Call9 and an ’embedded’ approach to emergency response in nursing homes

Back in March, this Editor noted the substantial $34 million raise over the past three years by Call9. The Brooklyn-based company has pioneered an innovative approach filling a non-glamorous but badly needed gap in care–providing in-facility emergency care in SNFs and rehab facilities. Embedded in-facility first responders summoned by SNF nurses provide immediate care at a higher level than nursing home staff, married to telehealth capability that connects to remotely located emergency medicine doctors via a video cart and diagnostics.  The goal is to provide care immediately, avoid unnecessary and potentially harmful ER/ED admissions (estimated at 19 percent of ambulance transports), and generally keep SNF patients healthier while on site.

The numbers are there. Call9 reported in their studies a 50 percent reduction in ER admissions and a savings of $8M per year for a 200-bed nursing facility. Even if these numbers are high, a reduction is welcome news to SNFs, payors, Medicare, and one would think nursing home patients and families. Hospital readmissions within 30 days are also a CMS quality measure important to SNFs–the lower the better.

The Hunter College Center for Health Technology in their blog reported that one Call9 feature is special training for staff at their in-house Call9 Academy in the unique emergency care demands present in a SNF. These were initally learned first hand by the founder, Dr. Timothy Peck, who lived three months in a Long Island SNF’s conference room in order to better understand staff and patient needs.

It not only saves money, but fills other gaps in care and social determinants of health. Part of the Academy training covers the gap in palliative care with residents, and can facilitate Medical Orders for Life-Sustaining Treatment (MOLST) preparation with families. Last year, Call9 partnered with Lyft to provide transportation for family members of nursing home residents who have had a change in condition. Other partnerships serve the needs of community paramedicine services to connect with telehealth services as part of CMS’ ET3 model. The company currently covers over 3,700 beds in New York State, recently expanding to Albany, its third city.

A similar company, Third Eye Health, based in Chicago, covers about 15,000 beds but is a ‘lighter’ system that concentrates on remote care without the embedded staff and purely tablet based remote consults initiated by staff nurses. Both indicate through their growth and funding a surge in realization that both improved care and major savings to healthcare can be realized here.

Care Innovations finds a home in Mississippi

The Intel-GE Healthcare joint venture, Care Innovations, last week inked a full five-year deal with the University of Mississippi Medical Center to use remote care management tools, such as their Health Harmony telehealth platform, in the home setting to reduce readmissions and ER/ED use. The chronic medical conditions they will be tracking are congestive heart failure, diabetes, chronic obstructive pulmonary disease (COPD), asthma, and hypertension. According to Healthcare Finance, the RPM, data analytics and application integration services they are developing may be offered outside the state. This follows on reported positive results produced by a statewide population health program, the Diabetes Telehealth Network, involving both CI and UMMC’s Center for Telehealth. The results for the six-month first phase of the remote care management program, which included 100 Mississippians with diabetes: a 1.7% average A1C reduction, zero hospitalizations and ER visits, and a savings of $339,184 over six months. The CI and UMMC goal is to enroll 1,000 patients per month through 2016, and to save $189 million in Medicaid cost among diabetics alone.  Care Innovations release. Health Data Management. This follows on GE Healthcare’s acquisition of healthcare consultancy Camden Group [TTA Nov 12]

CHF readmissions cut 53 percent with telehealth tablet

Favorable news for the growing area of tablet-based telehealth. A six-month trial of an tablet-based telehealth system for congestive heart failure (CHF) with patients at Philadelphia-area Penn Medicine’s (University of Pennsylvania) post-discharge program reduced readmissions from an already low 8 percent to 3.8 percent, a 53 percent positive change, versus the national average of 19.5 percent. The provided 4G tablet+app program through Health Recovery Systems is used by the patient for an average 85 days. He or she sends vital signs, symptoms, medication information (including side effects) to a nurse care coordinator; the app on the tablet provides coaching via patient education, instructional videos and individualized self-care plans coordinated with the telehealth nurse on the program. (more…)