Using tele-health to affect cardiovascular outcomes in rural areas: The case of Southern Appalachia - Preliminary findings

The Southern Appalachia Tele-Homecare program seeks to improve CHF outcomes while reducing hospitalization and costs in a rural, medically underserved area. SATH integrates patient participation and progressive self-care, tele-monitoring, home healthcare, call center monitoring, and standing physician orders in a multidisciplinary team. 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 8/31/11, 234 patients were enrolled; 116 in the treatment and 118 in the control group. Of the 120 patients currently eligible for the satisfaction survey, 81 completed (67.5% response). Most respondents (81%) rated their satisfaction with home health as 9 or 10. More patients in the treatment than control group reported a satisfaction score of 10. For the 6-month quality-of-life assessment, 82 of 93 eligible patients responded. The 12-month assessment was completed by 14 of 22 eligible patients. The average QoL score was 51.9 at 6-months and 51.4 at 12 months (maximum 105), with no significant differences between the two groups. FINANCIAL: While initial costs of care are higher in the treatment group relative to the control group ($1,048 vs. $550 per patient), the net savings, due to avoided home health visits and mileage costs, realized in the treatment group was half the cost of care in the control group. CONCLUSION: Tele-homecare can be successfully implemented in rural communities, and adapted to other chronic conditions and geographic locations.