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Reviving and Re-thinking RPM Program Helps Deaconess Health System Cut Readmissions in Half

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The 30-day readmission rate for the RPM population has been cut in half from 14% to 6.93%, which helped the organization avoid $500,000 in CMS penalties.

Evansville, Indiana-based Deaconess Health System, which includes 11 hospitals with 900+ total beds, 96 locations, an ACO, and a 500+ multi-specialty group was an early adopter of remote patient monitoring (RPM) technology when it was introduced a decade ago. However, the program didn’t produce the expected reduced readmission rate due to patient enrollment methodologies and inefficient manual data extraction processes that lacked quantifiable results. By 2018, the legacy program’s technology had aged out, and it was time for Deaconess Health, which serves patients in rural Southwestern Indiana, Southeastern Illinois, and Western Kentucky, to take RPM in a new direction.

As Amanda Bohleber, MD, a family physician, and chief transformation officer, and Allison Flowers, RN, telehealth clinical manager at Deaconess carefully reviewed the program, however, they discovered RPM itself wasn’t where the failure had occurred. It was how the program had been executed, especially when it came to patient selection.

After reviewing internal and industry data, Dr. Bohleber and Flowers put together a plan to revive the RPM program with a new approach designed to select patients who would benefit most. Their approach involved using an Epic tool that creates a readmission risk score to help identify patient candidates ideal for RPM.

“Our target was patients with a 20% or higher risk of readmission,” says Flowers. “They are the ones who may not ordinarily follow the plan of care they are given at the hospital as closely, which means they can quickly slip into old habits.”

Choosing the right technology partner

As soon as the trial launched, Dr. Bohleber and Flowers set out to find a connected care platform that offered all the features and functionality they were looking to incorporate in their new RPM program. “We quickly found that Vivify was ahead of the other companies in terms of what the platform could do,” says Dr. Bohleber. “We liked the way it integrated video functionality, and the fact that Bluetooth™ and cellular connectivity was built right in. It was also very easy to use, which is important since many of the patients with chronic conditions are older. We also liked the fact that the dashboards would make it easy to pull out the information we needed to show if the program was having an impact.”

Another deciding factor was logistics capabilities. When the program first launched, Deaconess decided to go with Vivify Home, which gives patients a fully self-contained kit that includes the appropriate Bluetooth-enabled devices, such as pulse oximeters and blood pressure cuffs, along with a tablet for reporting results and participating in video-based telehealth calls. Vivify also stepped in to handle all logistics, including kit delivery and pick up and patient training, which can be a significant drain on provider resources. “It saves our nurses many hours of administrative time, so they can focus on caring for patients,” says Flowers.

Readmissions Down, Savings Up

Unlike Deaconess’ previous attempt at RPM, the current program is data-driven and producing outstanding quantifiable results. The 30-day readmission rate for the RPM population has been cut in half from 14% to 6.93%, which helped the organization avoid $500,000 in CMS penalties. Dr. Bohleber and Flowers also used the health system’s electronic health records to examine what it billed the patients for the six months prior to them participating in the RPM program versus the six months after. That calculation showed $6.5 million in total cost of care savings.

Patient surveys also offer further evidence of the RPM program’s effectiveness and acceptance. Today, satisfaction scores consistently run in the 94% range, while the overall ease of use is rated 93%.

Finally, RPM demonstrated its true value during the COVID-19 pandemic. Deaconess added Vivify +Go—which enables patients to use their own smart device to report their conditions and interact with the RN team—to help monitor patients suspected of having COVID-19 but not considered sick enough to admit to the hospital. This quick pivot kept hospital beds available for those who truly needed them.

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