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gave their consent, project coordinators and fi eld nurses conducted home visits to install the device, train the in-home caregiver in data input and discuss patients’ concerns.


Results


After 90 days, the trial’s results revealed a tremendous impact on the care process. eCaring’s Web-based care-manage- ment system prevented nine ER visits, three hospitalizations, 12 doctor visits and three unplanned nurse visits – striking results considering several participating seniors had historically visited the ER twice a month. Such success can be explained by the detailed, real-time data generated by eCaring that allowed Morningside’s clini- cal staff to monitor, communicate and triage rapid changes in a patient’s status to avoid costly ER visits and prevent deterioration. T e following three examples from the trial speak to the cost savings and care improvement potential of the system. Names have been changed to protect patients’ privacy. • “Emma” typically made several ER visits ev- ery month for high blood sugar and changes in her mental condition. But, since begin- ning the trial, she has not visited the ER at all. T anks to an alert for high blood sugar from eCaring, Emma’s care managers were able to address the problem immediately with her caregiver over the phone.


• Historically, “Ryan” would also visit the ER on average twice per month for blood sugar fl uctuations. Since he began using eCaring, he hasn’t been back. As in Emma’s case, a high blood sugar alert from eCar- ing allowed caregivers to take appropriate action early, in Ryan’s home, preventing the need for re-hospitalization.


• High blood sugar and hypertension were the causes for “Maria’s” monthly ER visits, but since starting eCaring, the only ER visit she made was for a seizure not pre- ceded by an aura, which was urgent and unavoidable. During the trial, Maria’s care managers received eCaring alerts concerning her blood sugar and blood pressure, making early intervention possible and preventing any unnecessary ER trips.


T anks to timely notifi cation and early intervention, a substantial number of ER visits were prevented, presenting signifi cant cost savings to the healthcare system and improved care outcomes for the patients themselves. T e savings from services avoided were more than $60,000, roughly $2,500 per patient per month, while the eCaring system costs were around $1,200.


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T ese results indicate the profound impact eCaring’s care- management system can have on reducing healthcare costs, while improving quality for millions of patients with chronic conditions. Such patients include dual eligibles and the grow- ing number enrolled in managed-care organizations, such as accountable care organizations (ACOs), medical homes and managed long-term care plans. Laura Hernandez, RN, MSN, vice president of home care


and director of patient services at Morningside, affi rmed the positive experience clinical staff had with eCaring. She cited the ability of care managers and aides to log in, monitor and update a patient’s status in real time as a major improvement to the care-management process. For Hernandez, eCaring also had the additional benefi t of verifying that aides are actually with their patients, while ensuring compliance with instruc- tions from care managers.


The reality of preventable re-admissions It’s important to remember that in many situations, hos- pitalization of a patient experiencing health complications is both necessary and appropriate. While care coordination eff orts are improving care transitions from hospital to home, more work is needed to identify innovative solutions for enhancing care transitions for seniors. Reducing readmissions under the Aff ordable Care Act is


an opportunity for developing new models and tools, such as eCaring, to help healthcare providers understand and treat factors underlying readmissions. Medication management, social support and environ- mental factors all contribute to high re-hospitalization rates among the elderly. T ese factors should also be taken into account to ensure that we aren’t just reducing hospital read- missions, but improving patient-care outcomes and quality of life, as well.


HMT HEALTH MANAGEMENT TECHNOLOGY April 2013 11


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