Telehealth Effective for At-Home Healthcare

Telehealth, which is healthcare delivered remotely over the Internet, offers more than just a virtual visit from your doctor. Telehealth can also be used to proactively monitor patient health as a way to improve outcomes for long-term chronic conditions.

This fall a new study was released that showed the efficacy of remote monitoring of blood pressure. This latest research suggests that home monitoring of blood pressure readings at home is actually more effective than traveling to the doctor’s office.

Could it be that telehealth is more effective than the traditional doctor visit in other treatment areas? What are the results of the study and how can the data be extrapolated across the healthcare delivery network?

Remote monitoring is a subset of telehealth technology. The technique uses remote technology to track patient metrics and transmit that data to a remote clinician for diagnoses and treatment. There are many applications for this technology, and mHealth Intelligence says they are all becoming increasingly popular. Currently, here are some of the latest applications for telehealth remote monitoring:

• The Robert Wood Johnson University Hospital in New Jersey offers ER consults that bring together patients with hospital staff in crisis settings. The hospital uses these tools to send patient data to remote specialists while also offering the option of having real-time video conferencing.
• Remote monitoring is being used in a variety of settings to help senior cardiac patients improve outcomes, provide physician coverage in nursing facilities, and used across an entire country to connect patient data with caregivers.

While remote monitoring is just one subset of telehealth, a new study now shows that at-home blood pressure monitoring is actually more effective for diagnosis and treatment of these conditions than the traditional in-office medical visit.

In September 2018, the American Heart Association released new findings that showed home monitoring of blood pressure readings is more effective than in-office monitoring. The study was part of a pilot presented at the organization’s Joint Hypertension 2018 Scientific Sessions.

The Centers for Disease Control and Prevention (CDC) says that one in three Americans suffers from hypertension. That’s 75 million Americans — and the CDC says only around half (54%) have the disease under control.

Guidelines from the American Heart Association suggest that one way to get these numbers under control is to establish remote monitoring of patient blood pressure levels to help manage the disease. However, most clinical treatment plans do not require home pressure monitoring.

The AHA cited a study by Scott and White in Texas, which sought to establish remote patient monitoring of blood pressure levels as both a way to bring the disease under control, but also to gather more accurate patient data. Many patients suffer from a syndrome called “white coat hypertension,” which is a phenomenon that causes blood pressure to rise when a patient feels anxiety just from attending a traditional medical visit. When patient data is inaccurate, physicians may prescribe inappropriate amounts of medication and the quality of care could decline. Berkeley Wellness suggests that:

It may, in fact, be harmful to prescribe anti-hypertensive medication if blood pressure is normal when measured at home. That’s because, under those circumstances, the medication could cause your blood pressure to fall too low, putting you at risk for fainting.

The Scott and White study looked at data showing that 86% of patients using telehealth remote monitoring devices to chart blood pressure were able to keep their disease under control. The health system then provided free remote monitoring devices to 2,550 adults with chronic uncontrolled high blood pressure. The study found:

• By the third office visit, almost 67% of the patients in the study had better outcomes; physicians had more accurate readings and were able to bring their blood pressure back under control.
• Systolic blood pressures had decreased on average by 16.9 mmHg and diastolic fell by 6.5 mmHg on average at the end of the intervention.
• Six months after the study, almost 80% of participants achieved blood pressure control.

The study concluded, “Home blood pressure monitoring is vital to achieving control among hypertensive patients.” They also determined the cost savings when using a telehealth intervention included reduced inpatient hospitalizations, ER visits, and medication costs.

CMS has been paying attention to the cost savings and health benefits of telehealth applications. In July, mHealth Intelligence reported that the agency proposed changes to the Home Health Prospective Payment System that would allow home health agencies to request reimbursement for remote patient monitoring on the Medicare cost report form.

This is all part of the CMS initiative to embrace emerging technologies like telehealth to improve care quality, access, and reduce costs. Interestingly, earlier this year, 10-states moved to change their telehealth reimbursement policies to make the patient home an originating site. All of these changes come just after CMS launched MyHealthEData, with the goal of “putting patients at the center of their own care through seamless health data access.”

MyHealthEData would allow patients to “own” their healthcare data, instead of the hospital or medical practice “owning” the information in their EMR.

Remote monitoring is just one of the options for using telehealth technology. Ortho Live offers a telehealth application that is designed specifically for orthopedic providers. Through the use of our customizable, HIPAA-compliant desktop or smartphone application, we link orthopedists with their patients in a virtual visit that brings the doctor, literally, to where the patient lives. We believe that telehealth can positively impact the doctor/patient relationship by improving outcomes and access to care. Today, OrthoLive is using telehealth:

• To bring back the doctor house call and provide more convenient care.
• To bring sports medicine to America’s playing fields.
• To provide faster back-to-work ratios for workers’ compensation cases.
• To eliminate the uncomfortable back-and-forth for routine checks in the orthopedic patient.
• To give older doctors a steady stream of retirement income later in life.

Telehealth can do all these things – and more. Talk with the team at OrthoLive to find out how telehealth can change your practice.