{"id":14889,"date":"2016-07-08T09:00:16","date_gmt":"2014-07-08T16:00:16","guid":{"rendered":"http:\/\/www.accessrx.com\/blog\/?p=14889"},"modified":"2014-07-08T09:00:16","modified_gmt":"2014-07-08T16:00:16","slug":"how-nursing-homes-could-benefit-from-telemedicine-m0616","status":"publish","type":"post","link":"https:\/\/www.edrugstore.com\/blog\/current-health-news\/how-nursing-homes-could-benefit-from-telemedicine-m0616\/","title":{"rendered":"How Nursing Homes Could Benefit from Telemedicine"},"content":{"rendered":"

\"Nursing
Nursing homes typically don\u2019t have doctors on-site 24\/7, and residents consequently end up in hospitals more.<\/figcaption><\/figure> In nursing homes, physicians are typically on-call during nights and weekends.<\/p>\n

Unfortunately, what often happens when a nursing home resident is ill or injured during off-hours, is a nurse contacts the on-call physician by phone, and if the physician is unfamiliar with the patient, he or she usually has the patient sent to the emergency room in an abundance of caution. This results in sometimes-unnecessary ER trips that drive up healthcare costs for everyone.<\/p>\n

Telemedicine may be able to help. When a patient is sent to the ER for lack of in-person contact with a physician during off-hours, families and loved ones can worry needlessly, and time and money can be spent unnecessarily. An innovative telemedicine study published in Health Affairs<\/a> studied whether telemedicine in nursing homes could save Medicare money.<\/p>\n

The Health Affairs Telemedicine Study<\/strong><\/p>\n

The study, authored by David C. Grabowski and A. James O’Malley, chose several Massachusetts nursing homes with lower quality ratings, more beds, and fewer staff than average for the state. Telemedicine services were installed, and staff members and physicians were educated on how and when to use it.<\/p>\n

In the nursing homes that were more committed to using the telemedicine services, average savings were $151,000. Even factoring in the $30,000 cost of the telemedicine services, that\u2019s still over $120,000 saved. Every year, Medicare spends more than one billion dollars on hospitalizations of nursing home residents during off hours when physicians are on-call.<\/p>\n

Why Nursing Homes May Not Want to Use Telemedicine<\/strong><\/p>\n

Not all the nursing homes in the Health Affairs telemedicine study were equally engaged in the telemedicine project, and those that were less engaged saw lower benefits. One problem is that there are certain disincentives to using telemedicine in some cases. For one thing, it is Medicare that benefits from the savings.<\/p>\n

Another problem is that when a nursing home resident who is on Medicaid is admitted to the hospital for a few days and then returns to the nursing home, the nursing home can then bill Medicare for a certain period of time at a higher rate than what they were getting from Medicaid.<\/p>\n

How the Affordable Care Act Could Provide Incentives for Telemedicine<\/strong><\/p>\n

The Affordable Care Act (ACA) is funding several types of demonstration programs, one of which is the accountable care organization. This program links payments across healthcare settings so that the accountable care organization is responsible for all care costs of enrollees. Under this type of organization, the disincentive for telemedicine goes away, and the organization has an incentive to reduce its own risks of increased costs for unnecessary hospitalization.<\/p>\n

An expansion of accountable care models that put providers at risk for the total costs of caring for elderly patient populations is expected to create the business case for investment in telemedicine, say the study\u2019s authors<\/a>.<\/p>\n

Smart Devices and Nursing Home Telemedicine<\/strong><\/p>\n

Off-hours telemedicine is only one way telemedicine can be brought into healthcare for older people. Nonprofit Lutheran SeniorLife, a Pennsylvania company that runs senior living communities, has equipped residents with smart watches that are actually health monitoring devices. These devices, known as MobileCare Monitors, alert healthcare aides via text message and web-based interface when a resident falls down.<\/p>\n

Lutheran SeniorLife began using MobileCare Monitor in 2012 in its adult day care and home care programs. Since that time, the percentage of patients that Lutheran SeniorLife has had to place in nursing homes has dropped from 20% to 12%<\/a>. In this case, fewer people end up in nursing homes in the first place, which saves significant healthcare dollars.<\/p>\n

\"Wearable
Wearable smart devices can alert healthcare providers to changes in patient status.<\/figcaption><\/figure> Cost Savings with MobileCare Monitor<\/strong><\/p>\n

The web-based system installed by Lutheran SeniorLife costs a few thousand dollars for each of the three senior living complexes that use it, along with $400 for each patient\u2019s monitor and subscription to the service. But this is pocket change compared to the cost of moving someone into a nursing home.<\/p>\n

Medicaid pays $3,400 per month to cover care for residents of Lutheran SeniorLife senior living complexes, regardless of their needs. But when a resident has to move into a nursing home, Lutheran SeniorLife has to pay the entire $7,500 cost without additional reimbursement from Medicaid. Clearly it\u2019s more cost-efficient to make sure seniors can stay in their senior living complex rather than having to be moved into a nursing home.<\/p>\n

Expansion of Telemedicine<\/strong><\/p>\n

The company that makes MobileCare Monitor, AFrame Digital, has other telemedicine devices as well, including devices that can remotely monitor patient vital signs and notify caregivers if the readings go outside of normal condition. They also have devices that can alert caregivers if patients with dementia wander outside their home or facility.<\/p>\n

Telemedicine is finding more applications every year, as researchers learn how to take advantage of internet and telecommunications technology. The result is delivery of care to more people at lower costs, and cost savings due to prevention of health crises.<\/p>\n

A study by the Center for Information Technology Leadership<\/a> examined the impact of using telemedicine in emergency rooms and found that the cost of equipping all US emergency departments with telemedicine technology would easily produce a return on investment simply due to reductions in patient transfers and save an estimated $537 million per year. Telemedicine could also save significantly on the costs of physician-to-physician consultation, and provision of health services in correctional facilities and rural areas.<\/p>\n

At eDrugstore.com, we\u2019re committed to keeping consumers informed about their choices in healthcare, and telemedicine is providing exciting new methods of healthcare delivery in a variety of settings. eDrugstore.com<\/a> dispenses a variety of prescription lifestyle medications, in conjunction with US-licensed pharmacists. We ship orders quickly, often on the day they\u2019re placed, and provide the highest levels of online ordering security.<\/p>\n","protected":false},"excerpt":{"rendered":"

In nursing homes, physicians are typically on-call during nights and weekends. Unfortunately, what often happens when a nursing home resident is ill or injured during off-hours, is a nurse contacts the on-call physician by phone, and if the physician is unfamiliar with the patient, he or she usually has the patient sent to the emergency […]<\/p>\n","protected":false},"author":1,"featured_media":14891,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_autoblog_aioseo_focus_keyphrase":"","_autoblog_aioseo_title":"","_autoblog_aioseo_description":"","footnotes":""},"categories":[18],"tags":[929,189],"class_list":["post-14889","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-current-health-news","tag-nursing-homes","tag-telemedicine"],"acf":[],"aioseo_notices":[],"aioseo_head":"\n\t\t\n\t\n\t\n\t\n\t\n\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t