Reengineering the Discharge Transition Process of COVID-19 Patients Using Telemedicine, Remote Patient Monitoring, and Around-the-Clock Remote Patient Monitoring from the Emergency Department and Inpatient Units

2020 ◽  
Author(s):  
Rich Kodama ◽  
Sunny Arora ◽  
Swati Anand ◽  
Abu Choudhary ◽  
Jeremy Weingarten ◽  
...  
Keyword(s):  
Emergency Department ◽  
Patient Monitoring ◽  
Transition Process ◽  
Remote Patient Monitoring ◽  
Remote Patient ◽  
Discharge Transition ◽  
Inpatient Units

scholarly journals Tele-transitions of Care (TTOC). A 12-month, Randomized Controlled Trial evaluating the use of Telehealth to achieve Triple Aim Objectives.

2020 ◽  
Author(s):  
Kimberly Noel ◽  
Catherine Messina ◽  
Wei Hou ◽  
Elinor Schoenfeld ◽  
Gerald Kelly
Keyword(s):  
Emergency Department ◽  
Randomized Controlled Trial ◽  
Hospital Readmission ◽  
Patient Monitoring ◽  
Controlled Trial ◽  
Transitions Of Care ◽  
Emergency Department Utilization ◽  
Remote Patient Monitoring ◽  
Randomized Controlled ◽  
Remote Patient

Abstract Background: Poor transitions of care leads to increased health costs, over-utilization of emergency room departments, increased re-hospitalizations and causes poor patient experiences and outcomes. This study evaluated Telehealth feasibility in improving transitions of care.Methods: This is a 12-month randomized controlled trial, evaluating the use of telehealth (remote patient monitoring and video visits) versus standard transitions of care with the primary outcomes of hospital readmission and emergency department utilization and secondary outcomes of access to care, medication management and adherence and patient engagement. Electronic Medical Record data, Health Information Exchange data and phone survey data was collected. Multi-variable logistic regression models were created to evaluate the effect of Telehealth on hospital readmission, emergency department utilization, medication adherence. Chi-square tests or Fisher’s exact tests were used to compare the percentages of categorical variables between the Telehealth and control groups. T tests or Wilcoxon rank sum tests were used to compared means and medians between the two randomized groups.Results: The study conducted between June 2017 and 2018, included 102 patients. Compared with the standard of care, Telehealth patients were more likely to have medicine reconciliation (p = 0.013) and were 7 times more likely to adhere to medication than the control group (p = 0.03). Telehealth patients exhibited enthusiasm (p = 0.0001), and confidence that Telehealth could improve their healthcare (p= 0.0001). Telehealth showed no statistical significance on emergency department utilization (p = 0.691) nor for readmissions (p = 0.31). 100% of Telehealth patients found the intervention to be valuable, 98% if given the opportunity, reported they would continue using telehealth to manage their healthcare needs, and 94% reported that the remote patient monitoring technology was useful.Conclusions: Telehealth can improve transitions of care after hospital discharge improving patient engagement and adherence to medications. Although this study was unable to show the effect of Telehealth on reduced healthcare utilization, more research needs to be done in order to understand the true impact of Telehealth on preventing avoidable hospital readmission and emergency department visits.

scholarly journals Tele-transitions of Care (TTOC). A 12-month, Randomized Controlled Trial evaluating the use of Telehealth to achieve Triple Aim Objectives

2020 ◽  
Author(s):  
Kimberly Noel ◽  
Catherine Messina ◽  
Wei Hou ◽  
Elinor Schoenfeld ◽  
Gerald Kelly
Keyword(s):  
Emergency Department ◽  
Randomized Controlled Trial ◽  
Hospital Readmission ◽  
Patient Monitoring ◽  
Controlled Trial ◽  
Transitions Of Care ◽  
Emergency Department Utilization ◽  
Remote Patient Monitoring ◽  
Randomized Controlled ◽  
Remote Patient

Abstract Background : Poor transitions of care leads to increased health costs, over-utilization of emergency room departments, increased re-hospitalizations and causes poor patient experiences and outcomes. This study evaluated Telehealth feasibility in improving transitions of care. Methods : This is a 12-month randomized controlled trial, evaluating the use of telehealth (remote patient monitoring and video visits) versus standard transitions of care with the primary outcomes of hospital readmission and emergency department utilization and secondary outcomes of access to care, medication management and adherence and patient engagement. Electronic Medical Record data, Health Information Exchange data and phone survey data was collected. Multi-variable logistic regression models were created to evaluate the effect of Telehealth on hospital readmission, emergency department utilization, medication adherence. Chi-square tests or Fisher’s exact tests were used to compare the percentages of categorical variables between the Telehealth and control groups. T tests or Wilcoxon rank sum tests were used to compared means and medians between the two randomized groups. Results : The study conducted between June 2017 and 2018, included 102 patients. Compared with the standard of care, Telehealth patients were more likely to have medicine reconciliation (p = 0.013) and were 7 times more likely to adhere to medication than the control group (p = 0.03). Telehealth patients exhibited enthusiasm (p = 0.0001), and confidence that Telehealth could improve their healthcare (p= 0.0001). Telehealth showed no statistical significance on emergency department utilization (p = 0.691) nor for readmissions (p = 0.31). 100% of Telehealth patients found the intervention to be valuable, 98% if given the opportunity, reported they would continue using telehealth to manage their healthcare needs, and 94% reported that the remote patient monitoring technology was useful. Conclusions: Telehealth can improve transitions of care after hospital discharge improving patient engagement and adherence to medications. Although this study was unable to show the effect of Telehealth on reduced healthcare utilization, more research needs to be done in order to understand the true impact of Telehealth on preventing avoidable hospital readmission and emergency department visits.

scholarly journals Does remote patient monitoring reduce acute care use? A systematic review

BMJ Open ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. e040232
Author(s):  
Monica L Taylor ◽  
Emma E Thomas ◽  
Centaine L Snoswell ◽  
Anthony C Smith ◽  
Liam J Caffery
Keyword(s):  
Cardiovascular Disease ◽  
Emergency Department ◽  
Length Of Stay ◽  
Acute Care ◽  
Patient Monitoring ◽  
Acute Hospital ◽  
Invasive Monitoring ◽  
Remote Patient Monitoring ◽  
Remote Patient ◽  
Hospital Use

ObjectiveChronic diseases are associated with increased unplanned acute hospital use. Remote patient monitoring (RPM) can detect disease exacerbations and facilitate proactive management, possibly reducing expensive acute hospital usage. Current evidence examining RPM and acute care use mainly involves heart failure and omits automated invasive monitoring. This study aimed to determine if RPM reduces acute hospital use.MethodsA systematic literature review of PubMed, Embase and CINAHL electronic databases was undertaken in July 2019 and updated in October 2020 for studies published from January 2015 to October 2020 reporting RPM and effect on hospitalisations, length of stay or emergency department presentations. All populations and disease conditions were included. Two independent reviewers screened articles. Quality analysis was performed using the Joanna Briggs Institute checklist. Findings were stratified by outcome variable. Subgroup analysis was undertaken on disease condition and RPM technology.ResultsFrom 2050 identified records, 91 studies were included. Studies were medium-to-high quality. RPM for all disease conditions was reported to reduce admissions, length of stay and emergency department presentations in 49% (n=44/90), 49% (n=23/47) and 41% (n=13/32) of studies reporting each measure, respectively. Remaining studies largely reported no change. Four studies reported RPM increased acute care use. RPM of chronic obstructive pulmonary disease (COPD) was more effective at reducing emergency presentation than RPM of other disease conditions. Similarly, invasive monitoring of cardiovascular disease was more effective at reducing hospital admissions versus other disease conditions and non-invasive monitoring.ConclusionRPM can reduce acute care use for patients with cardiovascular disease and COPD. However, effectiveness varies within and between populations. RPM’s effect on other conditions is inconclusive due to limited studies. Further analysis is required to understand underlying mechanisms causing variation in RPM interventions. These findings should be considered alongside other benefits of RPM, including increased quality of life for patients.PROSPERO registration numberCRD42020142523.

scholarly journals Tele-transitions of Care (TTOC). A 12-month, Randomized Controlled Trial evaluating the use of Telehealth to achieve Triple Aim Objectives

2020 ◽  
Author(s):  
Kimberly Noel ◽  
Catherine Messina ◽  
Wei Hou ◽  
Elinor Schoenfeld ◽  
Gerald Kelly
Keyword(s):  
Emergency Department ◽  
Randomized Controlled Trial ◽  
Hospital Readmission ◽  
Patient Monitoring ◽  
Controlled Trial ◽  
Transitions Of Care ◽  
Emergency Department Utilization ◽  
Remote Patient Monitoring ◽  
Randomized Controlled ◽  
Remote Patient

Abstract Background : Poor transitions of care leads to increased health costs, over-utilization of emergency room departments, increased re-hospitalizations and causes poor patient experiences and outcomes. This study evaluated Telehealth feasibility in improving transitions of care. Methods : This is a 12-month randomized controlled trial, evaluating the use of telehealth (remote patient monitoring and video visits) versus standard transitions of care with the primary outcomes of hospital readmission and emergency department utilization and secondary outcomes of access to care, medication management and adherence and patient engagement. Electronic Medical Record data, Health Information Exchange data and phone survey data was collected. Multi-variable logistic regression models were created to evaluate the effect of Telehealth on hospital readmission, emergency department utilization, medication adherence. Chi-square tests or Fisher’s exact tests were used to compare the percentages of categorical variables between the Telehealth and control groups. T tests or Wilcoxon rank sum tests were used to compared means and medians between the two randomized groups. Results : The study conducted between June 2017 and 2018, included 102 patients. Compared with the standard of care, Telehealth patients were more likely to have medicine reconciliation (p = 0.013) and were 7 times more likely to adhere to medication than the control group (p = 0.03). Telehealth patients exhibited enthusiasm (p = 0.0001), and confidence that Telehealth could improve their healthcare (p= 0.0001). Telehealth showed no statistical significance on emergency department utilization (p = 0.691) nor for readmissions (p = 0.31). 100% of Telehealth patients found the intervention to be valuable, 98% if given the opportunity, reported they would continue using telehealth to manage their healthcare needs, and 94% reported that the remote patient monitoring technology was useful. Conclusions: Telehealth can improve transitions of care after hospital discharge improving patient engagement and adherence to medications. Although this study was unable to show the effect of Telehealth on reduced healthcare utilization, more research needs to be done in order to understand the true impact of Telehealth on preventing avoidable hospital readmission and emergency department visits.

scholarly journals Remote Patient Monitoring Using Radio Frequency Identification (RFID) Technology and Machine Learning for Early Detection of Suicidal Behaviour in Mental Health Facilities

Sensors ◽  
2021 ◽  
Vol 21 (3) ◽  
pp. 776
Author(s):  
Xiaohui Tao ◽  
Thanveer Basha Shaik ◽  
Niall Higgins ◽  
Raj Gururajan ◽  
Xujuan Zhou
Keyword(s):  
Mental Health ◽  
Machine Learning ◽  
Radio Frequency Identification ◽  
Patient Monitoring ◽  
Vital Signs ◽  
Remote Patient Monitoring ◽  
Rfid Technology ◽  
Rpm System ◽  
Frequency Identification ◽  
Remote Patient

Remote Patient Monitoring (RPM) has gained great popularity with an aim to measure vital signs and gain patient related information in clinics. RPM can be achieved with noninvasive digital technology without hindering a patient’s daily activities and can enhance the efficiency of healthcare delivery in acute clinical settings. In this study, an RPM system was built using radio frequency identification (RFID) technology for early detection of suicidal behaviour in a hospital-based mental health facility. A range of machine learning models such as Linear Regression, Decision Tree, Random Forest, and XGBoost were investigated to help determine the optimum fixed positions of RFID reader–antennas in a simulated hospital ward. Empirical experiments showed that Decision Tree had the best performance compared to Random Forest and XGBoost models. An Ensemble Learning model was also developed, took advantage of these machine learning models based on their individual performance. The research set a path to analyse dynamic moving RFID tags and builds an RPM system to help retrieve patient vital signs such as heart rate, pulse rate, respiration rate and subtle motions to make this research state-of-the-art in terms of managing acute suicidal and self-harm behaviour in a mental health ward.

Leadless and Wireless Cardiac Devices: The Next Frontier in Remote Patient Monitoring

2021 ◽  
Vol 46 (5) ◽  
pp. 100800
Author(s):  
Abdulaziz Joury ◽  
Tamunoinemi Bob-Manuel ◽  
Alexandra Sanchez ◽  
Fnu Srinithya ◽  
Amber Sleem ◽  
...  
Keyword(s):  
Patient Monitoring ◽  
Remote Patient Monitoring ◽  
Cardiac Devices ◽  
Remote Patient
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