249852 Using Tele-Health to Affect Cardiovascular Outcomes in Rural Areas: The Case of Southern Appalachia - Part II

Tuesday, November 1, 2011: 9:24 AM

Karen Cober, RN, MSN , Home Health Services, Mountain States Health Alliance, Johnson City, TN
Brian C. Martin, PhD, MBA , Department of Health Services Administration, East Tennessee State University, College of Public Health, Johnson City, TN
Amal Khoury, PhD, MPH , Department of Health Services Management and Policy, East Tennessee College of Public Health, Johnson City, TN
The Southern Appalachia Tele-Homecare program seeks to improve CHF outcomes while reducing hospitalization and costs in a rural, medically underserved area. SATH's model integrates patient participation and progressive self-care with tele-monitoring, home healthcare, and call center monitoring. A multidisciplinary team delivers care, and standardized physician orders enable nurses to provide immediate intervention for distressed patients. SATH employs a randomized control study design and a multi-pronged evaluation to assess quality of care, utilization outcomes, and cost-effectiveness. Results ( to be updated for presentation): ENROLLMENT: As of 2/1/11, there were 96 patients in the study; 44 in the treatment group and 52 in the control group. PATIENT SURVEY: Of the 51 patients currently eligible for the survey, 39 completed the survey (76% response rate). Preliminary findings indicate a high level of satisfaction with the tele-monitoring intervention. QUALITY OF LIFE ASSESSMENT: At 6 months post-enrollment, a patient quality of life assessment (Minnesota Living with Heart Failure Questionnaire) is administered. Findings from the QoL assessment will be available at the time of the meeting. FINANCIAL: Higher short-term treatment group costs are expected, due to the intensive intervention; however, overall cost savings are expected, due to decreased inpatient hospital and emergency department utilization. Treatment group patients have shown cost savings of $2,391 per patient related to home health visits and travel for the treatment. Conclusion: Tele-homecare can be successfully implemented in rural communities. This model can be adapted to other chronic conditions and geographic locations.

Learning Areas:
Chronic disease management and prevention
Conduct evaluation related to programs, research, and other areas of practice
Provision of health care to the public

Learning Objectives:
1. Discuss progress for an innovative model using tele-health for CHF management in rural areas. 2. Define the components of a comprehensive evaluation framework for disease management programs. 3. Evaluate the impact of a tele-health CHF program on the quality and cost of care. 4. Demonstrate a tele-health CHF disease management approach that can be applied to other conditions and geographic settings.

Keywords: Telehealth, Chronic Diseases

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Fifteen years of professional and academic experience. Co-investigator on grant.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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