NEW YORK, NY--(Marketwire - Feb 27, 2013) - AMC Health, a leading provider of telehealth solutions, presented a webinar discussing how a remote diabetes telemonitoring program at New York City Health and Hospitals Corporation (HHC) offers providers, accountable care organizations (ACOs) and insurers a national model for improving quality, coordination, cost effectiveness and management of diabetes and other chronic conditions. The webinar expanded upon study findings published in the Nov. 21, 2012 issue of the Journal of Managed Care Medicine.
The webinar, "Telemonitoring and Case Management Improve Diabetes Care: Lessons from the Front Lines," provided more than 360 participants with findings, insights, tips and tactics for establishing a successful telemonitoring program based on results from HHC's House Calls Telemonitoring program for Medicaid patients. High-risk patients in this program lowered HbA1C blood glucose levels by a significant 1.8 points and many become actively engaged in managing their disease and changing behaviors.
A recording of the webinar -- including questions and answers -- and a copy of the presentations are available for free at: http://www.amchealth.com/resources/webinars.php.
Presenters Jonathan Shankman, vice president of analytics and product development at AMC Health; Susan Lehrer, RN, BSN, CDE, associate executive director care management program at HHC; and Gary Welch, PhD, director of behavioral medicine research at Springfield, Mass.-based Bay State Medical Center described how telehealth solutions from AMC Health combined with HHC's nurse case management improved clinical and financial outcomes.
Shankman discussed the rationale for telehealth and previous research about its effectiveness, including highlights from several seminal peer-reviewed published studies and provided an overview for the state of telehealth program in the U.S. He discussed that despite the thousands of descriptions of telehealth implementations and pilots around the world, including a handful of randomized controlled trials, "... most of them do not map out a sustainable working model for a telehealth program, nor do they provide practical insights about how to implement and embed an effective telecare process into chronic disease management." He outlined how the HHC study is unique because it addresses "all those points and offers a road map for improving the quality, outcomes and cost effectiveness of care for the chronically ill."
Lehrer described the components and challenges of the House Calls program such as slow buy-in /resistance from clinicians, patients' poor overall and health literacy, a lack of understanding about their disease(s), and the need to modify some workflow processes. She also provided suggestions about how these and other challenges can be overcome.
Lehrer also identified what's needed to create and maintain a successful telehealth program and lessons learned from the HHC study, especially about unrealistic expectations surrounding how quickly patients can become knowledgeable, engaged and achieve self-management.
Dr. Welch provided specific program outcomes such as enabling high-risk patients enrolled in this program to lower their HbA1C blood glucose levels by an average of 1.8 points from a baseline of 9.8 percent. Every 1 percent drop in HbA1C decreases:
- Heart attacks by 14 percent
- Heart failure by 16 percent
- Strokes by 12 percent
- Peripheral vascular disease including amputations by 43 percent
- Diabetes-related complications and mortality by 21 percent
The program participants naturally fell into four subgroups, which influenced the benefit they received. Although all enrollees -- including those who dropped out -- experienced some improvement, the degree varied:
- Patients who dropped out voluntarily reduced HbA1C by an average of 1.4 percent
- Individuals who were excluded from the program after 10 months because they moved, died, did not adhere to the program or were no longer eligible, lowered their HbA1C by an average of 1.3 percent
- Persons who achieved the program's clinical goals consistently over 3 months cut their HbA1C by an average of 3.3 percent
- People who remained in program for at least two years but did not reach target control levels still reduced their HbA1C level by 1.9 percent
Webinar attendees also learned that patients demonstrated sustained participation in regular self-management tracking behaviors such as measuring their blood glucose levels and blood pressure and they consistently took part in weekly diabetes self-management and problem-solving phone sessions.
All the presenters shared their insights, suggestions and experiences with the more than 350 webinar attendees from hospitals/health systems, physician practices, payers, pharmaceutical manufacturers, universities, health associations, regulatory agencies, home health programs, and other organizations. Representing urban, suburban, town and rural communities in 44 states, Washington, D.C., Puerto Rico and Canada, attendees provided a wide-ranging geographic perspective, which contributed to a lively question and answer session following the presentations.
Among many takeaways, webinar attendees should now realize that:
- Providers and payers can realize substantial clinical and financial outcomes from telehealth.
- Clinicians can conduct very effective interactions and interventions remotely.
- Successful chronic disease management does not have to be as difficult as it has been because telehealth enables rapid coordination and intervention in a timely fashion.
- It is unrealistic to expect patients to manage their condition on their own without ongoing support and reinforcement from providers.
According to Shankman, "These takeaways show telehealth is an excellent fit for providers moving to implement medical homes, accountable care organizations and other delivery models that tie reimbursement to quality, care efficiency and outcomes achieved. Organizations that incorporate home telemonitoring will be better positioned to optimize care, reduce readmissions, manage the chronically ill and navigate the shift from fee-for-service to value-based purchasing."
About AMC Health
With headquarters in New York City, AMC Health is a leading provider of end-to-end telehealth solutions that provide customized, scalable, cost-effective programs that assist organizations serving at-risk populations. These programs deliver clinically actionable information that enhances care coordination, improves patient outcomes and reduces the overall cost of healthcare. For more information, visit www.amchealth.com.