July 23, 2019
BALTIMORE, MD–Senior Helpers®, the nation’s premier provider of in-home senior care, along with Curavi Health, a customized telemedicine solutions provider for the post-acute care setting, and Capital Coordinated Medicine (CCM), a home-based primary care (HBPC) practice, announced the results of a pilot study that tested a new model of connecting frail, functionally limited patients with primary care physicians via telemedicine.
Conducted in Washington D.C. and its surrounding area over the first half of 2019, the program engaged 33 patients who were seen virtually by a remote CCM physician using the assistance of an in-home ‘telepresenter’—a trained, certified nursing assistant provided by Senior Helpers. The telepresenter used Curavi Health’s telemedicine equipment to facilitate the virtual consultations.
Compared to the operational costs of an in-home visit by a primary care physician, the study found that telepresenter visits offered up to a 44 percent cost savings, with onsite visits by a telepresenter averaging 50 minutes, including equipment set up and takedown.
The telepresenter model was also found to be useful in supporting informed choices in care escalation compared to assessments based off information gathered from an initial phone intake. Seven of the 33 patients seen (21 percent) would have otherwise been referred to an emergency department had it not been for the telepresenter service.
“Our goal with this study was to showcase how trained in-home care workers can help HBPC practices better manage their staff resources to scale the benefits of primary care visits to larger cohorts of patients,” said Michael Hughes, Vice President of Strategic Development, Senior Helpers. “There’s been a resurging demand for in-home health consultations as the elderly population continues to climb. Our results illustrate that there is promise in using field-based telepresenters to help manage this demand.”
Telepresenter visits were available to patients who had first requested an in-home visit by a CCM physician. If a physician was not able to respond to a request within the first 24 hours, a telepresenter was sent to the patient’s home as an onsite member of the CCM team. Curavi Health’s telemedicine equipment included a Windows-based tablet with HIPPA-compliant telemedicine software, a tablet stand, a hand-held camera with a light, and equipment to capture basic vital sign information.
“The ability to be seen sooner by an HBPC physician benefits patients, physicians, and the healthcare system alike,” said Dr. Alan Abrams, consulting physician on the project. “Patients receive more immediate care, physicians can increase the numbers of patients seen, and responsive onsite examinations provide an opportunity for informed decisions in care escalation.”
“HBPC is widely recognized as an effective method of providing medical treatment for elderly and homebound patients, yet these care options can be limited where shortages in qualified medical professionals exist,” said Dr. Amy Schiffman, Founder and Medical Director at Capital Coordinated Medicine. “Bringing the doctor and equipment to the patient in the near term gives us opportunities to further diagnose and triage their related conditions, and make more informed choices about escalations in care, such as referrals to the emergency department.”
Despite efforts by industry and government to support the growth of telemedicine, only three percent of Medicare patients reported having any virtual connection with a medical professional within a prior six-month period. Telepresenter and other models that provide ‘warm introductions’ to telemedicine have the potential to increase its use, particularly amongst patients with functional limitations that challenge their ability to attend regular primary care appointments.
Functionally limited patients are considered among the highest consumers of healthcare services in the United States. It is estimated that five percent of U.S. patients consume 50 percent of all healthcare spending. Nearly two-thirds of these patients have some form of functional limitation. About one-third have limitations significant enough to require help with Activities of Daily Living, such as dressing and bathing.
“We are excited to extend our telemedicine solution to other post-acute and long-term care settings, including the home. We believe that this initial study shows how telemedicine can be used to provide goal-directed medical care directly in the patient’s home,” said Dr. Steven Handler, Chief Medical and Innovation Officer at Curavi Health. “By bringing this technology to the patient through use of a telepresenter, we were able to connect patients directly with their primary care team to deliver treatment more quickly. We’re hopeful this is a major stepping stone to a wider endeavor that’s able to cover a larger percentage of the homebound and elderly patient population.”