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Telehealth Data Collection Tool First Reporting Period Data Findings

Telehealth Data Collection Tool First Reporting Period Data Findings. September 26, 2007. Objectives. Provide an overview of the IPRO Telehealth Data Collection Tool design & development

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Telehealth Data Collection Tool First Reporting Period Data Findings

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  1. Telehealth Data Collection ToolFirst Reporting Period Data Findings September 26, 2007

  2. Objectives • Provide an overview of the IPRO Telehealth Data Collection Tool design & development • Discuss the importance of telehealth benchmark data to determine the impact of telehealth technology on home health care • Review the data findings for the first reporting period (05/01/07 – 07/31/07) • Identify additional resource tools to support use of telehealth technology in the home health provider setting

  3. Telehealth Data Collection Tool Originated as part of the Home Care Association of New York State Telehealth Taskforce with expertise & guidance provided regarding: • Design Elements • Important Data Components • Data Collection Process • Pilot Test Process • Tool Development & End Result Reports

  4. Goal for Telehealth Data Collection Tool Design & Development Design a standardized methodology for data collection to determine the impact of home telehealth • Patient Care Management • Improved Patient Outcomes • Acute Care Hospitalization • Emergent Care • Care Coordination • Cost of Care Delivery

  5. Telehealth Data Tool Pilot Group • Special Thanks!!! • At Home Care • Eddy VNA • Jewish Home & Hospital • Lifetime Care • St. Francis Hospital Home Care • St. Peter’s Hospital Home Care • VNA of Albany • VNA of Utica & Oneida County • VNS & Hospice of Suffolk • Warren County Home Health • Winthrop Hospital Home Care

  6. Important Design Elements • User-friendly Word-based application • Streamlined data entry process • HIPAA compliant • Ability to design & generate reports • Agency generated reports • Aggregate statewide reports • Ability to easily export data for statewide aggregation & analysis • Ability to import demographic data from agency source

  7. Telehealth Data Collection Tool Components • Agency Information Module • Patient History Module • Patient Information • Pre-Telehealth Care Patient History • Telehealth Care Services • Emergent Care Visits • Hospitalizations / Length of Stay • Cost Module • Report Module

  8. Standardized Measures to Demonstrate Clinical Outcomes • Compare 12-month period prior to THC to post THC: • Reason for hospitalization • Frequency of hospitalization • Length of Stay • Emergent care episodes • By ICD-9 • Type of equipment / peripherals / timeframes • Planned & unplanned visits & type of • intervention

  9. Installation Guidelines • Telehealth Data Collection Tool can be loaded to PC and can be loaded to a shared drive to allow access by multiple users • Detailed installation, data export & back-up procedures are provided in Instruction Manual

  10. Export of Data to IPRO • Tool allows for export of de-identified data to IPRO for aggregation into a statewide report

  11. Report Options • Telehealth Data Collection Report • Provides an aggregated breakdown of the data elements entered into the tool, capturing all patients who had a telehealth episode during the report period requested by the user • Patient Care Status • Emergent Care Visits – Primary Reason • Hospitalizations – Primary Reason & Length of Stay • Primary Reason for Telehealth • Number of Telehealth Episodes by Equipment Type • Type of Therapeutic Services Provided • Types of Peripherals & Time Frame Used

  12. Report Options • Telehealth Outcome Report • Provides an aggregated breakdown, by payertype, of the data elements entered into the tool, capturing all patients who had telehealth episode during the report period requested by the user • Number of Telehealth Patients & Episodes by Equipment Type • Total Length of Telehealth Episodes • Average Number of Direct In-Home Nursing Visits • Average Number of Remote Telehealth Visits • Average Number of Planned Home Visits • Average Number of Unplanned Home Visits • Reasons & Types of Interventions for Unplanned Home Visits

  13. Report Options • Telehealth Cost Report • The Cost Report provides detail on a number of cost and time allotment data elements that are entered by the user in the Cost Module that include the following: • Video Equipment Cost • Non-Video Equipment Cost • Telephone Monitoring Equipment Cost (for non-telehealth agencies) • Video Staff Labor • Non-Video Staff Labor • Staff training • Indirect Costs

  14. Aggregate Report Findings For First Data Submission Period 05/01/07 – 07/31/07

  15. Aggregate Report Findings for 05/01/07-07/31/07 • 12 of 21 agencies submitted 1st reporting period data • Six Upstate Agencies • Three CHHAs • One Hospital-Based • Three Combined • One Hospital-Based • Six Downstate agencies • Two LTHHCPs • One Combined • Three CHHAs • One Hospital Based

  16. Aggregate Report Findings for 05/01/07-07/31/07 • Number of Patients with one THC Episode: 274 • Medicare – 224 • Medicaid – 23 • Commercial Insurance – 19 • Self Pay – 1 • Managed Care- 7 • Number of Patients with 2 or more THC Episodes: 13 • Medicare – 12 • Medicaid – 1

  17. Aggregate Report Findings for 05/01/07-07/31/07 • Number of Patients by Type of Telehealth • Video – 59 Patients • Non-Video – 227 Patients • Telephone Monitoring – 2 Patients

  18. Aggregate Report Findings for 05/01/07-07/31/07 • Primary Home Care Diagnosis • CHF Atrial Fib • COPD Hypertension • Acute MI Diabetes • Post Surgical Care • Coronary Artery Disease

  19. Aggregate Report Findings for 05/01/07-07/31/07 • Average Length of THC Episode • Video – 43 days • Non-Video – 66 days • Telephone Monitoring – 32 days • Average Number of Direct In-Home Nursing Visits • Video – 9 visits • Non-Video – 11 visits • Telephone Monitoring – 8 visits

  20. Aggregate Report Findings for 05/01/07-07/31/07 • Remote Visit Definition • A remote telehealth visit is the exchange of health status information between a patient/caregiver and a health care provider using telecommunication technology. This may include: • An interactive videoconference between the health care provider and the patient/caregiver, or • The transmission of a set of vital sign data to a health care provider for the purposes of clinical care management, using non-video technology. • Average Number of Remote Visits • Video – 19 remote visits • Non-Video – 22 remote visits

  21. Aggregate Report Findings for 05/01/07-07/31/07 • Planned Home Visit Definition • A planned/scheduled direct in-home visit is an in person interaction that was scheduled at the time of admission and it is documented in the physician orders and within the Plan of Care. • Average Number of Planned Home Visits • Video – 13 planned home visits • Non-Video – 16 planned home visits • Telephone Monitoring – 10 planned home visits

  22. Aggregate Report Findings for 05/01/07-07/31/07 • Unplanned Home Visit Definition • An unplanned / unscheduled direct in-home visit is an in person interaction in the patient’s home or other site of residence that is a result of telehealth information received by the agency. If abnormal findings from the telehealth data require the intervention of a clinician and an additional direct in-home visit is made to provide that intervention – this is an unplanned /unscheduled home visit. • Average Number of Unplanned Home Visits • Video – 2 visits • Non-Video – 2 visits • Telephone Monitoring – 0 visits

  23. Aggregate Report Findings for 05/01/07-07/31/07 • Emergent Care Visits

  24. Aggregate Report Findings for 05/01/07-07/31/07 • Acute Care Hospitalization (ACH)

  25. Aggregate Report Findings for 05/01/07-07/31/07 • Cost Data • Analysis Limitations • 5 out of 12 agencies submitted cost data • Not all of the 5 agencies completed each of the questions in the Cost Module

  26. Aggregate Report Findings for 05/01/07-07/31/07 • Cost Data / Video Equipment • Average % of use – 85% • Average Case Mix Intensity – 1.35 • Average estimated labor cost installation - $35.00 • Who installs? Technician (4) Nurse (1) • Average estimated labor cost de-installation - $25.00 • Average estimated cleaning cost - $15.00 • Average length of time for RN video visit –18 minutes • Average length of time for patient education on use – 30 minutes

  27. Aggregate Report Findings for 05/01/07-07/31/07 • Cost Data / Non-Video Equipment • Average % of use – 83% • Average Case Mix Intensity – 1.37 • Average estimated labor cost installation - $67.00 • Average estimated labor cost de-installation - $66.00 • Average estimated cleaning cost - $15.00 • Average length of time per week spent on daily review of patient data – 64 minutes • Average length of time for patient education on use – 82 minutes • Who installs? Technician (4) Nurse (1)

  28. Interested in How Telehealth Impacts the Care Delivery for Your Agency?Patient OutcomesACH RateEmergent Care VisitsHigh Volume Diagnosis Patient Populations

  29. Telehealth Data Tool Request • Complete the Agency Commitment to Participate faxback form (available along with Webex training session on Home health section of the IPRO Web Site at http://providers.ipro.org/index/homehealth_downloads)

  30. Telehealth Data Tool Request • Upon receipt of faxback form, IPRO will forward agency a CD ROM loaded with the Telehealth Data Tool & an electronic and hard copy of the User’s Manual • Available free of charge • Ongoing technical assistance is offered

  31. Additional Telehealth Resources • Available on MedQIC Web Site at http://www.medqic.org in Tools section of Home Health section • Goals & Objectives of Telehealth • Teletriage • Cost & Vendor Considerations • Phone Monitoring • Finance Considerations • Telehealth Clinical Needs Assessment

  32. Additional Telehealth Resources • Available on MedQIC Web Site in Home Health section at http://www.medqic.org • Teletriage • Nursing Guidelines for Teletriage • Teletriage Encounter Tools • Decision Support Tools • Disease & Symptom Specific • Risk Level Assessment • Physician Education Tools • Telerehab • Medication Management

  33. Additional Telehealth Resources • Link provided from Home Health section of the IPRO Web Site athttp://providers.ipro.org/index/homehealth_downloads • Diagnosis Specific Tools for CHF, Diabetes, COPD & Cancer • Decision Support Tools • Patient Selection Criteria • Patient Self-Care Workbook • Staff Education Tools

  34. Questions Comments

  35. Contact Information • Sara Butterfield , RN, BSN, CPHQ, CCM / Project Director • Phone: 518-426-3300 ext. 104 • Email: sbutterfield@nyqio.sdps.org • Christine Stegel RN, MS, CPHQ • Performance Improvement Coordinator • Phone: 518-426-3300 ext. 113 • Email: cstegel@nyqio.sdps.org • Victoria Agramonte RN, MS • Performance Improvement Coordinator • Phone: 518-426-3300 ext. 115 • Email: vagramonte@nyqio.sdps.org This material was prepared by IPRO, the Medicare Quality Improvement Organization for New York State, under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services. The contents do not necessarily reflect CMS policy. 8SOW-NY-TSK1B-07-08

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