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● Telemedicine

Preventable readmissions: The care-


lder adults represent nearly a quarter of all emergency room (ER) visits. Seniors also tend to remain in hospitals longer and are readmitted more often than other patient groups. In fact,

nearly one in fi ve seniors end up back in the hospital less than a month after discharge. T is care transition crisis costs U.S. hospitals approximately $25 billion every year. To make matters worse, research sug- gests that 75 percent of these readmissions are avoidable. To spur hospitals into action, the Aff ordable Care Act intro- duced penalties under which hospitals stand to lose nearly $1 billion in Medicare funds in two years if they can’t bring their readmission rates down. With an aging population and rising healthcare costs, an innovative solution is urgently needed.

The need for innovation Technology, combined with better care-management

programs, can improve patient transitions from an inpatient hospital setting to the home setting. Already we are seeing a range of initiatives designed to identify the underlying causes of hospital readmissions and develop innovative strategies to reduce re-hospitalization among vulnerable seniors and people with chronic conditions.

Technology’s role For physicians and care managers, receiving actionable health data directly from a patient’s home can reduce ER visits and hospital readmissions. Real-time data, especially from the home of a high-risk population of seniors and individuals with chronic illnesses, can reveal developing problems before requiring hospitalization and other more costly healthcare services.

10 April 2013

transition crisis

Jane Fields is vice president of care management, eCaring. For more on eCaring: www.rsleads. com/304ht-205

Melody Wilding is director of outreach and strategic communications, eCaring.

Re-hospitalization among the elderly is a serious challenge facing the healthcare system today. Innovative solutions are required. By Jane Fields and Melody Wilding

One such technology is eCaring, a unique, cloud-based,

care-management system that gives healthcare providers and caregivers access to both clinical and behavioral data from a patient’s home, in real time. T e platform’s unique data integration helps care managers determine who is at risk for readmission, off ering hospitals protection against the new Medicare penalties, while also allowing patients to live at home longer in greater comfort and at lower cost.

Putting cloud-based care management to the test In October 2012, eCaring partnered with Morningside

House Long Term Home Healthcare to evaluate the system’s potential to improve care coordination for aging New York- ers. Morningside House, a member of the Aging in America family of providers, oversees fi ve subsidiaries delivering care to thousands of people in the New York City area. Eight patients (fi ve women and three men) were selected for a trial. All participants were low-income, dual-eligible (Medicare and Medicaid) seniors, over 80 years old and resid- ing in their own homes in the Bronx. In order to rigorously test eCaring’s eff ectiveness, care managers deliberately chose high-risk, clinically unstable patients with records of frequent hospitalization. Training for the pilot program took place in early October.

Directors, nursing managers and fi eld nurses received orienta- tion training to familiarize them with eCaring’s platform, and clinical staff established user accounts and profi les. eCaring’s system also enabled them to create customized alerts, tailored to patients’ specifi c health conditions, including both behav- ioral conditions and ranges of critical vital signs. Each patient received a 3G-enabled iPad loaded with eCar- ing’s state-of-the-art care-tracking system. After the patients


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