Citizens
Doing Well at Home
Citizens Memorial Healthcare brings its expertise into the
home care arena, using MEDITECH's well@home technology to
help chronic disease patients better manage their conditions.
(7/27/2010)
Citizens Memorial Healthcare (Bolivar, MO) is
an enterprise known for its extraordinary achievements. As
the first rural health system and nonacademic medical center
to receive the Nicholas E. Davies Award of Excellence in 2005,
and the first MEDITECH customer to achieve Stage 7 EMR
Adoption recognition from HIMSS Analytics, Citizens Memorial
is always raising the bar on quality health care.
But while Citizens' claim to fame is its inpatient facility,
leaders also have reason to be proud of its home care agency,
a "small but mighty" group of home health and
hospice staff that treats about 120 patients a day. Citizens'
home care team has been using MEDITECH's Home
Health product, to
provide efficient care to its home and hospice patients since
2002. But more recently, they also wanted to implement
telehealth technologies, specifically MEDITECH's well@home
telemonitoring technology, to reach out to the growing number
of patients with one or more chronic diseases.
"Our goal in home care is to keep patients out of the
hospital," says Valerie Noblitt, director of home care
services for Citizens Memorial. "In adopting well@home,
we were really focused on helping those patients with chronic
diseases to manage their conditions, and avoid ER visits
whenever possible."
Establishing
a Telehealth Network Program
To accomplish these objectives, Citizens created a telehealth
network program called Project Infocare: In-Home
Telemanagement, which was funded by the U.S. Department of
Health and Human Services Health Resources and Services
Administration.
"The purpose was to integrate in-home telemanagement
into our existing Project Infocare Electronic Medical Record
network, which incorporates data from across all of our
facilities—including the hospital, home care agency,
five long-term care buildings, and 16 physician clinics,"
says Noblitt. "But most importantly, this project was
initiated to measure the impact of telemanagement technology
on our home care population."
A study measured key results among three groups: 1) patients
without in-home telemanagement, 2) patients with in-home
telemanagement monitored by a nurse, and 3) patients with in-home
telemanagement actively monitored by a physician. Citizens'
goal was not only to evaluate whether or not in-home
telemanagement in an EMR environment improved quality of care
and outcomes, but also to gauge the potential impact of
having a physician or nurse monitor that data on a daily
basis.
"The well@home devices enabled patients to self-report
prescribed assessments such as weight and blood pressure,
learn more about their diseases, view tutorials on how to
properly perform physiologic measurements and their
prescribed treatments, and receive reminders to take their
medications," says Jennifer Earl, IS specialist for
Citizens Home Care. "Those assessments were then
electronically submitted to our EMR. And we soon saw that
telemanagement does work, and having nurses monitor the data
was equally as helpful as having physicians doing that."
Beating
the Benchmarks
One major improvement shown was in the reduction of hospital
re-admissions among the telehealth group: just 9% of those
patients were readmitted after discharge, far lower than the
national benchmark of 29%. Furthermore, Citizens continues to
experience improvements in emergent care episodes, admission
rates, re-hospitalizations, and home care visits from the
Project Infocare initiative, as well as a reduction in home
care-related costs. As a result, Citizens has been named to
the OCS Home Care
Elite list, a
compilation of the most successful Medicare-certified home
health care providers in the U.S., for the past two years.
"Telehealth has made a such big impact on our community,"
says Earl. "We are looking forward to using this
technology even more, with some different patient populations.
We figured, why not use home care to bring convenient care to
more patients? There's no reason not to."
MEDITECH
Medical
Information Technology, Inc.
MEDITECH Circle
Westwood, MA 02090
781-821-3000
www.meditech.com