April 2, 2016

Proof in Outcomes

Delivering Value

The ActiCare Health Monitoring Program has been specifically developed to help you and your organization improve health outcomes while significantly reducing costs per patient, enabling higher profitability and program growth. The platform, combined with our 24×7 support, allows your care coordination team to maintain the closest possible contact with patients, fostering better adherence to discharge instructions and helping to identify risks or complications early, so that you can make timely interventions where appropriate. By making it so efficient to monitor and communicate with your patients we minimize administrative burdens facing your team while simultaneously reducing overall costs to care for each patient. Additionally, the responsiveness, attention, and education we offer your patients are designed to improve satisfaction levels and support your QAPI initiatives, bolstering the reputation of your department or health system.

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Greater Patient Satisfaction

Beautiful elderly couple enjoying in the nature with their dog.A recent study of 15,710 individuals who received kidney transplants observed that patients who reported greater satisfaction with their care had significantly better graft and survival rates than patients who did not (1). Similarly, a 2009 review of VAD outpatient management strategies found that patients receiving more extensive follow-up support reported higher levels of satisfaction and experienced better clinical outcomes than patients who did not (2).

Patient satisfaction is the hallmark of the ActiCare Health monitoring experience. First and foremost, our high-touch service gives patients access to the information and care they need, when they need it. By monitoring their health in the comfort of their homes, we also help to reduce patient and caregiver time spent traveling to and from appointments. And, because our program is designed to improve safety, outcomes, and time spent in the hospital post-surgery, we offer an option that can significantly improve quality of life, giving transplant and VAD recipients an opportunity to live with greater freedom.

Stopping the Revolving Door

Several studies have now shown that hospital readmissions following solid organ transplantation and VAD implantation occur all too frequently. A national analysis of nearly 12,000 liver transplant recipients found that more than one-third were readmitted to their transplant center within 30 days of their initial hospitalization and, for some transplant centers, readmission rates were as high as 50% (3). A nationwide study of kidney transplant recipients uncovered strikingly similar results, and both studies reported that rehospitalization came at very high costs–approximately $44,000 for liver patients and $11,000 for kidney patients (3,4).

Readmission rates for patients with VADs are even higher. A 2015 study found that, of 148 VAD patients followed for at least 12 months, more than 81% were readmitted to the hospital, at a rate of 2.1 readmissions per year (5). A 2014 study of 693 VAD patients reported similar readmission rates and found that 16% of patients had five or more readmissions during a follow-up period of less than eight months (6).

Fortunately, many readmissions can be prevented, especially if patients who are at risk for rehospitalization are more actively monitored post-discharge (7,8). A 2016 longitudinal study of 98 VAD recipients found that patients who received home monitoring services were 36% less likely to be rehospitalized for all causes and 59% less likely to be readmitted for LVAD-specific complications than patients who did not (9).  The ActiCare Health Monitoring Program has been developed with a primary goal of reducing avoidable readmission days. By monitoring patients vital signs and symptoms daily, we are able to identify early warning signs of rejection, infection, or other complications that could lead to more costly downstream hospitalizations. And, by providing you with greater visibility into patients’ current health status, we allow you to make more timely interventions where appropriate, directly through our technology. Finally, we help to reinforce your care instructions, so that patients remain on track and in position to have the best possible recovery.

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(1) Srinivas R et al. “Association between patient satisfaction and outcomes in kidney transplant.” Am J Med Qual. 2015 Mar-Apr; 30(2):180-5.

(2) Wilson et al. Ventricular Assist Devices: The Challenges of Outpatient Management. J Am Coll Cardiol. 2009;54(18):1647-1659. doi:10.1016/j.jacc.2009.06.035.

(3) Wilson GC et al. “Variation by center and economic burden of readmissions after liver transplantation.” Liver Transpl. 2015; doi: 10.1002/lt.24112.

(4) McAdams-DeMarco MA et al. “Early hospital readmission after kidney transplantation: patient and center-level associations.” American Journal of Transplantation. 2012; 12: 3283–3288.

(5) Hernandez et al. Present-Day Hospital Readmissions after Left Ventricular Assist Device Implantation: A Large Single-Center Study. Tex Heart Inst J. 2015 Oct; 42(5): 419–429.

(6) Dunley MS et al. Abstract 208: Hospital Readmissions After Left Ventricular Assist Device Implantation. Circulation: Cardiovascular Quality and Outcomes. 2014; 7: A208.

(7) Paterno F et al. “Hospital utilization and consequences of readmissions after liver transplantation.” Surgery. Oct 2014; 156(4): 871–880.

(8) Taber DJ et al. “Inclusion of dynamic clinical data improves the predictive performance of a 30-day readmission risk model in kidney transplantation.” Transplantation. 2015 Feb; 99(2): 324-30.

(9) Psotka, M., Svetlichnaya, J, Kassemos, M., Kobasic, K., McClure, K., Sharma, S., …Klein, L. (2016, November). Home Monitoring is associated with fewer hospital readmissions following left ventricular assist device implantation. Poster session presented at the American Heart Association Scientific Sessions, New Orleans, LA.