Healthcare expenses are skyrocketing due to varied reasons like increased hospitalization, increased patient readmission rate, etc. As per the reports of the Agency for Healthcare Research and Quality (AHRQ), around $41 billion is spent each year on patient readmission within 30-days of discharge. 

If the hospitals don’t reduce preventable 30-day readmissions, they would be fined and lose a substantial amount of revenue because of the Hospital Readmissions Reduction Program instituted by the Centers for Medicare & Medicaid Services (CMS) in 2012. This program is created to reduce the rate of 30-day readmissions of Medicare patients, which hit a high of nearly 20 percent. 

CMS reported that nearly 2573 hospitals and 2597 hospitals faced costly readmission penalties in 2018 and 2017, respectively, for some of the most common conditions such as pneumonia, chronic lung disease, congestive heart failure, and mental health disorders, septicemia, etc. The penalty would be up to 3% of a hospital’s annual Medicare reimbursements. But the strange point to be noted is nearly 1621 hospitals were identified to be penalized for five years at a stretch. Just avoiding penalties is not enough to reduce readmissions. This program is also meant to prevent disease exacerbations, even land patients back in the hospital. 

The primary issue is that no provider is ready to ensure that the patient’s healthcare is coordinated across various settings. Lack of accountability and care coordination leads to increased costs for the hospitals. Additionally, the gap between discharge and homecare is another problem. At times, patients might fail to follow-up on their treatment plan. 

However, several hospitals are fighting back to reduce patient readmissions and bring healthcare expenses under control by using telemedicine services to extend the patient relationship even after discharge by keeping people out of the hospital. Telemedicine is defined as using technology to deliver healthcare information via videoconferencing, remote monitoring, calls, email, and messaging. It removes the barrier between the provider and the patients to allow care to be available anywhere, anytime. Around 52% of hospitals now use Telemedicine, with 10% just ramping up. 

Careful planning and proper coordination among each of the patient’s providers, caregivers, and patients themselves are needed to reduce readmissions. There are a few key elements that should be focussed on to reduce readmissions via telemedicine. 

Cause Identification 

  • The potential reasons for readmission should be identified to begin with. According to The Healthcare Cost and utilization Project, several causes such as congestive heart failure, schizophrenia, respiratory failure, alcohol-related disorders, deficiencies like anemia, diabetes, hypertension, COPD, acute renal failure increase the patient readmission rates. 

  • To reduce readmissions, it’s mandatory to connect patients to an in-house or community-based support team. As per the Deloitte report in 2017, only 62% of hospitals screen patients consistently or systematically. 

  • Telemedicine helps by performing initial screening and completing the necessary checks before the patients make their way to the hospital. 

 

Transition management 

  • Hospitals must improve care transition, mostly when the patients leave the hospital to receive care in another place. A proper care transition program should be developed where the nurse practitioner manages the patient’s post-discharge care. 

  • Telemedicine facilitates this care transition program, where the nurse practitioner can perform home visits within 72 hours post patient’s discharge. Telemedicine platform, medications, regular follow-ups via calls, appointment scheduling, and patient’s health record can be managed well. 

  • Telemedicine allows providers to monitor their patients' health at home remotely, which creates better outcomes by lowering overall healthcare expenses. 

 

Patient engagement and education improvement 

  • As per the article dated 2017, ‘Lack of patient involvement in care decisions and not receiving written discharge instructions are associated with unplanned readmissions up to one year,’ nearly 24% of patients were at risk for readmission since they didn’t receive written instructions for care after getting discharged from the hospital. 

  • Here, telemedicine allows a provider to provide the discharge instructions via secure email. Even the inevitable questions will be answered in case if the patient has missed enquiring while in hospital. 

 

Follow-ups management through monitoring 

  • Patients need not have to travel to the clinic or hospital to make up their appointments, where they are more likely to become a no-show. 

  • Through telemedicine platforms, the provider can address patients' concerns and determine if they should go to the ER. 

 

By implementing the above four steps proactively via telemedicine, readmission rates and healthcare expenses will decrease, followed by maximum revenue and improvement in patients’ health outcomes. That’s where everyone wins.

 

As the population grows older and as value-based care gains a considerable demand, hospitals will face the necessity of new solutions to put an end to increased healthcare expenses. Telemedicine has the potential to change treatment protocols and reduce readmission rates for the costliest conditions plaguing U.S. healthcare today. Today, there are many innovative services such as videoconferencing tools like Skype that allow patients to talk to a specialist, cyber-surgeons who operate on patients at distant locations through remote robotics; and virtual ICUs high-profile critical care providers monitor patients at community hospitals. That’s how it’s sure that telemedicine will transform the U.S. healthcare system. 

So, are you planning to adopt telemedicine in your practice? You can talk to our Hifinite team about its implementation in your practice. You will then realize how much you and your patients will achieve the bottom line. 

 

References

https://pxjournal.org/cgi/viewcontent.cgi?article=1205&context=journal

https://www.advisory.com/daily-briefing/2017/08/07/hospital-penalties

https://encoretelemedicine.net/telehealth-and-reducing-hospital-readmission-rates/

https://blog.evisit.com/four-ways-telemedicine-can-help-reduce-readmission-rates

How does Telemedicine help in reducing patient readmission rates?

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