Telehealth Outpaces ADRs and Readmissions: Analytics is Behind Its Success

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Posted By: Sarianne Gruber November 20, 2017

sgruber-200 (1)By Sarianne Gruber
Twitter: @subtleimpact

Today’s healthcare decision makers are embracing telehealth solutions with a very tactical perspective and rely on analytics to ensure successful strategies. The Castleton Group is an organization made up of healthcare and information technology experts, with an overarching goal to deploy solutions that will benefit hospitals and long-term care facilities. These seasoned professionals stay abreast on innovators especially those focused on keeping patients healthy and out of the hospital.  Howard Reis, Founding Partner, and COO sees the most successful leaders in telehealth incorporating and depending on a multitude data sources for the best products.  And, the more data, the more robust are the outcomes. One of them is to “attack the most common causes of hospitalizations and readmissions.”  Due diligence process begins with the data.   How will the telehealth data be integrated into the field?  How will telehealth data be at the core of the patient-centric care? How does the data measure the patient’s journey with minimum disruption with optimal benefits?

As healthcare facilities become dissatisfied with existing solutions, the market may seem daunting with the number of telehealth solutions. The Castleton Group researches and evaluates what are best breakthrough solutions for an institution’s problem.  The first step is to get stakeholders established with best practices and proven results, which relies on a combination of data and analytics. Then the technology is deployed in their individual facilities. It is the data analytics that will prove the success of a project using multiple KPI metrics such as tracking readmissions. Telehealth solutions use multiple sources of data at (1) the patient level with personally monitored data, (2) provider level collected electronic health record data and (3) external data like social determinants of health which includes demographics and population health management. Solutions also depend on information technology for health information exchange connectivity and interoperability.    Whether in the cloud, data warehouses or data lakes, IT analytical applications and algorithms direct the allocation of care and cost. Common practices include risk stratification models, treatment adherence studies and epidemiological cohort studies.   Promoting patient wellness and adherence as well as preventing admissions and readmissions is the catalyst for Castleton’s technical and data-driven due diligence.  Here are projects at the forefront of analytics and beating readmissions.

The prevalence of heart failure is now over 5.7 million adults.1 Close to 1 million of these heart failure patients are hospitalized annually at a cost of more than $17 billion to the Medicare program.2 MyHealthConnection, Inc. is the distributor of the breakthrough whole-body non-invasive cardiac system called MyNICAaSTM. This hemodynamic monitor navigator tool system was developed in Israel and is FDA approved. Non-invasive hemodynamic monitoring is made simple just by using this sensor and is easily transportable and portable. MyNICaSTM measures the amount of blood the heart is pumping and the resistance of the blood vessels.   Studies have substantiated its equivalency to the Swan Ganz, for measuring stroke volume, cardiac output, total peripheral resistance and total body water. Research studies have also demonstrated how the newest results are comparable to standard methods.   A team led by Dr. Nathan Levin from Mount Sinai School of Medicine in New York published a notable study entitled Comparison of Stroke Volume Measurements during Hemodialysis using Bioimpedance Cardiography and Echocardiography in the 2017 Hemodialysis International. The study showed the marked similarity in stroke volume measurements using a noninvasive, regional bioimpedance cardiology device, MyNICaSTM, compared to the Doppler echocardiography (Echo) in a hemodialysis care.  Home healthcare has begun using this technology with very positive results.  The MyNICaSTM is supplied to the patient’s home with the assistance of a visiting health provider. Instantly, the patients’ data is tracked and integrated with other metrics for a 360-degree view of the patient.  Sava Senior Care, which has SNF 300 locations around the country, reported 67 CHF patients at five different facilities each over 90 days stay, had zero readmissions with CHF related- symptoms. Kindred Home Health was also able to reduce readmissions by 30.9% with the MyNICaSTM.

 Adverse Drug Reactions (ADRs) are a major public health concern, causing over 100,000 fatalities in the United States every year with an annual cost of $136 billion.3 Early detection and accurate prediction of ADRs is thus vital for drug development and patient safety.4 Also, it is estimated that over 350,000 ADRs occur in U.S. nursing homes each year.5 Medication Therapy Management (MTM) programs have reported positive effects on reducing hospitalizations. Castleton is very encouraged with SURVEYOR Health’s MedRiskMaps, a next generation, evidence-based decision support software designed for clinical pharmacists. The platform contains analytics toolsets such as spreadsheets that integrates data from multiple sources including EHRs and HIEs.  MedRiskMaps can visually model patients’ medication risk including the additive side effects of taking many medications. Query-based simulations can crosslink and mitigate risk through prospective changes of therapy.  Pharmacists performing more exhaustive clinical pharmacy and MTM reviews require far less time than the current standard practice of running interaction checkers and reading each and every drug monograph and insert.  This companion tool right along with the expertise of the pharmacist increases productivity and decreases the potential adverse events, and in the long term reduces the chance of malpractice suit.

Howard Reis is Founding Partner and COO of  The Castleton Group and President of Health ePractices. Howard has more than 25 years of telemedicine experience starting when he was the Project Manager for NYNEX Corporation in an early broadband trial with four Boston teaching hospitals. For the past ten years, Howard has been working with commercial teleradiology providers and continues to believe that the rest of telemedicine industry can continue to take advantage of the lesson learned from teleradiology.

References

  1. Mozzafarian D, Benjamin EJ, Go AS, et al. on behalf of the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Heart disease and stroke statistics—2016 update: a report from the American Heart Association. Circulation. 2016;133: e38-e360
  2. Circulation. 2012;126:501-506 Originally published July 23, 2012, https://doi.org/10.1161/CIRCULATIONAHA.112.125435
  3. YuxiangTana1YongHua1XiaoxiaoLiua1ZhinanYinaXue-wenChenbMeiLiuc Improving drug safety: From adverse drug reaction knowledge discovery to clinical implementation Author links open overlay panel
  4. https://doi.org/10.1016/j.ymeth.2016.07.023Gurwitz JH, Field TS, Avorn J, McCormick D, Jain S, Eckler M, et al. Incidence and preventability of adverse drug events in nursing homes. Am J Med 2000;109(2):87–94.
  5. https://doi.org/10.1016/j.ymeth.2016.07.023Gurwitz JH, Field TS, Avorn J, McCormick D, Jain S, Eckler M, et al. Incidence and preventability of adverse drug events in nursing homes. Am J Med 2000;109(2):87–94