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Robin Hill

Want to reduce readmissions? Let’s start with keeping patients healthier

By Robin Hill

Reducing hospital readmissions has been a top target of value-based care and population health management initiatives since the terms were coined. And for good reason.

The Agency for Healthcare Research and Quality (AHRQ) says patients readmitted within 30 days of discharge cost hospitals $41.3 billion, which puts them among the most expensive episodes to treat. While some readmissions are unavoidable, most are not – making them ideal targets for disrupters in the population health management space.
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Since the goal of value-based care is to improve health outcomes while reducing costs, finding ways to keep patients from being readmitted to the hospital is fast becoming an imperative – and a key metric. One of the most significant of these strategic initiatives is giving clinicians the ability to monitor patient health outside of the acute care setting.

Through the use of turnkey remote care monitoring platforms, clinicians can empower patients to do more to manage their own health and remain compliant with their plans of care long after they return to their homes. Additionally, the ability to collect biometric, behavioral, and other key data from at-risk patients on a continuous basis means those patients are never fully discharged from the care they require.

Yet there is another factor that comes into play – the patient’s active participation in the remote care management program. The most powerful remote care technology in the world won’t succeed in keeping patients healthy if those patients don’t use it properly, which means actively working to improve patient engagement is critical to delivering the maximum benefits. The reality is, patients who are confident in the technology, enthusiastically generate accurate data, understand the impact their participation has on their overall outcomes, and feel empowered to troubleshoot issues as they encounter them will have the greatest success.

The time for isolated interventions is past. Studies show that comprehensive remote care programs are far more effective at reducing unplanned hospital readmissions than individual encounters. Ensuring they achieve wider adoption and are successful in driving systemic care improvements, however, requires a few essential components:

Start with the path of least resistance. Typical value-based outcome goals for chronic heart failure (CHF) patients are reducing length of stay and 30-day readmissions, making this condition a natural place to start a remote care management program. After all, those outcomes (along with greatly improved patient satisfaction) are easy to track. From there, the program can be easily extended to COPD, hypertension, and diabetes, which naturally leads to programs that support core uses cases such as smoking cessation. Health systems that began remote care management programs in one obvious area are now using them to manage multiple acute and chronic conditions across many service lines.
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