RelyMD co-founder and director of virtual health, Dr. Bobby Park presents during LeadingAge NC's 2017 Annual Conference. View these slides to learn how nursing homes and CCRCs are utilizing telemedicine to decrease hospitalizations and save on costs for their facility.
10. About 84% of healthcare executives felt that the development of telemedicine
is either very important (53%) or important (32%) to their organizations.
*Source: Foley 2014 Telemedicine Executive Summary
After telemedicine services were employed by the Veterans Health
Administration post-cardiac arrest care program, hospital readmissions
decreased by 51% for heart failure and 44% of other illnesses.
*Source: The Promise of Telehealth For Hospitals, Health Systems and Their Communities, TrendWatch, January 2015
According to a study on the Geisinger Health Plan, patient readmissions were
44% lower over 30 days and 38% lower over 90 days, compared to patients not
enrolled in the telemedicine program.
*Source: The Promise of Telehealth For Hospitals, Health Systems and Their Communities, TrendWatch, January 2015
25. 80% of hospital
admissions among
nursing facility
residents are caused
by…
PneumoniaUTI
Dehydration
CHF
Falls/Trauma
26. Approximately 45% of
hospital admissions
among individuals
receiving Medicare or
Medicaid nursing facility
services could have
been avoided.
CMS 2005
29. One study showed
telemedicine helped
decrease hospitalizations by
up to 11.3%.
Commonwealth Fund
-9.7
-11.3
-5.2
-12
-10
-8
-6
-4
-2
0
Decrease in Nursing Homes’ Hospitalization
Rates in More-Engaged and Less-Engaged
Facilities After Telemedicine
Total Treatment Group More Engaged Facilities
Less Engaged Facilities
Control Group
-5.3
Percent decrease in hospitalizations per 1,000 resident days
30. Another showed even
greater results.
McKnights
“We have seen a reduction in our return to hospital rates,
retained 75% of the patients who had a sudden acute
change in condition (resulting in over 500 retained
patient days), and helped contribute to millions in
healthcare savings by eliminating avoidable hospital
admissions.”
-10 months after implementing a telemedicine solution.
31. What that means for
your facility’s cost
savings.
CMS Innovations Award. RAVEN. Dr. Steven Handler at UPMC
Facility Cost Each Potentially Avoidable
Hospitalization:
• 6.1 Average Hospital Length of Stay
• Loss of 6 days of SNF revenue (“head in bed”)
• Average RUGs payment of $380 per day Medicare Part A
• Lost Resident Revenue $380 x 6.1 days = $2318
• Labs / Nursing Readmission Cost = $ 200
Average SNF Loss Per Hospitalization
$2518
34. Rural nursing homes
are feeling the heat.
Less applicants to
choose from
Located further
from hospitals
Inability to attract
top medical talent
Rely more on
Medicaid
36. 1 2 43 5
A resident within a nursing
facility experiences a medical
situation that requires a
physician consultation.
37. 1 2 43 5
The resident’s nurse accesses
a telemedicine platform and
connects with a physician
from a tablet or computer.
38. 1 2 43 5
The nurse & telemedicine
physician review the health
concerns & assess symptoms
via video.
39. 1 2 43 5
The physician helps the nurse
determine if a hospital
transfer is necessary. If not,
the physician helps to
establish a treatment &
monitoring plan.
40. 1 2 43 5
Medical visit notes are added
to the resident’s record to
provide clear communication.
41. 1 2 43 5
If the physician feels that a
hospitalization is necessary,
they will call ahead to the
designated ED to help
facilitate the hospital visit.
*
43. BARRIERS TO ENTRY
• Telemedicine parity
• Reimbursement models
• Facility technical capabilities
• Cost of entry, depending on chosen provider
• Forward-thoughtfulness of facility & owners
44. ABOUT RELYMD
Founded in 2015 by a group of over 100 emergency-medicine physicians
Fully staffed by Wake Emergency Physicians, PA
All of our providers are located in North Carolina
45. VISIT WITH A DOCTOR
Web Browser Phone Call
Mobile App
(Mobile Phone, Tablet)
Nursing homes must rely more and more on Medicare reimbursement which is being held and reduced based on 5-star ratings while losing higher-rate payers.
https://www.agingcare.com/questions/nursing-home-discriminate-because-of-pay-152961.htm
We need to look at why hospital readmissions are happening…
Nursing homes must rely more and more on Medicare reimbursement which is being held and reduced based on 5-star ratings while losing higher-rate payers.
https://www.agingcare.com/questions/nursing-home-discriminate-because-of-pay-152961.htm
Most hospitalizations are avoidable,
Telemedicine is already helping forward-thinking nursing homes prevent hospital admissions
Nursing homes must rely more and more on Medicare reimbursement which is being held and reduced based on 5-star ratings while losing higher-rate payers.
https://www.agingcare.com/questions/nursing-home-discriminate-because-of-pay-152961.htm
Not meant to replace primary physician, but helps to extend the level of service a physician provides by being available for calls anytime of the day or night. This could be when the primary doctor is not in the location, especially during after-hours. In addition, the nature of telemedicine being techologically advanced and all online allows all patient records and updates to be easily added to a resident’s record so the primary doctor can review when he is on site for follow ups to any medical conditions that occurred.
Nurses are happy because they’re able to have more support in the strategy of keeping a resident in-home. Often when a doctor is unavailable, the only option is to send a resident to the hospital because they lack the skill and qualification to diagnose. Now they have a doctor who can do those things in their pocket.
Telemedicine can help with all of these:
Bolsters their staff numbers by providing extra care availability
Gives the home access to top-notch emergency medicine physicians from the Raleigh-area
Prevents the longer transports to hospitals saving time to access care for residents. Also- helps the community by keeping limited EMS services available for true emergencies.
Helps keep Medicaid penalties lower with better care
Telemedicine can help with all of the above. So how would a telemedicine service work within a nursing home?