Photography by Glenn Oakley.
“They were pretty much getting all of their diabetes care in the ER,” says Michael Adcock, executive director of UMMC’s Center for Telehealth.
Participants were given tablets to educate them and monitor their symptoms at home. Providers would intervene in real time when necessary.
“It’s transformational,” Adcock says. “After six months, we had zero hospitalizations and ER visits related to diabetes.”
Savings from the reduction in hospital admissions through the first six months totaled $339,000. UMMC has since extended the program, which now uses iPad minis with cellular connectivity, to adult and pediatric diabetes, heart failure, chronic obstructive pulmonary disease, hypertension, adult and pediatric asthma and high-risk pregnancies. An iPad alarm alerts patients to take their measurements using Bluetooth-enabled glucometers, scales or blood pressure cuffs, and conduct brief health sessions to gauge symptoms. The data then is sent electronically to center staff.
St. Luke’s has a similar remote patient monitoring program that also disperses iPad minis and Bluetooth-enabled peripherals for patients with diabetes, hypertension, coronary artery disease, congestive heart failure and COPD. Data gathered through telehealth software is transmitted to the virtual care center, where a nurse receives alerts when patients answer questions or have aberrant vital signs.
The nurse can reach out to patients by phone, secure text message or a two-way audiovisual link in the home to then direct them to appropriate care.
“We knew there was an opportunity, but we didn’t recognize the magnitude of opportunity that the program would present to our patients,” Stadler says.
Customized Carts Optimize Urgent Care
Since fall 2017, MainStreet Family Urgent Care, which has 16 clinics in rural Alabama, has leveraged telemedicine tools to offer urgent-care services. After countless inquiries from its patients, the organization decided to add primary-care services last summer.
MainStreet’s business model, designed to address the challenge of recruiting providers to rural areas, is to employ small staffs (often a nurse practitioner and medical assistants) and connect with a cadre of remote physicians.