Md. Hospital Readmissions Drop 89% for Telemedicine Patients

The Frederick News-Post, Md.

Every morning, Kimberly Wivell helps her mother measure her blood pressure, her weight, her oxygen levels and her temperature.

The pulse oximeter, which measures oxygen levels, the blood pressure cuff and the scale all connect to a tablet. That tablet allows two health professionals at Frederick Memorial Hospital to monitor patients from their homes. Wivell texts with a nurse weekly about her mother's vital signs, with the ability to audio or video chat if she is worried about her mother.

Having the tablet at home is a relief, Wivell said, because it means that there is someone looking out for her mother and fewer emergency department trips.

"I don't ever want to be without it," she said.

FMH launched the Chronic Care Management Program pilot, a program created by Lisa Hogan, chronic care management team leader, in October 2016. Through the program, patients are given 4G tablets, the blood pressure monitor, the pulse oximeter and scales. It is free of charge.

Since then, hospital readmissions for enrolled patients decreased 89 percent over a 30-day period. For those patients, emergency department visits decreased by 49 percent, according to a press release from the hospital.

Readmissions are also down for patients in the program for six months, Hogan said.

Hogan, a registered nurse, and a nurse practitioner get the vitals from the enrolled patients. If a person is doing well, the team contacts the patient weekly. If a person's vitals look off, the nurses will text or call to learn more.

If a person does not submit vitals for two days, the team will also contact the patient to make sure everything is OK.

Currently, there are 154 patients enrolled in the program, with 50 more tablets available. The tablets are easy to use, Hogan said, adding that the oldest enrolled patient is in their 90s.

The program helps keep readmissions down, which in turn reduces hospital costs, Hogan said. The hospital's goal is to keep people safely at home.

For Wivell, staying at home means not having to travel from Emmitsburg to Frederick. When her mother, Margaret Chesser, says she does not feel well, Wivell can take her vitals with the monitor. Chesser has chronic obstructive pulmonary disease and chronic heart failure, so a cold can make it hard for her to breathe.

Wivell said that when her mother had a cold recently, Hogan came to Wivell's and listened to her mother's chest. She did not need to go to the emergency department.

This meant that Wivell's husband did not have to take the day off, since neither Wivell nor Chesser drives, and the family did not have to spend nearly an entire day in the emergency room.

"I cannot tell you how much of a relief that is," she said. "Instead of going in, sitting in the emergency room for hours for them to give her oxygen and then tell her, 'You're fine, go home.' To have this machine here and to have Lisa backing it up is a godsend."
For the hospital, that was a bed that was open for other patients and thousands of dollars saved.

Not everyone avoids a hospital trip just because they are in the Chronic Care Management Program, Hogan said. If a person's vitals are bad enough, the team will tell a patient to come to FMH.

Patients say the program is a lifeline, Hogan said. Some of the patients are referred to the program after visiting the hospital. Others come through doctor's offices or the health department.

Hogan said the program helps strengthen the bond between the hospital staff and their patients. Because Hogan and the nurse practitioner call every week, they get to know the patients well.

"It's very satisfying to me to be able to talk our patients every week and to be able to hear them say that they're doing better," Hogan said.