Telemedicine provides value to Patients, Physicians, Healthcare Providers, and Payers.  The current trend in healthcare is to reduce length of stay, eliminate returns to the hospital and improve clinical outcomes, all for less.  As seen with the creation of the Readmissions Reduction Program  in 2012,part of the Affordable Care Act, Healthcare has changed.  The days of sending patients back to the Hospital for common changes in conditions such as rising temperatures, need for IV hydration/ABT, change in mental status, increasing or new pain, uncontrollable nausea/vomiting, unstable vitals, increasing or new SOB, chest pain, or change in respiratory rates are no longer accepted.  Post-Acute\Skilled Nursing providers are admitting patients who are more acute and require more clinical care than ever before.   Post-Acute\Skilled Nursing providers have to change traditional clinical operations to meet the clinical demands of more acute patients and the quality demands from the payers.  Furthermore,  Post-Acute\Skilled Nursing providers need to accept that payers are now going to embed their clinicians into the clinical decision making process.

Given that readmissions to the hospital and length of stay are being heavily scrutinized by payers and hospitals, the standards of care needs to be elevated to ensure positive clinical outcomes.  Often times Post-Acute\Skilled Nursing providers have reduced clinical oversight of their patients during the night shift.  Advanced clinical oversight from Physicians and Advanced Nurse Practitioners is normally not readily available for staff RNs.  Historically when an RN identifies a sudden change in condition on the night shift, they have to call the primary care physician.  If the RN is unable to get a hold of the Physician, they need to call 911 so the patient can be evaluated in the Emergency Department (ED).  Payers and Hospitals want to eliminate these avoidable readmissions to the Hospital due to financial implications.  Hospitals are required to meet the objectives outlined in the Readmissions Reduction Program or face up to a 3% penalty of all Medicare claims.  Managed Care, Private and Medicare payers, want to eliminate avoidable readmissions to the hospital to eliminate the costs associated with hospital admissions.  The average cost of a hospital readmission is estimated at $15,000 per admission.  Many readmissions to the hospital are avoidable, with an average readmission cost of $15,000, avoidable readmissions to the hospital need to end.

Payers have begun to change their role related to the clinical care of their patients.  Payers now want to control the clinical decisions that are made for their patients.  Payers are utilizing their own RN case managers along with Advanced Nurse Practitioners and Physicians to make clinical decisions to achieve the desired clinical outcomes.  It is not unusual for Post-Acute\Skilled Nursing providers to be required to contact the payers Advance Practice Nurses in the event of a change in condition.  Often times these Advance Practice Nurses are required to be on call for changes in conditions overnight.  Many payers require their clinicians to be contacted in the event of a change in condition in hopes to prevent an avoidable readmission to the Hospital.  It is important to note that the staff RN needs to utilize critical clinical decision making because emergency changes in conditions should be sent to the Hospital via a call to 911.

Payers who leverage their clinical resources to manage their patients require a solution to see patients without geographical barriers.  Telemedicine will play a major role to enhance payers clinical oversight provided during the night shift but also around the clock.  Payers can use Telemedicine to allow Physicians and Advanced Nurse Practitioners to follow their patients from a central location or a home office. In order for Physicians or Advanced Practice Nurses to perform a comprehensive remote assessment of a patient the providers will need diagnostic tools. The use of a Stethoscope is a fundamental diagnostic tool that every clinician uses to assess and manage their patients.  Many Telemedicine solutions simply use video conferencing to allow a face to face patient and physician encounter.

Advanced Telemedicine solutions such as the CARE Telemedicine solutions by Curatess include necessary diagnostic tools for remote Physicians and Advance Practice Nurses to perform advanced remote clinical assessments.  In addition to being able to listen to heart, lung, and bowel sounds, clinicians need a high quality image of their patients.  The CARE Telemedicine solution allows Physician and Advance Practice Nurse to remotely control a high resolution\HD, Pan, Tilt and Zoom camera to observe physical discomfort, skin color, troubled respiratory rates, or any other visual symptom.  Traditional web cameras are unable to provide the video quality that is necessary in making advanced clinical decisions to manage a change in condition remotely.

Telemedicine will be used by Payers as another clinical tool to assist managing clinical outcomes for their patients.  Payers are scrutinizing Healthcare providers for return to hospital rate as well as length of stay.  Post-Acute care\Skilled Nursing providers will need to enhance the advanced clinical oversight both during the day as well as in the evening and weekend.  If Post-Acute\Skilled Nursing providers do not modify their existing methods, it will be difficult to meet the demands being placed on Healthcare.  Patients are leaving the Hospital sooner, and therefore are admitted to Post-Acute care\Skilled Nursing providers with higher clinical needs.  Healthcare has changed so the delivery of Healthcare also needs to change.  Telemedicine enhances Healthcare delivery and allows immediate access to Physicians and Advance Practice Nurses to manage changes in condition within the current care setting.  Curatess Telemedicine solutions empower Healthcare providers with the  necessary tools to meet the current and future demands of Healthcare.  To learn more about how the CARE Telemedicine Solution works or to contact our team, please visit our website at www.curatess.com.

Sources
www.cms.gov