Patient Generated Health Data: Preventing Readmissions and

Achieving the Triple Aim

Presented by Brad Tritle, CIPPPresident / CEO

vitaphone e-health solutions USA

September 12, 2014

Presentation Objectives

• To define and explain Patient Generated Health Data

• To define the Triple Aim and identify how Remote Patient Monitoring achieves it

• To show examples of Remote Patient Monitoring that reduced Readmissions

• To show vitaphone processes as an example of Remote Patient Monitoring

Prediction

• “within 5 years, the majority of clinically relevant data…will be collected outside of clinical settings.”*

• Dr. Gregory Abowd, Distinguished Professor, Georgia Tech;

• 2011 American Medical Informatics Association (AMIA) Keynote Address

Definitions

• Patient Generated Health Data (PGHD): • “PGHD are health-related data—including health history, symptoms, biometric data,

treatment history, lifestyle choices, and other information—created, recorded, gathered, or inferred by or from patients or their designees (i.e., care partners or those who assist them) to help address a health concern.”

- HHS ONC PGHD White Paper

• Remote Patient Monitoring (RPM): • “Type of ambulatory healthcare where patients use mobile medical devices to perform a routine test and

send the test data to a healthcare professional in real-time.  Remote monitoring includes devices such as glucose meters for patients with diabetes and heart or blood pressure monitors for patients receiving cardiac care.”

-- American Telemedicine Association

• Triple Aim: 1. Improving the patient experience of care (including quality and satisfaction);

2. Improving the health of populations; and

3. Reducing the per capita cost of health care.

-- Institute for Healthcare Improvement (IHI)

Telemedicine Service Center

• Telemedicine Service Center (TSC): • A clinical call center that both monitors biometric data –

triaging and filtering alerts as they arise – and engages and educates patients. It delivers Remote Patient Monitoring and Patient Engagement/Education Programs.

• Vitaphone operates TSCs in both Germany and the U.S. The German operation was the first ISO-certified TSC in the world.

Examples of Patient Generated Health Data

According the US Government (HealthIT.gov) PGHD include, but are not limited to:• health history• treatment history• biometric data• symptoms• lifestyle choices

Examples include blood glucose monitoring or blood pressure readings using home health equipment, or exercise and diet tracking using a mobile app.

vitaphone extends the providers’ reach across time and space – into the home – to collect PGHD

Physician

Patient

PGHD: Devices &Questionnaires

- Management Organizations

- Contract Research Organizations

- Telemedicine Service Center

vitaphone extends the providers’ reach across time and space – into the home – to collect PGHD

And we couple it with health questionnaires and educational content. Goal: An Activated Patient

Examples:

Weekly questionnaireAlert questionnaireOutline of educational materialSupporting collateralWhat is heart failure?How do I manage my medicines?How can I live with heart failure? And much more…..

Telemedicine for the Heart: A Congestive Heart Failure Program Yielding 2 of the Triple Aims

Partners: German Foundation for the Chronically IllAssociate Partners: Techniker Krankerkasse

Start of Project: January 1, 2006End of Project: Unlimited (ongoing)

Number of Patients: 1,100

NYHA Stage I: 0NYHA Stage II: 627NYHA Stage III: 429NYHA Stage IV: 44

Transmitted Biometrics: Body weight, heart rate, blood pressure

Duration: 6 to 27 months per patient

Result: 21.5% fewer hospitalizations compared to control group. P=.03 1. Increased Quality2. Savings!

Other Industry Evidence of Reduced Readmissions/Savings (2 of the Triple Aims)

New England Healthcare Institute: • 60% reduction in readmissions and $5,034 savings/patient/year

compared to standard care• 50% reduction in readmissions and $3,703 savings compared to

disease management without monitoring

Veteran’s Health Administration• 25% reduction in bed days• 20% reduction in readmissions

Meridian Health• Reduced CHF readmission rates from 14.9% to 4.8%

TEN-HMS Study (Europe)• 25% reduction in bed days• 10% cost savings compared with nurse telephone support• 2.1X Return on Investment, compared to nurse telephone support

Check out the Oakland-based Center for Tech and Aging for additional positive outcomes here in California!!! www.techandaging.org

The Third Aim: Improving the Patient Experience

Patient Experience Survey: 1 = Strongly Disagree; 2 = Disagree; 3 = Neither Agree/Disagree4 = Agree; 5 = Strongly Agree

The courtesy call was helpful in understanding the program

4.62

The equipment was easy to use 4.45The weekly follow up calls and education were useful 4.62I learned new information that will be helpful in managing my hypertension

4.41

I better understand my hypertension, risk and key management principles that will help to better manage my condition

4.45

The staff was friendly and courteous 4.69

From the vitaphone “30 Days to Make a Difference” hypertension pilot (published in JHIM Fall 2013)

Triple Aim #1 - Enhance Patient Care

• Assisting with accuracy and speed of diagnosis

• Enabling fast design and optimization of the care path, including medications

• Identifying and preventing issues before they become acute events

• Facilitating doctor-patient and loved one - patient communication between visits

• Providing a case management infrastructure that enables a continuum of care

• Increasing patient engagement, and knowledge of their disease, combined with the awareness of being monitored (reactivity phenomenon), leads to improved compliance

Triple Aim #2 - Reduce Costs

• Readmission Reduction. Continuous evidence – based medical information provides early intervention and improved treatment analysis.

• Thresholds and alerts provide a “closed loop” for fast communication and actions.

• Better understanding of the patient’s condition allows stratification of risk and care.

• The patient to nurse ratio can increase and still allow the HIGH TOUCH aspects of care.

• Accurate, timely and organized information provides better diagnoses and treatment and supplements Meaningful Use initiatives.

• Moving care to the least cost point of care

Triple Aim #3 - Increase patient satisfaction

Patients feel that you care for them, even when you’re not “there.”

• Product and services are easy to set up and use.

• The entire health team, including the patient, is more involved and informed.

• Weekly patient questionnaires and educational modules support care continuity

• Satisfaction survey the final week

• Post-test of patient’s understanding of their disease, medications, risks, complications, etc. (covered in educational modules)

The future of PGHD, reduced readmissions and Triple Aim achievement?

Brad Tritle – President / CEO

btritle@vitaphoneus.com

P: 702-374-1270

Sales

Bruce Bowers – National Sales Manager

Chronic Disease Management

bbowers@vitaphoneus.com

P: 602-791-3066

Opportunities