The ADOPT Toolkit: Planning and Building Best-in-Class Remote Patient Monitoring Programs
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1 The ADOPT Toolkit: Planning and Building Best-in-Class Remote Patient Monitoring Programs November 15, 2012 AgeTech Conference 1
2 Agenda Background and Goals Using the ADOPT Toolkit RPM Toolkit Applications ADOPT Toolkit in Practice Q&A 2
3 Today s Presenters David Lindeman, PhD Director Center for Technology and Aging Valerie Steinmetz, MPH Program Director Center for Technology and Aging Alan Little, MBA Senior Advisor Center for Technology and Aging 3
4 The Center for Technology and Aging Center for Technology and Aging s mission: To accelerate diffusion of proven technologies ( ADOPT ) National resource center on health technologies that promote better care, better outcomes, and lower costs for chronic disease management and the independence of older adults Conducted technology demonstration projects with over 100 US health care and aging services organizations Professional services, research and evaluation, information dissemination, and public policy 4
5 CTA Technology Demonstration Grants Medication Monitoring and Adherence Remote Patient Monitoring Technologies for Improving Post Acute Care Transitions Mobile Health Solutions Improve efficiency of care delivery Improve health outcomes Reduce the cost of care Improve chronic disease management Increase the rate of adoption 5
6 The ADOPT Toolkit Aim is to help organizations quickly and effectively develop and scale technology-enabled solutions for chronic disease management (e.g., remote patient monitoring, mhealth) A collaboration between CTA, grantees, health care organizations, and experts Web-based toolkit for planning, development and implementation of technology-enabled solutions Consists of guides, practical examples and models, templates 6
7 Remote Patient Monitoring Toolkit Contributors 1. AltaMed Health Services 2. California Association for Health Services at Home 3. CalOptima 4. Centura Health at Home 5. Dignity Health 6. HealthCare Partners Institute 7. NEHI / Atrius Health 8. Sharp HealthCare 9. Veterans Administration (Central CA) 7
8 Acknowledgements 8
9 Agenda Background and Goals Using the ADOPT Toolkit RPM Toolkit Applications ADOPT Toolkit in Practice Q&A 9
10 Orientation to ADOPT Toolkit Website Toolkit Structure Toolkit Focus Areas Workstream Framework Access and Select Tools Review and Provide Feedback toolkit.techandaging.org 10
11 ADOPT Toolkit Homepage Register to access tools Click on the About ADOPT tab for directions on how to use the toolkit website Access all 4 toolkits from the homepage Learn more about CTA and CTA services through the respective tabs 11
12 Toolkit Structure: Four Focus Areas 12
13 8 Workstreams Workstreams are not sequential Program Team can self-select to workstreams they are interested in 13
14 RPM Program Planning Download Guides First Sub-task Tools Sub-task Download Individual Tool Tools 14 Download all Workstream Tools in a Zip file
15 Two Routes to Select Tools 15
16 CTA ADOPT Toolkit: Remote Patient Monitoring RPM technologies help manage and monitor health conditions of older adults, particularly those with chronic illness, and people who have trouble accessing care. Includes standalone or integrated home monitoring devices and peripherals Top five targeted health conditions being monitored Heart failure 77.1 percent Diabetes 74.3 percent COPD 54.3 percent Medication adherence 54.3 percent Asthma 42.9 percent (2011 Performance Benchmarks in Telehealth and Telemedicine) 16
17 Benefits of Remote Patient Monitoring Improve monitoring of patients between office visits and hospitalizations Change patient behavior Increase patient, caregiver, and clinician engagement Reduce ED and hospital visits Improve care management Provide patient education Improve patient and clinician satisfaction 17
18 Agenda Challenges in Today s Health Care Ecosystem Using the ADOPT Toolkit RPM Toolkit Applications Alan Little, MBA Senior Advisor Center for Technology and Aging ADOPT Toolkit in Practice Q&A 18
19 Before Getting Started The Role of Technology Executive Champion Managing Expectations Acting on Actionable Data Planning and Design Operational Workflows Ability to Scale Patient and Provider Engagement 19
20 RPM Starter Kit 20
21 Addressing Challenges 1 Organizations often do not sufficiently understand program goals, clinical focus, or operational capacity Question: How prepared are we to implement an RPM program? What will success look like? ADOPT Section: Program Planning Tool: Telehealth Organizational Readiness Assessment 21
22 Example Readiness Assessment 22
23 Example Readiness Assessment 23
24 Addressing Challenges 2 Organizations often struggle with how to promote the program and engage all operational and management levels Question: How can I best communicate RPM general concepts and potential results? ADOPT Section: Program Planning Tool: Making the Case for RPM 24
25 Example Making the Case for RPM 25
26 Addressing Challenges 3 Organizations often struggle to fully anticipate all program related costs (one-time and recurring) Question: What are the initial program costs and what should I budget for next year? ADOPT Section: Financial Management Tool: Remote Patient Monitoring Program Model Budget 26
27 Example Program Model Budget 27
28 Addressing Challenges 4 Organizations often do not fully analyze the potential cost benefit Question: What are the program costs and potential returns? ADOPT Section: Financial Management Tool: ROI Calculator 28
29 Example ROI Calculator 29
30 Agenda Background and Goals Using the ADOPT Toolkit RPM Toolkit Applications ADOPT Toolkit in Practice Q&A 30
31 Sharp HealthCare Remote Patient Monitoring Initiative 12/ /2011 Focus: To reduce 30-day readmissions for heart failure patients using remote patient monitoring technology with the support of The Center for Technology and Aging and the San Diego Beacon Community Goal Statement: Reduce 30-day readmissions by 30%. The RPM 30-day readmission rate was 10%, compared with a 20.7% rate for the reference group. Patient Population: Underserved (Medi-Cal, Unfunded, County Medical Services) or Medicare Fee for Service patients at Sharp Grossmont Hospital (SGH) or Chula Vista Medical Center diagnosed with Class II or III stage heart failure with a reference group of similarly diagnosed patients, with the same payor mix who were not enrolled in the RPM program. 30-Day Readmissions: Results for patients enrolled for at least 30 days (Sharp s 20%) Status Readmits/ Total Pts 30-Day Readmit Rate Dis-enrolled* 3 / 15 20% Graduated: 5 / % Overall: 8 / 80 10% * Disenrollment reasons: Surgery, admit to SNF, moved out of region, worsening CHF, patient/family request, death, admit to hospice) Intervention: Remote Patient Monitoring device used daily to measure weight and functional status via yes/no questions coupled with nurse education and health coaching which included at least two home visits. 31 Lean Six Sigma Department
32 Define Measure Analyze Improve Control Benefits of Toolkit Facilitates quick program start (from decision to enrolling first patient) Allows project leaders to focus on intervention design rather than administrative work Reliable documentation Collateral comes from organizations that have a proven track record with patient satisfaction and patient care outcomes Change Management Strategy Sharing that program was designed using input/tools from successful projects will help with buy in from stakeholders 32 Lean Six Sigma Department
33 Sharp RPM Example: Self-Care Heart Failure Index (SCHFI) Patient Activation Survey SCHFI Maintenance Score Goal > 70% Better Pre SCHFI score Post SCHFI score Patient scores above 70% - indicative of self activation. 98% of patients scored above the target of 70% on the maintenance domain of the SCHFI survey after completing the program. 33 Lean Six Sigma Department
34 Agenda Background and Goals Using the ADOPT Toolkit RPM Toolkit Applications ADOPT Toolkit in Practice Q&A 34
35 CTA Services and Technical Assistance Additional focus areas and tools for ADOPT Toolkit Technology for Care Transitions Late 2012 mhealth Toolkit Early 2013 CTA services and technical assistance Technology Readiness Assessments Technology Implementation Planning & Evaluation Technology Learning Collaboratives Contact: 35
36 ADOPT Toolkit - Q&A Contact CTA: support@techandaging.org
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