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Humana Tests Remote Patient Monitoring to Reduce Readmissions

 |  By Margaret@example.com  
   January 15, 2014

The insurer's chronic care health division is partnering with several telehealth providers to test various remote monitoring formats for common causes of readmissions.

Humana is testing a pilot project that adds a new wrinkle to patient engagement and telehealth: passive remote patient monitoring.

Humana Cares/SeniorBridge, the Louisville-based healthcare insurer's chronic care health division, is partnering with HealthSense, a provider of senior care technology, in a year-long pilot. The project uses in-home sensors and remote monitoring technology to monitor how changes in daily activities may signal a change in health status for certain Medicare Advantage enrollees.

Humana has enrolled 100 Medicare Advantage members in the pilot, which is under way in Florida, Kentucky, North Carolina, South Carolina, and West Virginia. Many of the pilot participants are over age 70 and have multiple chronic illnesses, including congestive heart failure, COPD, diabetes, and hypertension. They have each experienced at least two hospital admissions over the past 12 months and already receive regular weekly visits from in-home care managers. They were recruited to the pilot program by the care managers.

Among the pilot goals, says Denise Streible, RN, a program manager with Humana, is to detect emerging health concerns before they turn into emergencies that could require a costly trip to the ER or a preventable hospital readmission. Those readmissions are top of mind for most providers these days as new rules make 30-day readmission rates public and can result in lower reimbursements.

The remote monitoring program, dubbed eNeighbor, sets up 11 sensors throughout a participant's home. There are four types of sensors:

  • Motion sensors placed on walls that monitor the movement pattern within the home
  • Contact sensors placed on the refrigerator or kitchen cabinets
  • Bed sensors placed between the mattress and box springs
  • Toilet sensors that monitor flushes

Together the sensors and Healthsense software collect information to establish the daily routine of each participant. No biometric measurements such as blood pressure are included. The daily routine is the benchmark for establishing when medical assistance is needed without a person needing to check in, punch a button, or pull a cord.

The goal is to detect changes in daily activities. If a participant typically opens the refrigerator door at 7 am but doesn't one morning, then a telephone call will be made to the home. If no one answers, then the care manager and the member's emergency contact will be alerted.

More subtle changes can also be identified. "We can learn about things like restless sleep, which could mean a member is in pain, or increased toileting, which could indicate a urinary tract infection. Information like that can help us to get our members connected with their physician faster and helps us update their care plans," says Streible.

"We really expect that this type of information is going to help us intervene early," she adds. It may also help in educating members about some of the more subtle signs of a health problem.

ENeighbor is one of several pilots Humana has undertaken to measure the effectiveness of remote patient monitoring. Many are focused on CHF, which is a leading cause of hospital readmissions. A study published last year in The Journal of the American Medical Association found that 24.8% of Medicare patients admitted for heart failure were readmitted within 30 days after discharge.

One CHF pilot monitors more than 400 Humana Medicare Advantage members in Ohio. The remote patient monitoring solutions include Bluetooth-enabled weight scales and blood pressure monitors and interactive voice response technology. Humana is partnering with AMC Health, a New York-based telehealth provider. Coaches and care managers work with participants to modify unhealthy behaviors and help them comply with their treatment regimens.

In 2011, Humana teamed with Intel-GE in a long-term pilot to remotely manage the care of 2,000 CHF patients in 33 states. The program combines daily monitoring of biometric measures by Humana nurses as well as face-to-face tele-meetings via computer. Depending on the results, the program may be rolled out to members with other chronic conditions, such as diabetes.

Margaret Dick Tocknell is a reporter/editor with HealthLeaders Media.
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