scholarly journals Home Telehealth Done in an Integrated Disease Management Program Results in Substantial Cost Savings and Reduction in Healthcare Utilization

2015 ◽  
Vol 21 (8) ◽  
pp. S78
Author(s):  
Michael G. Dickinson ◽  
Kevin L. Vos
Keyword(s):  
Disease Management ◽  
Healthcare Utilization ◽  
Disease Management Program ◽  
Cost Savings ◽  
Management Program ◽  
Integrated Disease Management ◽  
Substantial Cost ◽  
Home Telehealth

Abstract 2095: Health Policy: Can an Open Access Model for Intravenous Diuretics in an Outpatient Heart Failure Disease Management Program Reduce Hospital Costs?

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Dylan L Steen ◽  
Valerie Reed ◽  
Gwendolyn Roxas ◽  
Maria Fonseca ◽  
Barbara Lopez ◽  
...  
Keyword(s):  
Heart Failure ◽  
Weight Gain ◽  
Open Access ◽  
Disease Management ◽  
Disease Management Program ◽  
Hospital Costs ◽  
Cost Savings ◽  
Management Program ◽  
Inpatient Cost ◽  
Heart Failure Disease Management

Background: Heart failure (HF) is the most frequent discharge diagnosis for patients older than 65 and one of the most expensive diseases to treat for CMS. Patients with early symptoms of decompensated HF may need access to IV diuretics when oral medications used in a sliding scale dosage are no longer effective. Indigent patients without access to a private physician are at particular risk of having to use the emergency room (ER) for this reason. This model results in more costs and potential admissions. We sought to reduce ER use and improve quality of care and service to indigent patients followed in a Heart Failure Disease Management Program (HFDMP). Methods: Grant funding was procured to provide free furosemide IVP, potassium and metolazone for patients enrolled in a HFDMP at Jackson Memorial Hospital. The HFDM program consist of intense patient education using DVD’s in both English and Spanish, written material, log books for weight, activity, blood pressure and diuretic use. Patients are instructed to weight daily and add an additional oral dose of furosemide at home for weight gain of greater than 2 pounds. For weight gain of greater than 5 pounds unresponsive to oral therapy, patients were given access to the clinic without an appointment for “walk-in” IVP furosemide, potassium and metolazone. Results: 173 new patients were enrolled into program in 3 months (10/07 through 12/31/07). Of these, 115 visits for IVP furosemide were recorded from 54 patients. 16 patients used it multiple times (range 2–11). Average ER cost for all CHF patient seen and discharged after diuresis at JMH is $25,692. Therefore, an estimated cost savings of 115 avoidable ER visits is $2,954,586. In the last three quarters of 2007, of all CHF patients seen in the ER, 96.6% are admitted. The average inpatient cost for a primary diagnosis of CHF was $26,404.05 (LOS 5.25 days). The average for a CHF patient seen and discharged from the ER was $5,295 (LOS <48hrs). All monetary values are Billed Charges. Conclusion: An open access IVP furosemide program is cost effective alternative to ER and inpatient treatment for CHF patients requiring diuresis.

Electronic inhaler monitoring and healthcare utilization in chronic obstructive pulmonary disease

2019 ◽  
Vol 26 (7-8) ◽  
pp. 495-503 ◽  
Author(s):  
Khaled Alshabani ◽  
Amy A Attaway ◽  
Michael J Smith ◽  
Uddalak Majumdar ◽  
Richard Rice ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Disease Management ◽  
Pulmonary Disease ◽  
Healthcare Utilization ◽  
Disease Management Program ◽  
Electronic Monitoring ◽  
Management Program ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Improvement Project

IntroductionThe effect of electronic inhaler monitoring (EIM) on healthcare utilization in chronic obstructive pulmonary disease (COPD) has not been studied. We hypothesized that the use of EIM in conjunction with a disease management program reduces healthcare utilization in patients with COPD.MethodsThis is a retrospective pre- and post-analysis of a quality improvement project. Patients with COPD and high healthcare utilization (≥one hospitalization or emergency room visit during the year prior to enrolment) were provided with electronic monitoring devices for monitoring controller and rescue inhaler utilization for one year. Patients were contacted when alerts were triggered, indicating suboptimal adherence to controller inhaler or increased use of rescue inhalers, potentially signalling an impending exacerbation. Healthcare utilization was assessed pre- and post-monitoring, with each subject serving as his/her own control.ResultsPatients with COPD and high healthcare utilization ( n = 39) were recruited. Mean EIM duration was 280.5 (±120.6) days. The mean age was 68.6 (±9.9) years, FEV1 (mean forced expiratory volume in one second) was 1.1 (±0.4) L, and mean Charlson Comorbidity index was 5.6 (±2.7). Average adherence was 44.4% (28.4%). Compared with the year prior to enrolment, EIM was associated with a reduction in COPD-related healthcare utilization per year (2.2 (±2.3) versus 3.4 (±3.2), p = 0.01). Although there was a reduction in all-cause healthcare utilization, this was not statistically significant (3.4 (±2.6) versus 4.7 (±4.1), p = 0.06).DiscussionEIM in conjunction with a disease management program may play a role in reducing healthcare utilization in COPD patients with a history of high healthcare utilization.

scholarly journals Impact of an integrated disease management program in reducing exacerbations in patients with severe asthma and COPD

2014 ◽  
Vol 108 (12) ◽  
pp. 1794-1800 ◽  
Author(s):  
Vipul V. Jain ◽  
Richard Allison ◽  
Sandra J. Beck ◽  
Ratnali Jain ◽  
Paul K. Mills ◽  
...  
Keyword(s):  
Disease Management ◽  
Severe Asthma ◽  
Disease Management Program ◽  
Management Program ◽  
Integrated Disease Management

scholarly journals Impact of a Post-Discharge Integrated Disease Management Program on COPD Hospital Readmissions

2017 ◽  
Vol 62 (11) ◽  
pp. 1396-1402 ◽  
Author(s):  
Ashlee N Russo ◽  
Gayathri Sathiyamoorthy ◽  
Chris Lau ◽  
Didem Saygin ◽  
Xiaozhen Han ◽  
...  
Keyword(s):  
Disease Management ◽  
Disease Management Program ◽  
Hospital Readmissions ◽  
Management Program ◽  
Integrated Disease Management ◽  
Post Discharge

scholarly journals Disease Control for Florida Tomatoes

EDIS ◽  
2013 ◽  
Vol 2013 (6) ◽  
Author(s):  
Mathews Paret ◽  
Ken Pernezny ◽  
Pam Roberts
Keyword(s):  
Plant Pathology ◽  
Disease Management ◽  
Disease Control ◽  
Environmental Conditions ◽  
Disease Management Program ◽  
Management Program ◽  
Plant Diseases ◽  
Integrated Disease Management ◽  
Tomato Production ◽  
Successful Approach

Successful disease management has always been vital in Florida tomato production, given the generally ideal environmental conditions for most plant diseases. An integrated disease management program is a successful approach. This 7-page fact sheet was written by Mathews Paret, Ken Pernezny, and Pam Roberts, and published by the UF Department of Plant Pathology, June 2013. http://edis.ifas.ufl.edu/vh056

scholarly journals Impact and Sustainability of a 10-year Community Pharmacy Disease Management Service

2021 ◽  
Vol 12 (1) ◽  
pp. 13
Author(s):  
Tammy Lopez ◽  
Wesley Nuffer
Keyword(s):  
Cardiovascular Disease ◽  
Disease Management ◽  
Community Pharmacy ◽  
Disease Management Program ◽  
Pharmacy Practice ◽  
Cost Savings ◽  
Management Program ◽  
Management Service ◽  
National Guidelines ◽  
Care Services

Background. Community pharmacy practice needs to demonstrate services beyond traditional dispensing roles to continue to function in a changing marketplace. Pharmacists have established themselves as being capable of improving patient outcomes and saving healthcare dollars by providing disease management services to patients. This paper describes a sustained community pharmacy-run disease management program that continued after a grassroots grant-funding effort in 2007. Methods. The city of Colorado Springs recognized the successes shown by the pharmacy during the Ten City Challenge funded project, and decided to financially support pharmacy diabetes care services. Partnering with the local School of Pharmacy, the pharmacist obtained advanced training and continued to deliver individualized counseling and management to approximately 100 patients per year for the past 14 years. Objective lab measurements (systolic and diastolic blood pressures, A1C values, total lipid profiles) were obtained or performed, and clinical goals were set based on national guidelines. Patients received a series of appointments to learn how to control their diabetes, and later their cardiovascular disease. Financial estimates were calculated using 2008 baseline numbers and adding estimated inflation based on published Segal rates. Results. The pharmacy services successfully maintained participation of approximately 100 patients annually each year since its inception. Average lab value markers for disease control were at or close to clinical guideline recommendations for the population. Services were associated with estimated cost savings for the health system. Positive results led to expansion in services to include cardiovascular disease in 2017. Conclusions. A community pharmacy has successfully sustained a disease management program for patients for over 14 years, demonstrating high patient enrollment, health outcomes at or near clinical guidelines for control, and positive financial outcomes associated with the program.

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