Extending Care from Hospital to Home

1. Extending Care from Hospital to Home CP338.01 5/3/13

2. Agenda • Changing trends in healthcare • Identifying key pain points • Partnering with home health • Why telehealth • Measuring outcomes • Next steps

3. A new definition of success in healthcare The shift to a patient-centric model is creating a seismic change in Healthcare implementation Source: Reflection on the Future of Disease Management by Sam Nussbaum, MD

4. Drivers of patient-centric care Patient population trends • Growth in chronic diseases • Increase in aging population Source: Center For Disease Control (CDC) Increased patient engagement • Proactively involved with maintaining • health on a daily basis • Desire to live independently longer CMS payment model • Penalties for readmission rates above the • national average • Value-Based Purchasing payments based on quality • of care vs. fee for service • Meaningful Use incentives for utilizing certified EHR’s • to capture and share health information with care providers and patients

5. Identifying industry pain points Top Initiatives Pain Points • Reduce readmissions to avoid reimbursement penalties • Prepare for changing reimbursement models (value-based purchasing, bundled payments, shared savings) • Maximize Value-based Purchasing incentives for meeting quality of care standards Financial • Improve satisfaction surveys results and patient engagement/loyalty to secure incentive payments • Better patient oversight and care transitions to increase quality of care and improve patient acquisition costs Patient Satisfaction & Quality • Utilize analytics to access patient care data to decrease staffing costs and length of stay Operational & Clinical Efficiencies

6. Partnering with Home Health

7. About (Your Agency Name Here) (PLACEHOLDER: Include information about your agency including history, services, awards, and unique value/how you are different from other agencies)

8. Patient populations that we serve • Mobile Healthy and At Risk patients who do not have a skilled need or are not homebound • Frequent fliers who need a daily connection to health monitoring to prevent emergent care use • Chronic disease patients who need assistance managing their care • Post acute patients not transferred to a SNF • Patients needing skilled nursing, PT/OT/MSW and/or daily monitoring services • (PLACEHOLDER: Add your other agency services here (home making/CNA /Hospice, etc.) At Risk Mobile Healthy Fragile • Event-based • Value: • Event-initiated oversight and patient/disease management tools • Population: • mPERS/Disease Management/ Care Transitions • Our fit: PERS/Telehealth monitoring • Full Clinical Oversight • Value: • Daily monitoring using telehealth products and services • Population: • Fragile, Homebound, Chronically Ill • Our fit: Telehealth monitoring • Patient Self-Managed • Value: • Enables Care Manager to offer support to Elders when and how they need it • Population: • Mobile/Healthy Elder • Our fit: PERS

9. How Home Health can help address your pain points Daily health status monitoring • Patients can remain in their homes, and maintain their independence, while being monitored for changes in health status • Changes in condition will trigger an action to review and modify the patient’s care plan, if needed, before a re-hospitalization occurs Education • We teach patients and families about their conditions, including compliance with care plans and how to make better choices to improve their health Transparent access to patient data • Co-case manage our mutual patient(s) by accessing patient data in real time • Review your patients’ information at any time with our analytics tools • Allowing family members to review care through secure online access to patient information Improve patient satisfaction • Daily clinical oversight with remote monitoring provides patients with a sense of security and greater peace of mind through interaction or human interaction Result = Cost containment The value of daily health status monitoring helps control costs for your hospital

10. Telehealth Solution Overview

11. Demystifying “Tele-Confusion” Where does Telehealth fit? Telehealth Telecare Telemedicine Activity Monitoring & Sensing Remote Diagnostic & Treatment Remote Patient Monitoring Services enabling elderly & vulnerable to live independently in home or facility Use of telecom & IT to provide remote access to care to chronic populations Health data transfer between care providers & patient for diagnosis & treatment via live connections Description • Physician & Patient teleconsulations • Telesurgery, teleradiology, tele-ICU • Holter & CRM home monitor • Video conferencing • Activity & sensor monitoring • Gas & smoke detection • Medication management • Personal Emergency Response System (mPERS) • Full clinical oversight through full vitals monitoring • Data management platform • Implementation services • Decision support tools • Disease management • Video visits Services & Devices

12. Our Solution: LifeStream Health Management Platform We utilize Honeywell HomMed’s LifeStream Health Management Platform, and our telehealth solutions are supported by their Clinical Consulting Services LifeStream Care Provider Software Daily Monitoring Physician engagement Our Monitoring Services Installation Connect Manager Genesis Touch Genesis DM Patient Devices and Peripherals LifeStream MobileHelpmPERS Peripherals Analytics View

13. Solution Overview: Patient Devices Scheduled or unscheduled biometric collection: Walks patients through the process to assist with compliance Optimized for mobility: Honeywell HomMed devices can be used both inside or outside the home Wired and wireless peripherals: Devices can be used in any room with or without dedicated wired connectivity Integrated video capabilities: Hold video visits and educational sessions with patients, family members, and other care providers • Telehealth • Mobile & desktop • 3G/4G & WIFI • Range of peripherals • Telecare • Mobile wireless • Location services • Falls (Q313) • Applications • Video visits • Deliver educational materials

14. Solution Overview: Care Provider Software We track and manage patient data through Honeywell HomMed’s software management interface • Single consolidated view of patient data: Review and manage patient data from LifeStream’sclinical dashboard • Flexible, efficient workflows: Schedule and customize patient biometric collection, ask specific disease management questions, and deliver relevant education to the patient • Integration with common HIT interfaces: Connect patient data with your health records (EHR) and electronic medical records (EMR) with HL7, one-way, or two-way interfaces. Connect Manager LifeStream Care Provider Software Analytics View

15. Solution Overview: Clinical and Monitoring Services • Daily Monitoring: Our clinicians review patient biometric data daily and respond to changes directly with each patient • Physician Engagement: We will work with you to identify the reporting and communication methods you prefer to stay informed about your patients. • Installation: We will install the telehealth monitor in the patient’s home • HomMed Clinical Consulting: We work closely with Honeywell HomMed to adopt rigorous standards for our telehealth program and ensure our staff is properly trained Daily Monitoring Physician engagement Our Monitoring Services Installation

16. Measuring Outcomes

17. Measuring a successful telehealth program We benchmark our agency against the following criteria: • Readmission rate: How often are our patients re-admitted to the hospital and were any of the incidents preventable? • Quality of care and patient satisfaction: Are our patients satisfied with their care? • Operational and clinical efficiencies: Are we able to care for more patients and reach them more often with telehealth?

18. Outcome Data: Home Health Compare (PLACEHOLDER: Enter your agency’s outcome and home health compare data here) http://www.medicare.gov/HomeHealthCompare

19. Outcome Data: Our patient data examples

20. Hospital Compare (PLACEHOLDER: List the Hospital Compare data for the hospital you are presenting to) http://www.medicare.gov/hospitalcompare/

21. Telehealth Success Throughout the Industry

22. Care Cycle Solutions Example In an ongoing look at 6,000+ patients, readmission rates for the first 30-days of care averaged 7.3% for monitored patients vs. 14.2% for patients that did not receive telehealth monitors. 30-Day Rehospitalization Rates Medicare Beneficiaries – US Average* 19.60% Texas Medicare Beneficiaries* 19.40% Louisiana Medicare Beneficiaries* 21.90% Home Healthcare Partner – Non-TeleHealth 14.89% CareCycle Solutions – TeleHealth 7.30% “We believe that telehealth services are key building blocks required for the delivery of quality home healthcare.” Wayne Bazzle, CEO of CareCycleSolutions, Dallas, TX

23. Advanced Telehealth Solutions ROI Example Insurance Cost [PM/PM $500 x 12 Months] 1000 Lives x $6,000 5% of People [50] generate 55% of total cost: 55% of cost [an opportunity for savings of] = = = $6,000 PM/PY Avg. $6,000,000 $3,300,000 Focusing on highest cost members of a population yields sustainable savings over time Karen Thomas, President, Advanced TeleHealth Solutions

24. Next Steps: Post-discharge process

25. The handoff to home health Recommended process for hospital and home health agency prior to patient discharge 24 hours prior to discharge: • Review patient care plan • Identify communication frequency/reporting plan • Deliver monitor to patient and provide telehealth education at bedside, or develop a plan for in-home assessment depending on your preference During monitoring: • Regular communication between hospital and home health according to pre-discharge plans • Alert physicians to changes in health and revise care plan if needed • Evaluate need for video visits to reinforce care plans or introduce additional educational information

26. Testimonials

27. What do patients and family members say about us? (PLACEHOLDER: List 3 – 4 of your patient testimonials here)

28. Thank you – How do we get started?