Philips Hospital-to-Home (H2H)System Improves Patient management Outcomes

Saturday, April 9th, 2011 at 10:57 AM

As the feds and payors focus on curbing readmission rates, hospitals and caregivers need to revisit management of the hospital-to-home transition. Philips Healthcare shared a new multi-vendor, multi-disciplinary model during the annual meeting of the American College of Cardiology.

Philips pointed out that although incentives are not aligned to reduce readmissions currently, the paradigm will reverse on Oct. 1, 2012, when Medicare will no longer reimburse for heart failure and acute MI patients who are readmitted within 30 days of their initial hospital stay.

The Hospital to Home (H2H) Learning Destination at ACC.11 walked visitors through three patient scenarios and illustrated how technology could improve patient management and outcomes.

The H2H Learning Destination focused on three patients: Jose, an acute MI patient treated with a stent and subsequently diagnosed with sleep apnea; Brian, a stage III heart failure patient with diabetes, hypertension and sleep apnea; and Maria, an 82-year old suffering worsening atrial fibrillation despite a transcatheter aortic valve replacement and antiarrhythmic medications.

Jose’s hospital stay entailed standard clinical systems such as echocardiography and 16-lead cardiograph, with patient data stored in the cardiology information system. Other components were cableless monitoring of NBP S_pO₂, sleep diagnostics, a hospital registry for MI patients and discharge planning including risk stratification.

After discharge, Jose was provided with a CPAP sleep therapy system and an activity monitor in the home. Other tools to engage the MI patient in his care included social media and a personal health record. Community providers also were engaged in Jose’s care through sleep diagnostics and sleep apnea monitoring, a centralized telehealth center and 30-day readmission risk profiling.

Brian received similar in-hospital services. However, his stay included placement of a CRT-D implant. Bedside patient education and a patient monitor with an early warning system and centralized monitoring were employed in the hospital. This centralized telehealth center incorporates two-way audio and video capabilities and allows nurses to escalate care as needed.

Post-discharge, Brian’s plan included diuresis center monitoring, sleep diagnostics, sleep apnea monitoring, supplemental oxygen, home telehealth monitoring, remote cardiac monitoring and remote monitoring transmitters. Instructive components included social media, a personal health record and patient education. An automated medication dispensing system helped Brian to manage multiple medications. Brian also was enrolled in an ambulatory quality improvement registry.

Providers stressed that a comprehensive model that weds education, multidisciplinary management and consistency and standardization is key to addressing the readmission challenge.