Failure. A Chance to Improve Patient Care? Dtsch Arztebl Int 2010; 107(8): 131–8.