Saturday, February 7, 2009

Home-Health Models in Arkansas Praised

There was a really nice article by Carolyne Park in my local paper on Sunday, Feb 1, 2009, that states that the National Association for Home Care and Hospice would like to use our local Baptist Home Health model as the model for a national pilot program.

Baptist Health’s home-health model for treating chronically ill patients uses technology and a team approach to identify obstacles and help patients better manage their diseases. 

Patients are provided a small telehealth computer.  The patient then must use the secure network to send daily data (ie heart rate, blood pressure, oxygen level, blood sugar levels, etc) via phone line to Baptist’s main home health office in Little Rock.   A team of registered nurses and advanced practice nurses check the results for any potential problems.  If anything is noted, a team member will phone the patient.

The Center for Disease Control and Prevent states that 45% of Americans (133 million in all) have at least one chronic disease, such as heart disease, cancer, stroke, chronic obstructive pulmonary disease or diabetes.  The percentage is 60% in older adults who often have two or more chronic conditions.  These chronic diseases are the leading cause of death and disability in the US.  They also account for more than 75% of the nation’s $2 trillion health-care costs.

The home-health model is being viewed as a possible way to lower these deaths and decrease the overall cost.  Home-health nurses have time on their side.  By working closely with the patients, the nurses help the patients learn about their disease(s), care, and prescriptions.  By making home visits, they see the conditions they patient lives in (ie food in cabinets/refrigerator), whether there are family/friends for support, and can better access the patients for depression.  By doing this, the hope is that there will be fewer hospitalizations and fewer complications from the chronic diseases.

Medicare has been collecting data for many years on home health agencies and the outcomes of the patients they serve. This data is reported on the Medicare websites. The Baptist Health website list (last updated June 20, 2008) gives their numbers:

The quality of care you will receive from BAPTIST HEALTH Home Health is demonstrated by our outcomes in these 3 crucial areas (from data reported by our Little Rock office*):

  • Only 21% of our patients needed urgent, unplanned medical care.  This is among the lowest percentage of all home health agencies located in Pulaski County.
    • Average for all home health agencies in Arkansas is 23%
    • National average is 21%
  • Only 24% of our patients needed to be rehospitalized while under our care.  This is the lowest percentage of all home health agencies located in Pulaski County.
    • Average for all home health agencies in Arkansas is 32%
    • National average is 28%
  • A total of 72% of our patients were able to remain at home after they discharged from our agency.  This is the highest percentage of all home health agencies located in Pulaski County.
    • Average for all home health agencies in Arkansas is 63%
    • National average is 68%

St. Vincent Health System’s Visiting Nurse Association also combines technology with home health care. It has used telehealth computers to monitor patients in their homes for several years.  The Arkansas Gazette article states that “the technology has helped St. Vincent reduce hospital visits by its 400 home-health patients in 11 central Arkansas counties. In 2007, about 4.5 percent of the association’s heart-attack patients were rehospitalized, compared with a national rate of 37 percent.”

 

REFERENCES

Home-health program seen as national model; Arkansas Democrat-Gazette, Feb 1, 2009; Carolyne Park (subscription required)

Baptist Health Home Health Network

St. Vincent Health System’s Visiting Nurse Association

National Association for Home Care and Hospice

 

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