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Telemonitoring reduced readmissions, costs in patients with HF
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A telemonitoring program developed by Geisinger Health Plan to monitor patient weight, changes in physical condition, appetite and prescription adherence resulted in reduced hospital readmissions and cost savings, according to study findings.
Geisinger, a managed care organization in rural central Pennsylvania, implemented the program in March 2008 to extend a case manager’s ability to monitor patients treated for HF. Most patients presented with comorbidities such as hypertension (92%), CAD (81%), chronic kidney disease (56%) and diabetes (54%). Fifty-one percent of enrolled patients (n=541) were women, elderly (mean age, 79 years) and in patient-centered medical homes (87%).
Participants were provided with Advanced Monitored Caregiving Bluetooth scales equipped with interactive voice response that allowed case managers to ask patients questions about their health. Questions, including those about medication adherence, shortness of breath, swelling and appetite, were selected to reflect changes in health.
To be eligible for study inclusion, patients were required to safely step up and off the scale, have good cognitive function in order to respond to questions and have a land or cellular telephone to transmit the data.
Monitored patients were 23% less likely to be admitted to the hospital than they had been in the past (OR=0.77; 95% CI, 0.65-0.91), and 30-day (OR=0.56; 95% CI, 0.33-0.92) and 90-day (OR=0.62; 95% CI, 0.41-0.93) readmission rates were reduced.
Compared with their previous history, patient costs were 11.3% lower, and the return on investment was estimated to be 3.3, or $3.30 for every $1 spent.
The researchers said it was important to note that the monitoring program was designed to enhance existing case management and not as a stand-alone treatment, and that improvements may have been related to greater adherence.
“It may be that the benefits associated with telemonitoring are not related to the intensity of home monitoring but to improvements in patient adherence to instructions provided regarding weight control, diet, and medications,” the researchers wrote.
Disclosure: The researchers are employed by Geisinger Health Plan and received no financial support for the study.
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