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Taking care home

November 15, 2017

Health monitoring at home empowers patients and cuts costs

s_malovecShannon Malovec, TELUS Health
As Principal of Patient Engagement at TELUS Health, Shannon is a strategic health informatics leader for patient-facing products, applications, delivery and consulting. With executive experience at the provincial and international level, she is passionate about transforming healthcare through patient engagement.

Moving from acute to self-care can be tough. Home health monitoring (HHM) helps maintain the critical connection between patients and care teams during these transitions. In some B.C. pilots, heart failure patients with HHM in place used healthcare services 76% less than heart failure patients not using home monitoring.

When her patients’ pedometer readings are low, Claire knows something’s wrong.

“One of my COPD patients was down to only hundreds of steps a day,” said Claire, a Victoria home health monitoring nurse. “When I called him, he said he wasn’t getting outside for his daily rehab walk because his oxygen supply kept freezing up.” Claire quickly connected her patient with a technician, who then fixed the problem.

And this happened without a single patient appointment or nurse visit.

Claire and her patient were part of a home health monitoring (HHM) pilot program, one of several in British Columbia and Yukon, where pedometers are one of the devices that patients with chronic conditions such as COPD and heart failure are using to manage their recovery.

Easing the transition from acute to home

“All patients, but especially chronic disease patients, need a safe and high quality transition from hospital to home,” said Dr. Kendall Ho, Lead for University of British Columbia Digital Emergency Medicine and co-lead of Vancouver’s TEC4Home HHM pilot program, together with Vancouver Coastal Health and Providence Health Care.

The statistics illuminate the critical need for better transitions.

In Canada, 18% of COPD patients are admitted to hospital once a year, while 14% are admitted twice. A full 40% of discharged heart failure patients are re-admitted to hospital within three months.1

Recurring hospital admissions are discouraging for patients, but also costly to the system. To combat these issues, HHM programs like the ones running in Yukon and several B.C. Health Authorities (Island, Interior, Vancouver Coastal and the Provincial Health Services Authority) extend patient monitoring beyond hospital walls.

“Patients are healthier at home, where they’re at ease, with family, and in familiar surroundings,” said Gayle Anton, Director of Chronic Disease Management and Home Health at B.C. Interior Health. “With our HHM programs, we’re bridging the gap by providing specialty care in patients’ homes that allows for intervention as needed.”

In the HHM pilots, heart failure and COPD patients are set up at home with devices that measure their heart rate, weight, blood pressure, oxygen saturation and activity level. Every day or more often, they send these vitals to an HHM nurse and answer an online questionnaire on how they feel, physically and mentally.

“With minimal training and support, most patients find the devices easy to use and the protocol simple to follow,” said Lisa Saffarek, Senior Specialist, Virtual Care & Telehealth at Vancouver Island Health Authority.

HHM pilots return astounding results

Some B.C. health authorities, such as Interior Health, have been successfully using some form of HHM for over a decade. Recent results from chronic disease pilots in both Interior and Vancouver Island Health Authorities confirm why.

Pilot participants loved the programs: 100% of COPD patients said they would recommend it to others. And 86% of healthcare professionals reported satisfaction with their ability to deliver care.

But most remarkably, the need for healthcare service was dramatically reduced. For example, patients in Interior and Island Health’s heart failure pilots used care 76% less than the average heart failure patient.

While this shows overwhelming promise for cost savings, the bottom line is that HHM keeps patients healthier—and happier. What contributes to this striking improvement in health? Put simply, three factors: HHM encourages engagement, strengthens care team connections and permits earlier interventions.

Click to enlarge

Engaged patients

Technology is at the heart of HHM. But it’s how patients engage with the technology and their provider team that makes HHM successful.

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