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

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.