Improve Patient Outcomes through Post-Discharge Virtual Care

June 24, 2019 Auto Bot News 0

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New approaches to care management are
required as our nation faces a wave of aging
Americans with new and increasing healthcare
needs. Adding headwinds to this scenario are the
anticipated physician shortage and a continued
push toward value-based care. 
In this whitepaper, learn the benefits of virtual care
and the strategies providers should be considering
now to take advantage of the growing technology. 
<h2>The Need for Virtual Care</h2>
The demographic numbers are quite striking:
<ul>
<li>By 2030, there will be more than 80 million Americans 65 or older – up from 56 million today. </li>
<li>Not only is a larger aging population anticipated – they are
also expected to be sicker, with more than 66 percent of
Medicare beneficiaries having two or more serious and costly
chronic conditions. </li>
<li>A recent report by the nonpartisan Congressional Budget Office (CBO) stated that “while the sheer number of older adults is rising, so too is the cost of their healthcare as individuals are more frequently living with multiple chronic and complex medical conditions.”</li>
</ul>
This comes at the same time our nation is looking at an impending physician shortage. According to the Association of American Medical Colleges, the US is projected to have a shortfall of up to 121,300 physicians by 2030. Additionally, when the need for geriatric care is rapidly growing, data from the National Resident Matching Program shows that only 35 of the 139 geriatric fellowship programs were filled in 2018.  
This “perfect storm” of the growing number of older patients needing care solutions with fewer specialized physicians to meet their needs, also comes when the Medicare program and other payers are increasingly demanding value-based care.
In order to drive value and a positive patient experience with
fewer resources, providers are increasingly turning to a new
solution – virtual care. Earlier in the year, <a href="https://www.modernhealthcare.com/article/20181207/SPONSORED/181209938/health-care-outlook-for-2019-five-trends-that-could-impact-health-plans-hospitals-and-patients" target="_blank">Modern Healthcare</a> predicted that a significant growth in virtual care was a top
trend for 2019. Virtual care programs will become increasingly
important, particularly for chronic care management. 
<img src="https://www.kindredhealthcare.com/images/default-source/blog-images/the-kindred-continuum/topic-6-improve-patient-outcomes-infographic-2.jpg?sfvrsn=11598fea_0" data-displaymode="Original" alt="Infographic: Population Increase in 65 or Older: 2019-56 million in 2030-80 million. Projected Physician Shortfall: Shortfall of up to 121,300 physicians by 2030." title="Infographic: Population Increase in 65 or Older: 2019-56 million in 2030-80 million. Projected Physician Shortfall: Shortfall of up to 121,300 physicians by 2030." />
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<h2>What Is Virtual Care?  </h2>
“Virtual care is a broad term that
encompasses all the ways healthcare
providers interact with their patients
without seeing them in person.
In addition to treating patients using
telemedicine, doctors will use live
video, audio and instant messaging to
communicate with their patients
in a variety of ways. This may
include checking in with patients after
an in-person visit, monitoring their
vitals after surgery, or responding to
patient questions.   
 
“Simply put, the term virtual care is
a way of talking about all the ways
patients and doctors can use digital
tools to communicate in real-time,
regardless of whether the doctor is
using this technology to treat a patient.
While telemedicine refers to long-distance patient care, virtual care is
a much broader term that refers to a variety of digital healthcare services."
 
- <a href="https://intouchhealth.com/finding-the-right-term-for-modern-digital-healthcare/" target="_blank">InTouchHealth</a>
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<h2>Encouraging Virtual Care</h2>
Over the past several years, the Centers for Medicare and Medicaid
Services (CMS) has recognized the value of telemedicine and virtual
care. For several years, including in the 2019 payment rule, the
agency has added HPT and HCPCS physician codes for Medicare
to encourage adoption of activities including virtual check-ins,
remote evaluation and interprofessional internet consultation.
It is anticipated that Medicare and other payers will continue to
incentivize adoption of virtual care. 
Physicians agree that virtual care programs will become invaluable to
patient care. Deloitte’s 2018 Survey of US Physicians found the top
benefits were reported by participating doctors as being:
<ul>
<li>Improved access to care</li>
<li>Improved patient satisfaction</li>
<li>Staying connected with patients and caregivers</li>
</ul>
<h2>Challenges to Adoption</h2>
Despite predictions for major growth in virtual care and telemedicine, there are still significant barriers to adoption. According to Deloitte’s 2018 Survey of US Physicians, only 14% of physicians have video visit capability and only 18% of the rest plan to add the ability in the next one to two years. 
Physicians cited the top challenges to telemedicine and virtual care as
lack of reimbursement, complex licensing requirements and the high
cost of technologies – not to mention the security measures needed to
protect patient privacy. 
One way providers can bridge these obstacles is to partner with post-acute providers or other entities who already offer virtual care solutions, thereby gaining access to existing resources and infrastructure.
<h2>Case Study: Kindred Hospital’s Successful AfterCare Program </h2>
At Kindred, we saw an opportunity to enhance the patient
experience as well as offer continued clinical support to our
patients to prevent a decline in their health status – especially
those who were transitioning directly home. Recognizing this
need, and the role of virtual care, we developed an ongoing
care management and patient engagement service called AfterCare, a program that is offered by and facilitated through our Kindred Contact Center.
As part of this virtual care solution, the AfterCare program features Registered Nurses telephonically reaching out to patients, on a scheduled timeline, in order to identify and manage clinical gaps and medication regimens to prevent patient decline or hospitalizations.  
Our patients receive calls at 24-48 hours, one week, two weeks
and 30 days post-discharge to assess their progress and identify
any post-discharge needs. We break down these identified needs into four groups:
<ul>
<li>DME: Did they receive it and do they understand it?</li>
<li>Medications: Were they able to get their prescription medications filled? Do they understand them? Do they have enough ‘critical’ meds to last them to their scheduled PCP follow-up appointment?</li>
<li>PCP Appointment: Is it scheduled in an appropriate time frame?</li>
<li>Post-Discharge Services: Have they been initiated and is the patient/caregiver satisfied?
</li>
</ul>
In addition to the telephone support, before discharging,
our Case Managers are proactively identifying and addressing
patient needs. Post-discharge, should an identified need arise
through a follow-up call, we will initiate the intervention process. 
The first year of this pilot program proved incredibly successful
for Kindred Hospitals and our patients.1
For patients within
the AfterCare program, from July 2016 through May 2017, the
program produced many benefits such as:
<ul>
<li>A decrease in the rehospitalization rate, from 7% to 2%*1</li>
<li>The percentage of patients discharging with an identified need decreased from 21% to 6%</li>
</ul>
Results in 2018 were even more impressive for Kindred patients
in the AfterCare program: 
<ul>
<li>The rehospitalization rate within the first 30 days declined
to 0.6%* </li>
<li>The percentage of patients with an ongoing satisfaction concern was also less than one percent</li>
</ul>
This program is offered to all Kindred Hospital patients as they
transition home, and the success can be tapped into and shared
by all of our referral partners. 
To learn more about how Kindred can help your patients through virtual care solutions, please <a href="https://www.kindredhealthcare.com/our-services/transitional-care-hospitals/healthcare-professionals/make-a-referral" target="_blank">Contact Us</a>.
<img src="https://www.kindredhealthcare.com/images/default-source/blog-images/the-kindred-continuum/topic-6-improve-patient-outcomes-infographic-1.jpg?sfvrsn=63598fea_0" data-displaymode="Original" alt="Infographic: Our patients receive calls at 24-48 hours, one week, two weeks and 30 days post-discharge to assess their progress and identified any post discharge needs." title="Infographic: Our patients receive calls at 24-48 hours, one week, two weeks and 30 days post-discharge to assess their progress and identified any post discharge needs." />
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Sources:
*Patient Reported Data
 
 
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