Specifically, the program will focus on individuals being discharged from long-term care facilities as they transition to life back at home.
Steve Davis, an associate professor of health policy, management and leadership in the School of Public Health, will explore whether telehealth can help keep patients from being re-institutionalized, so they can continue living in their own communities.
The year-long program will start accepting participants this fall. The approximately 30 people who enroll will be rural West Virginians who are receiving services through Medicaid “traumatic brain injury” or “aged and disabled” waiver programs.
“We looked at Medicaid claims data to see what some of the top reasons were for these individuals going back to an emergency department or a hospital,” Davis said. “We designed the program based on what we were seeing.”
The participants will have recently left a long-term care facility, such as a nursing home or an inpatient rehabilitation center, and they will likely have a range of conditions they must manage at home, including diabetes, hypertension and obesity.
Each patient will be given a scale, a thermometer and devices to track glucose levels, blood pressure and blood oxygenation. Those at risk of falling will also get a fall monitor. The patients’ medical team will help them set up the equipment and instruct them on how, and how often, to use it.
All of the devices will transmit data to nurses charged with monitoring the patients’ health 24/7. If any metric deviates from a healthy range — or, in the case of fall risks, if a patient falls — a nurse will be notified, day or night.
Knowing immediately about a medical problem can prevent what Davis calls a “cascade” of events that can land someone in long-term care again.
For example, if a diabetic patient’s blood sugar rises to a moderately high level, a nurse can call, remind the patient to take his or her insulin, and try to prevent future spikes by pinpointing the food that triggered the increase. This way, the patient can get his or her glucose level under control promptly, before it reaches a severely high level that necessitates a trip to the emergency room.
At the end of the pilot program, the researchers will assess its cost-effectiveness based on the number of times patients are hospitalized, readmitted to long-term care facilities and seen at the emergency department or an urgent care clinic. The team expects telehealth to drive these numbers down.
The researchers will also survey the patients and health care providers to determine their satisfaction with the service and how it could be improved.
“Telehealth itself — once it’s up and running — is pretty easy to use, from an end user perspective, but actually designing and implementing it can be very complicated,” Davis said. “You’ve got competing visions and goals. You’ve got to deal with comorbidities, all of the different types of technologies, a whole range of devices and vendors. Because of that, we believe that telehealth has not reached its widespread potential — especially in a rural environment.”
Davis’ research team includes Jennifer Mallow from the School of Nursing, Margaret Jaynes from the School of Medicine, Nathan Pauly and Lindsay Allen from the School of Public Health and Marcus Canaday from the West Virginia Bureau for Medical Services.
©2019 The Register-Herald (Beckley, W.Va.). Distributed by Tribune Content Agency, LLC.
