12 October, 2008
| Sponsored by: | Philips Teleheatlh Solutions |
| Co-sponsored by: | National Association of Home Care & Hospice (NAHC) DMAA: The Care Continuum Alliance Fazzi Associates, Inc. |
The home care industry faces a significant challenge. With over 9,000 certified agencies, 4,500 hospice agencies, and countless private duty agencies serving well over four million seniors each year, nearly every agency faces the same clinical challenge – how to successfully, from both a quality and financial perspective, serve their most difficult patients; those with chronic disease.
| Chronic Disease | Persons Served | Number of Visits | Cost |
| Diabetes | 295,000 | 18,191,000 | 2,284,877,000 |
| Hypertension | 138,000 | 2,878,000 | 358,451,000 |
| COPD | 71,000 | 1,534,000 | 194,496,000 |
| CHF | 181,000 | 4,014,000 | 515,913,000 |
| Total | 685,000 | 26,617,000 | $3,353,737,000 |
| Source: Health Care Financing Review, 2007 Statistical Supplement, Table 7.6, Persons Using Medicare Home Health Agency Services, Visits, Total Charges, Visit Charges, and Program Payments, by Principal Diagnosis Within Major Diagnostic Classifications (MDCs): Calendar Year 2006 |
The numbers and financial implications are staggering. Johns Hopkins University reported that 90% of Americans over the age of 65 have one or more chronic diseases, 70% have two or more. When you couple this fact with a May 2008 AHRQ Report (Health Care Expenses for Adults with Chronic Conditions, 2005) that found that those with one or more chronic conditions accounted for the overwhelming majority of total medical expenses for all conditions (95.8% for the near elderly (ages 55-64), and 98.8% for the elderly age 65 and over), the significance of these numbers becomes clear.
What Was the Philips National Chronic Disease / Telehealth Best Practice Project?
The Philips National Chronic Disease / Telehealth Best Practice Project brought together a panel of five nationally recognized chronic disease medical experts and home care clinical telehealth experts from nearly every state. The National Expert Design Panel reviewed the medical realities of managing chronic conditions, as well as all available telehealth protocols from national groups (e.g. QIOs, AHRQ, ATA) and the proven experience and protocols of agencies who have demonstrated success in using telehealth with one or more chronic patient populations. Using these insights, the National Expert Design Panel systematically developed best practice parameters and protocols for addressing each of the four major chronic diseases.
What Was the Goal of the Project?
To develop a set of best practice protocols for the optimal use of telehealth services for home care patients suffering from one or more of the four major chronic diseases served by Medicare-certified home health agencies: CHF, COPD, hypertension, and diabetes. The major focus was how to use telehealth to improve quality and reduce cost for each of these populations.
Who Were the National Medical Experts?
Five of our nation’s most recognized, most published and most distinguished chronic disease medical leaders served as medical leaders of the project. They were:
Dr. Philip Corsello, Medical Director of National Jewish Health Disease Management Programs
Dr. Gerard Criner, Professor of Medicine, Temple University, Section of Pulmonary and Critical Care Medicine
Dr. Christopher Hebert, General Internist and Staff Physician, Cleveland Clinic Department of Nephrology and Hypertension
Dr. Jay Skyler, Professor of Medicine, Division of Endocrinology Diabetes & Metabolism, University of Miami, Past Board of Directors Member American Diabetes Association and President of the Florida Affiliate
Dr. Frank Smart, Chairman, Department of Cardiovascular Medicine, Atlantic Health and The Gagnon Heart Hospital, Morristown Memorial and Overlook Hospital
Who Were the National Home Care Telehealth Leaders?
Over 40 national home care telehealth leaders participated in the project. They represented every region of the country and 35 states. Their experience ran the gamut for agencies across the U.S.: primarily rural areas and heavily urban areas; for-profit and not-for-profit; hospital-based agencies, hospital-affiliated and freestanding. Agency sizes ranged from under one million dollars in revenues to the nation’s largest agency with an overall budget in excess of one billion dollars.
How Did the Project Work?
The project was intense. After nine months of preparation, an Expert Design Forum was held in Chicago to review published protocols from national sources and best practice protocols from many of the agencies. The project was vendor neutral; agencies that used nearly every major vendor participated. Once together, the Expert Design Forum ran from 3:00 to 10:00 PM the first day, and 7:00 to 12:00 NOON the next. During that time, medical realities for each of the major chronic diseases were reviewed, key components of an ideal protocol identified, and recommended systematic guidelines were developed for each component of the four chronic diseases.
What Were the Major Findings?
First, the Expert Design Panel identified five areas deemed most critical to best practice protocols for each of the chronic diseases:
1. Inclusion/Exclusion Criteria
2. Focus of Monitoring / Telehealth Parameters
3. Patient Education Focus
4. Expected Outcomes
5. Service Guidelines
Second, the home care telehealth leaders and medical experts developed specific activities that should take place within each of the five topic areas.
What are the Next Steps?
These new chronic care / telehealth protocols will now be tested and refined by participating agencies and project stakeholders with the ultimate goal being finalization of clinical protocols that lead to better quality outcomes and better financial outcomes for agencies using telehealth.
For More Information about the Sponsor: Philips Telehealth Solutions
Call Mike Lemnitzer, Senior Director at 978-609-7235 or email michael.lemnitzer@philips.com