Rounding up August’s end: ‘blended’ mental healthcare, Army’s telehealth innovation, Montefiore’s 300% ROI on social determinants, telehealth needs compliance

[grow_thumb image=”http://telecareaware.com/wp-content/uploads/2017/12/Lasso.jpg” thumb_width=”NaN” /]Our UK readers have the summer bank holiday in the rearview mirror, and our US readers are looking forward to a break over next Monday’s Labor Day holiday in the US. It’s sadly the end of the traditional summer season, though Summer, The Season lingers on for a few precious more weeks.

Here are some short takes on items of interest over the past month:

Blended care–eHealth and direct clinician care–for mental health. The NHS has been promoting online webcam and instant messaging appointments as an alternative to ease pressure and waiting times for mental health patients, but the evidence that they are effective on their own is scant. Blending digital health with F2F clinical care may be the way to go. This Digital Health News explores how the two could work together and still save time and money.

Army testing telemedicine and remote monitoring for triage. The US Army’s MEDHUB is designed to streamline communication flow between patients, medics and receiving field hospitals.  MEDHUB–Medical Hands-free Unified Broadcast–uses wearable sensors, accelerometers, and other FDA-cleared technology to collect, store, and transmit de-identified patient data from a device to a medical facility, allowing clinicians to better prepare for inbound patients and more promptly deliver appropriate treatment. The 44th Medical Brigade and Womack Army Medical Center at Fort Bragg, North Carolina have already volunteered to test the system. MEDHUB was developed by two subordinate organizations within the US Army Medical Research and Materiel Command. Army release, Mobihealthnews 

Soldier, don’t take your health tracker to the front. Or even the rear. Deployed US Army soldiers have been told to leave at home their wearable trackers or smartphone apps, government issued or otherwise, that have geolocation capability. Turns out they are trackable and heat mappable–in other words, these trackers and apps can tell you where you are. (And don’t use Google either). Mobihealthnews

Social determinants of health part of Montefiore Health System’s approach to reducing emergency room visits and unnecessary hospitalizations.  Montefiore, based in the Bronx and lower Westchester, invested in housing for the homeless through their Housing at Risk Alert System. The system noticed through their analytics that the issue was housing. Many of their ‘frequent flyers’ cycled between shelters and the ER (ED). Oncology patients were at risk for eviction. Montefiore acquired respite housing (160 days) and housing units for up to a year through organizations such as Comunilife. They claim a 300 percent return on investment. Healthcare Finance

Telehealth needs compliance health. A study from Manatt Health, a division of law firm Manatt, Phelps & Phillips, LLP, presents what readers already know–the inconsistent statutes, regulations and guidance various states are implementing around the provision of telehealth services points out the growing need for compliance assistance. Manatt Health Update (blog) 

AHRQ ‘evidence map’ pinpoints chronic condition telehealth, telemental health (US)

The US Government’s Agency for Healthcare Research and Quality (AHRQ) released a final and fairly positive report analyzing telehealth effectiveness. It was a meta-review of 58 systematic research reviews on telehealth. Criteria were that the studies could examine real time or asynchronous telehealth, onsite or at distance, and that the patient interacted with healthcare providers for the purposes of treatment, management, or prevention of disease.

The abstract’s conclusions are positive for remote patient monitoring (RPM) for chronic conditions and for telemental health:

  • Positive outcomes came from the use of telehealth for several chronic conditions and for psychotherapy as part of behavioral health
  • The most consistent benefits were when telehealth was used for communication and counseling, plus remote monitoring in chronic conditions such as cardiovascular and respiratory disease
  • The improvements were in outcomes such as mortality, quality of life and reductions in hospital admissions

POLITICO’s Morning eHealth has additional and most interesting background. The AHRQ was tasked by two Senators, John Thune (R-SD) and Bill Nelson (D-FL) to analyze telehealth for effectiveness through a literature review and “to give a government’s view – not an industry-funded study or a poorly-conducted academic study – on what the technology could do if, for instance, Medicare paid for more of it.” The December draft seemed to be ambiguous on telehealth studies to date, citing uneven quality and the poor definition of telehealth. (more…)