Using tele-health to affect cardiovascular outcomes in rural areas: The case of southern appalachia - final results

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 8/31/12, 289 patients were enrolled; 178 in the treatment and 111 in the control group. Of the 190 patients currently eligible for the satisfaction survey, 172 completed (92% response). Intervention patients were significantly more satisfied with their home health than control patients. For the 6-month quality-of-life assessment, 156 of 180 eligible patients responded. The 12-month assessment was completed by 98 of 131 eligible patients. The average QoL score was 51.9 at 6-months and 49.7 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 ($3,821 vs. $1,087 per patient), the net savings, due to avoided home health visits and mileage costs, realized in the treatment group was 62% of 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. ALL FINDINGS WILL BE UPDATED THROUGH THE END OF THE PROJECT PERIOD (MARCH 31, 2013) FOR PRESENTATION.