Impact of patient-centred home telehealth programme on outcomes in heart failure

Abstract

Background Telehealth is a promising intervention to reduce readmissions and healthcare-associated costs in patients with heart failure. Methods We performed a retrospective analysis of the impact of telehealth on 197 heart failure patients who had successfully completed one year of home telehealth monitoring following a heart failure admission as part of a clinically mandated programme at a Veterans Affairs Medical Center. Outcomes were compared both within the group (one year before and one year after home telehealth monitoring), and to a contemporary control cohort of 870 heart failure patients who were admitted but not enrolled in home telehealth. The following outcomes were analysed: admissions for any cause, heart failure admissions, total hospital days per patient, average length of stay per admission, urgent care and emergency room visits, and primary care visits. Results Both the home telehealth and control cohorts consisted of older male patients. Total hospital days per patient was significantly reduced by home telehealth monitoring in the home telehealth group (2.4 ± 3.5) in comparison to the previous year without monitoring (4.1 ± 4.6, p < 0.0001) and to the control group (3.8 ± 5.3, p < 0.001). A significantly lower admission rate (1.1 ± 1.6) and length of stay (5.7 ± 11.3 days) were observed during home telehealth monitoring within the home telehealth group compared to the prior year (1.6 ± 1.7, p < 0.05 and 9.5 ± 14 days, p < 0.01 respectively) but not in comparison with the control group (1.4 ± 2.0, p < 0.07). The home telehealth group also had a significantly lower length of stay when compared to the control group (5.7 ± 11.3 vs 9.0 ± 14.9, p < 0.01). The number of urgent care and emergency room visits, or primary care visits, was not significantly different during home telehealth monitoring as compared to the prior year. Conclusions Personalised and patient-centred home telehealth monitoring in heart failure patients was successful in reducing outcomes without an increase in outpatient and urgent care visits.

Comparing telehealth to traditional office visits for patient management in the COVID-19 pandemic: A cross-sectional study in a respiratory assessment clinic

“…and home healthcare, to our knowledge, there has been little direct study of subsequent utilization after telehealth visits. [31][32][33][34] Gordon et al did a similar study in 2017 examining urgent care visits completed via telehealth vs. in-person care and found similar healthcare utilization for each modality after the initial visit, supporting our findings here. 35 This study adds value to the telehealth conversation because it examines subsequent care utilization after telehealth appointments, a key metric in the viability of telehealth in this setting.…”

Changes in the digital health landscape in cardiac electrophysiology: A pre-and peri-pandemic COVID-19 era survey

“…This increase in adoption is particularly important as some studies are beginning to suggest that video-telehealth consultations improve patient access to specialty care, decrease hospital J o u r n a l P r e -p r o o f admissions or emergency room visits, and possibly improve outcomes. 9,10 Some patients and clinicians who have used virtual video visits find them to be equivalent to in-person visits, without a perceived differential in the quality of care. 11,12 In a study from the Cleveland Clinic cardiac EP group, 60% of patients and nearly 70% of clinicians preferred to continue with virtual telehealth visits for further follow-up care.…”

Assess the Performance and Cost-Effectiveness of LACE and HOSPITAL Re-Admission Prediction Models as a Risk Management Tool for Home Care Patients: An Evaluation Study of a Medical Center Affiliated Home Care Unit in Taiwan

“…Our results reveal a 40% reduction in the readmission rate by proactively targeting preventive intervention toward high-risk hospitalizations of home care patients. Previous studies also showed that a great portion of 30-day readmissions are avoidable through a series of resource-intensive interventions, including post-acute support, post-discharge monitoring [24], telehealth rehabilitation programs [25], and home care case management [26,27]. A readmission prediction model is of course the very first step to stratify patients and optimize resource utilization for home care patients.…”