Transcript Fairview Telemonitoring: A Systems Analyis and Roadmap

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
• 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
More randomized
controlled studies
needed regarding
patient outcomes and
financial impact to
healthcare systems
Challenges
Control
Group
Selection
Patient
Recruitment
Patient
Compliance
Length of
Time in TM
Different
Payment
Systems
Current EHR Systems - Overview
P.A.S.S.
(Transitioning
to Epic)
• Fairview Hospitals EHR
Manual
• Fairview Home Care &
Hospice EHR
Horizons
(McKesson)
Manual
Lifestream
(Honeywell)
• Fairview
Telemonitoring
information system
Fairview Patient Episode and
Transition to Telemonitoring
“TM Tracker”
Reports
P.A.S.S.
(Transitioning
to Epic)
Manual
“Connected”
via Patient ID
Horizons
(McKesson)
Analytics
Manual
Lifestream
(Honeywell)
Manual
TM Tracker
(UM)
Proposed Tool – “TM Tracker”
• TM Patient Metric capture
Rehospital
izations
Length
of Stay
ER
Visits
TM Patient Process
Other
Encou
nters
w/ HC
TM
Tracker
“TM Tracker” Interface
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.
Questions?
Appendix: Current Fairview TM
Patient Process