Strategies to Improve Time to Activation within an Ambulatory Remote Patient Monitoring Program
DOI:
https://doi.org/10.30953/tmt.v7.361Keywords:
Remote Patient Monitoring, RPM Strategies, Care Coordination, Quality Improvement, Process OptimizationAbstract
Remote patient monitoring (RPM) programs have been shown to effectively decrease rates of healthcare utilization among patients with chronic conditions. Immediately enrolling a patient and activating them in the RPM program either upon or soon after discharge is an important step in achieving these benefits. We tested interventions across three Plan-Do-Study-Act quality improvement cycles to understand the extent to which operational improvements would lead to timely activation. Each improvement cycle resulted in decreased time to activation, with the cumulative effect (as applied to patients on the COVID-19 RPM program) resulting in a reduction that was overall greater than the sum of the individual improvements. As additional healthcare systems develop and deploy RPM programs, the learnings from this project can help to provide insight into the operational and logistical challenges encountered in providing these services as well as potential interventions that can be used to achieve timely activation.
Downloads
References
Roberts AW, Ogunwole SU, Blakeslee L, Rabe MA. The population 65 years and older in the United States: 2016 [Internet]. Washington, DC: U.S. Census Bureau; 2018 [cited 2021 November 5]. Report No.: ACS-38. Available from: https://www.census.gov/content/dam/Census/library/publications/2018/acs/ACS-38.pdf
Colby SL, Ortman JM. Projections of the size and composition of the U.S. Population: 2014 to 2060 [Internet]. Washington, DC: U.S. Census Bureau; 2015 [cited 2021 November 5]. Report No.: P25-1143. Available from: https://www.census.gov/content/dam/Census/library/publications/2015/demo/p25-1143.pdf
Atella V, Piano Mortari A, Kopinska J, Belotti F, Lapi F, Cricelli C, et al. Trends in age-related disease burden and healthcare utilization. Aging Cell [Internet]. 2019 [cited 2021 November 5];18(1):e12861.Available from: https://onlinelibrary.wiley.com/doi/10.1111/acel.12861
Maresova P, Javanmardi E, Barakovic S, Barakovic Husic J, Tomsone S, Krejcar O, et al. Consequences of chronic diseases and other limitations associated with old age—a scoping review. BMC Public Health. 2019:19;1431. doi: 10.1186/s12889-019-7762-5
Bazzoli GJ, Brewster LR, Liu G, Kuo S. Does U.S. hospital capacity need to be expanded? Health Aff. 2003:22(6);40–54. doi: 10.1377/hlthaff.22.6.40
Hansen LO, Young RS, Hinami K, Leung A, Williams MV. Interventions to reduce 30-day rehospitalizations: a systematic review. Ann Intern Med. 2011;155(8):520–8. doi: 10.7326/0003-4819-155-8-201110180-00008
UpToDate [Internet]. Wolters Klower; c2021. Hospital discharge and readmission [updated 2021 September 30; cited 2021 November 5]. Available from: https://www.uptodate.com/contents/hospital-discharge-and-readmission
Crossen-Sills J, Toomey I, Doherty M. Strategies to reduce unplanned hospitalizations of home healthcare patients: a step-by-step approach. Home Healthc Nurs. 2006;24(6):36976. doi: 10.1097/00004045-200606000-00007
Su D, Michaud TL, Estabrooks P, Eiland LA, Schwab RJ, Hansen G, et al. Diabetes management through remote patient monitoring: the importance of patient activation and engagement with the technology. Telemed J E Health. 2019:25(10):952–9. doi: 10.1089/tmj.2018.0205
Haddad TC, Blegen RN, Prigge JE, Cox DL, Anthony GS, Leak MA, et al. A scalable framework for telehealth: the Mayo Clinic Center for Connected Care response to the COVID-19 pandemic. Telemed Rep. 2021;2(1):78–87. doi: 10.1089/tmr.2020.0032
Coffey JD, Christopherson LA, Glasgow AE, Pearson KK, Brown JK, Gathje SR, et al. Implementation of a multisite, interdisciplinary remote patient monitoring program for ambulatory management of patients with covid-19. NPJ Digit Med. 2021;4:123. doi: 10.1038/s41746-021-00490-9
Healthcare Cost and Utilization Project [internet]. Rockville, MD: Agency for Healthcare Research and Quality; 2017. A comparison of all-cause 7-day and 30-day readmissions; [updated 2017 October 31; cited 2021 October 12]. Available from: https://www.hcup-us.ahrq.gov/reports/statbriefs/sb230-7-Day-Versus-30-Day-Readmissions.pdf
Ponniah A, Shakib S, Doecke CJ, Boyce M, Angley M. Post-discharge medication reviews for patients with heart failure: A pilot study. Pharm World Sci. 2008;30(6):810. doi: 10.1007/s11096-008-9230-7
Logue MD, Drago J. Evaluation of a modified community based care transitions model to reduce costs and improve outcomes. BMC Geriatr. 2013;13:94. doi: 10.1186/1471-2318-13-94
Plan-Do-Study-Act (PDSA) directions and examples [Internet]. Rockville, MD: Agency for Healthcare Research and Quality; 2020. Available from: https://www.ahrq.gov/health-literacy/improve/precautions/tool2b.html
Ting DSW, Carin L, Dzau V, Wong TY. Digital technology and COVID-19. Nat Med. 2020;26:459–61. doi: 10.1038/s41591-020-0824-5
Bailey JE, Gurgol C, Pan E, Njie S, Emmett S, Gatwood J, et al. Early patient-centered outcomes research experience with the use of telehealth to address disparities: scoping review. J Med Internet Res. 2021;23(12):e28503. doi: 10.2196/28503.
Published
How to Cite
Issue
Section
License
Copyright (c) 2022 Mark Stemler, Nicole Ploog, Shelby Gathje, Jordan Coffey
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Authors retain copyright of their work, with first publication rights granted to Telehealth and Medicine Today (THMT).
THMT is published under a Creative Commons Attribution-NonCommercial 4.0 International License.
