Reducing Acute Hospital Readmissions Through Telehealth Technology

In the United States, a renewed interest occurred in telehealth in the 1990s according to McGonigle and Mastrian because of escalating costs, the need for greater access for all

Telehealth uses technology to provide services that assist in the management of long term health conditions. For patients, telehealth can be a blessing that allows them to remain in their homes rather than moving to rehabilitation facilities. By taking an active role in their own care, some patients are reducing the number of medications they take, visiting emergency rooms less frequently and even lessening depressive symptoms.

Telehealth has become a preferred method of healthcare delivery for many patients and healthcare professionals alike. Some key benefits include its convenience and cost effectiveness. It also allows patients to play a more active role in their own healthcare, which has been found to dramatically increase patient outcomes. While research suggests that the advantages of telehealth outweigh the disadvantages, it is important to note that not everyone would benefit from this form of technology. It is crucial for the patient’s healthcare team to assess if this method of healthcare delivery is appropriate for that individual patient. In today’s society, staying current on the latest technologies is extremely important. Although telehealth

The purpose of this paper is to discuss how technology has impacted the health care delivery system. Health care technology is advancing at an increasingly rapid rate in the United States, and globally. Patients and providers are witnessing these changes through the use of telehealth, and telemedicine applications. Telehealth, and telemedicine are often used interchangeably, however there is a difference between the two applications. Telehealth is the use of technology to deliver health care, health information, or health education at a distance (U.S. Department of Health and Human Services, n.d.).

The benefits of telehealth consultations are immeasurable; clients are able to access a knowledgeable health care professional and receive a telephone triage/assessment and recommendations. This allows the patient to have immediate access to good health advice and quicker solutions. Telemedicine is one of the many vehicles of telehealth; for example, the cardiologist orders an outpatient Holter Monitor trial to evaluate arrhythmias. The technician calls the patient at the sign of any abnormal rhythm and investigate the activity performed when the reading fluctuation then the reported is communicated to the cardiologist. If warranted, the cardiology staff will contact the patient with instructions schedule an immediate appointment. Telehealth services resources would benefit the client in this next example, an individual’s come in for a sick visit expecting a prescription to be written for their illness; they receive informative instructions because of the nature of the

monitored by medical professionals. According to McKnight (2012), “Studies indicate patients with telehealth care are noted to have a 25% reduction in the number of inpatient hospital days and a 19% reduction in the rate of hospitalizations” (p. 4).

Many of these barriers exist from lack of essentially knowing the benefits of what the incorporation of telehealth can offer within the aspect of this type of community. At times, there has been a great interest in telehealth surrounding its potential to reduce health care costs along with the improvement of patient outcomes, but at times there has been no known scientific evidence base underpinning it (McLean, Sheikh, Cresswell, Nurmmatov, Mukherjee, Hemmi & Pagilari, 2013).

Telehealth has been a large topic of debate in recent years because of the economic, political, and regulatory points of view. In deciding outcomes in these areas, it is the responsibility of all healthcare professions to identify information gaps in order to come to the more rational and beneficial conclusion about telehealth (Grace, 2014). Economically, there are concerns regarding the access and affordability of telehealth equipment. At the same time, telehealth is being adapted in ways to be utilized with technological devices that many individuals already have access to like telephones, cellular phones, and personal computers/laptops. Telehealth can positively impact both clients and providers by increasing access to care and reducing the time and costs associated with traveling for health care (Allen, Aylott, Loyola, Moric, & Saffarek, 2015). As telehealth develops technological devices can be made more affordable and can be covered by insurance policies (Thomas et al., 2014). Many nurses functioning as case managers can help provide the tools and resources individuals require to manage their health.

The Affordable Care Act was enacted to improve health care and to lower health care cost in America. The ACA developed different strategies to meet these goals called the “pay for performance” programs. These strategies are aimed at the different providers to improve quality care. The strategy that I selected is the “Hospital Readmissions Reduction Program” this program/strategy is also known as the HRRP and was begun in October of 2012. HRRP is aimed at hospitals and penalizes hospitals that have a high 30 day readmission rate. The penalties are assessed and based on a number of comparisons, those such as, performance, patient demographics, comorbidities and frailty.

Telehealth is the monitoring via remote exchange of physiological data between a patient at home and health care professionals at hospitals or clinics to assist with diagnosis and treatment. As our society ages and health care costs increase, government and private insurance payers are seeking technological interventions. Technological solutions may provide high quality healthcare services at a distance, utilize professional resources more effectively, and enable elderly and ill patients to remain in their own homes. Patients may experience decreased hospitalization and urgent care settings, and out of home care may not be required as the patient is monitored at home. However, no study has been able to prove telehealth

For years, healthcare costs have continued to increase in the United States and policymakers are constantly trying to find ways to reduce spending. According to reports, in 2011, about $900 billion out of the $2.6 trillion annual health care spending was wasteful spending. In the following year, there was a reported $690 billion wasted annually on healthcare. This wasteful spending is attributed to ineffective health care delivery, cost of adverse events, and poor care coordination that has led to avoidable readmissions (Lallemand, 2012). In the United States, readmissions are the highest amongst patients with chronic diseases accounting for about 90% of avoidable readmissions in 30 days after discharge, and costing the industry an estimated $17 billion. These readmissions are a result of inadequate discharge planning, lack of follow-up, and lack of education on disease management (Jayakody et al., 2016). Policymakers on the federal and state level have developed and implemented several programs, some varying state to state, to help reduce wasteful spending while improving quality of care.

The delivery of health care has always been influenced by technological developments and innovations. This is particularly true in modern health care professionals where they are obsessed with technology and rush to apply them. One of the most recent applications of ICT – Information and computer technology- is telehealth. Telehealth is the use of communication, diagnostic and information technology to provide health care when patients and providers are geographically separated [2], Technologies include videoconferencing, the internet, store -and-forward imaging, streaming media, terrestrial and wireless communications. Telehealth could be as simple as two health professionals discussing a case over the telephone or as

Often the biggest barriers to accessing healthcare are cost and location. Lower income individuals just do not have the resources to have optimal healthcare, or cannot take the time away from employment to deal with health issues. One potential solution to help with these problems could be “telehealth.” Telehealth allows a lower level healthcare practitioner to communicate with a physician or specialists when necessary. Remote rural areas use a Physician Assistant or a Nurse Practitioner on location in remote areas.

There is an increasing need within the U.S. for quality health care to be provided to individuals who have limited access whether it is due to a rural environment, disabilities, or in the field of battle. Telemedicine is literally medicine provided at a distance. Telehealth is able to alleviate some of the effects of a growing shortage of professionals such as primary care physicians. In this type of health care delivery, the dynamics between the patient and the entire health care system changes. Telemedicine meets the increasing demands of patients to have greater access, or responsiveness, from a health care provider. It also meets the needs of the provider who is very interested in time-saving, safety-enhancing assistance in their daily practice. Employers and health plans are also very interested in telemedicine as a means of improving compliance with treatment plans and care management initiatives (Hodgkins, 2008). The use of email also allows the patient to have increased access to their health care providers. Instead of calling their health care provider’s office, patients are now able to email their non-emergent health care questions to their provider. Conversely, health care providers are able to email patients reminders for appointments or wellness tips.

There are several forms of technology that is used to monitor, assist patients with self-care management, assist physicians with delivering care to their patients, including consultation with specialist, and overcoming barriers with transportation. “60% of the healthcare executives, physicians, and nurses in this inaugural survey said that telemedicine was a high priority for 2015“ (Vockley, 2015, para. 7) Telemedicine