By Jonathan French, CPHIMS, SHIMSS, Senior Director, Quality and Patient Safety, HIMSS
As value-based care expands across the globe, health systems are looking for solutions to improve patient outcomes. Using case studies from HIMSS Davies Award recipients as models, we’re able to see how leveraging digital health can help reduce the cost of care and the amount of follow-up visits—boosting overall patient satisfaction.
Ochsner Health System used digital health solutions in their battle to improve chronic disease management across the state of Louisiana. Diabetes and hypertension, chronic diseases that require numerous office visits and regular health monitoring, were two targets for developing digital health tools. With these tools, providers can measure a patient’s compliance and health without the patient coming into the office.
For hypertension patients, Ochsner provided remote monitoring devices to measure blood pressure. Using a minimum of one reading per week, data is automatically uploaded into the EHR, where it is used to identify changes in patient health and trigger interventions if needed. If a patient does not submit a reading within eight days, they receive a text reminding them to take a reading.
Diabetes patients utilized a similar tool—a wireless, digital glucometer to measure blood sugar—with monthly automated reports advising them of their progress.
Using the data collected by the remote monitoring devices, care coordinators and subject matter experts—like pharmacists and health coaches—leverage dashboards to intervene if a patient shows signs of deterioration or is not following the care plan. Providers can drill down to individual patient-level data and receive progress summaries for all patients enrolled in the program.
As result of the program, hypertension patient medication compliance rose to 99% and systolic blood pressure dropped almost 20 points on average. And diabetes patients participating in remote monitoring improved, on average, A1C control by a full point over patients following standard management protocols.
Better outcomes and fewer face-to-face appointments saved between $1,000 and $5,000 on average per patient. Improved patient outcomes resulted in more than $300,000 in savings for the health system, with patients reporting 12% higher patient satisfaction rates.
One of the biggest factors in costly and avoidable hospital readmissions is poor compliance with medication plans. Parkland Hospital, a safety-net hospital providing care to underserved patients across the Dallas metro area, launched an outpatient parenteral antibiotic therapy (OPAT) program to allow patients access to antibiotic therapy and treatment at home following hospitalizations that involved an infection.
The most significant challenge to implementing the OPAT model was identifying which patients would have the ability to administer their antibiotics at home. Parkland leveraged a clinical and skills assessment tool delivered at the bedside prior to discharge to test and record a patient’s ability to self-administer IV antibiotics. Using these insights, they were able to determine if the patient had the skills to administer the IV safely at home.
Once a patient meets eligibility criteria, they are provided access to on-demand videos to walk through the administration process and a QR code reader for accessing information at home.
The program has been a remarkable success. For OPAT patients, the 30-day readmission rate was 47% lower compared to OPAT provided in the hospital. This led to 27,666 fewer days of inpatient care, saving the hospital $40 million. This approach helps patients and providers avoid the inconveniences, complications and expenses of hospitalization, while saving money and improving patient satisfaction and outcomes.
Lessons emerged from both stories about leveraging digital health tools to improve health. First and foremost, both organizations utilized a variety of data sources—including elements of clinical data, behavioral health and social determinants data, plus clinical intuition—to properly risk adjust each patient to determine if they were a good fit for the program.
Case management and monitoring of patient compliance using medication and wellness interventions was required in both scenarios as well. Any time gaps in care were demonstrated, case managers leveraged data to trigger clinician engagement.
By measuring success and using data to drive additional improvements, both health systems were able to provide digital health tools to keep people out of the hospital and healthy, increasing patient satisfaction significantly.