As a company that works to create successful service lines in the cardiovascular, neurosciences, and orthopedic specialties, Corazon has seen (and helped develop!) many and varied ways to accomplish this goal. In these uncertain times especially, innovative ways to ensure continued growth and productivity in these key clinical areas are essential.
Beginning with the onset of the coronavirus pandemic, though continuing to gain traction all throughout healthcare, is the use of telehealth. Corazon has witnessed a sharp increase in ways hospitals and physician practices have made use of technology to either replace, supplement, or enhance care delivery.
A deep dive into telehealth utility in any one of these service lines would be extensive, as each specialty can employ this strategy in different ways. But given the rise in its popularity, telehealth used in cardiology (still too broad a topic for a blog!) has proven useful for heart failure most noticeably.
Simply stated, heart failure (HF) is a chronic, long-term condition in which the heart cannot pump enough blood to the rest of the body. HF patients are highly-prone to hospital admissions, and oftentimes end up requiring an episode of home care as well. After the initial incident, a HF admission is typically followed by outpatient care that unfortunately lasts until the next hospitalization, and the cycle repeats. This unfortunately-unending progression makes for a costly and somewhat inefficient recurring admission – discharge – maintenance care – readmission process.
Enter, telehealth. With the technology-based foundation of this type of care, the telemonitoring aspect of the process is highly valuable for chronic sufferers of HF. In fact, a 2018 trial followed a group of heart failure patients, each a Medicare beneficiary, for six months of home care. The group was divided into two categories:
- Group A: Patients who were followed closely by their cardiologist via on-site visits, weekly nurse check-ins, and Q&A sessions about hospital visits and symptoms.
- Group B: Patients who used telehealth via at-home monitoring devices (stethoscope, pulse ox, scale, and a video monitor) to track their own vitals and stats on a regular basis with daily submission to the physician office. This group also had weekly telehealth visits with a nurse to discuss any symptoms.
The results of this trial were very telling…from an emergency department utilization perspective, 60% of Group A had at least one ED visit, while only 38% of Group B visited the ED. This trend held true from a hospitalization perspective as well. 55% of the Group A had at least one hospitalization, compared to only 48% from the telehealth Group B. And perhaps not surprisingly, cost differentials between the group were significant. Costs reached approximately $39,000 for a telehealth patient, versus $51,000 for the Group A patients who received more traditional hands-on care.
So in summary, to perhaps see a very small “silver lining” of the large cloud that is Covid-19, it seems that non-traditional areas of a hospital or service line are beginning to find ways to use telehealth as a necessary means to ensure patient care is still delivered, despite the challenges this pandemic has placed on hospital capacity, perceptions about safety, and the need for chronically and/or seriously ill patients to still have access to the care they need.
Indeed, Corazon has long recognized the benefits of telehealth as a supplemental component of a full care continuum within a clinical area; however, as a new normal emerges, we believe that telehealth has a solid and permanent place as a strategy for delivering care to a diverse group of patients.
Further, telehealth has been shown to be not only easier on the patient, but actually a safer method in Covid-heavy areas of the country. The financial burden is also less – on the hospital and the patient – which allows for greater application as well. Close to 6 million people in the United States suffer from heart failure, so broadly applying the trial results to that population can no doubt have a significantly positive affect overall. Patients may be more likely to comply with regular and consistent visits if done virtually. And the hardship for travel to and from a hospital, especially for HF patients who are typically of advanced age and may suffer from limited mobility, is a major satisfier as well.
Indeed, telehealth has been a long-standing fixture in many hospitals, but as the applications for this technology and techniques can be shared among various clinical areas, the patient AND the hospital will benefit from the continuation of non-Covid types of care – a must for hospitals to remain viable in the remaining months of 2020 and beyond…
