Five years ago, the federal government announced it would begin fining hospitals if Medicare patients were discharged but had to come back. Experts argued there was little incentive to follow-up on patients, since medical centers would make more money if people were re-admitted.
Some hospital administrators dreaded the change, but at the University of Virginia, they’re excited to report dramatic reductions in re-admissions.
Arthritis has long been a problem for 71-year-old Harry Yowell, and this year he decided to have joint replacement surgery. It went well, and two days later, he was discharged from the hospital. Nurse Lisa Slate is with Broad Axe Care Coordination, a company that works with the university of Virginia Medical Center to monitor patients from home.
“They are educated on what to expect, on what to watch for after the surgery.”
On day one, the company showed Yowell how to use simple equipment to check his vital signs and transmit data directly to Broad Axe.
“What they measure specifically are their blood pressure, their oxygen saturation, their heart rate and their temperature.”
Yowell said it was easy enough.
“I don’t mind that. You push a button. It’s no big deal.”
And he was happy to be out of the hospital.
“Obvious reasons. I wanted to be home. Got my TV, my remote control, my family and everything around.”
His wife Barbara found the service reassuring.
“Makes it easy. If anything came up, if Harry had any questions, we could call them.”
And visiting nurse Angela Key-Kirby was on call to investigate any possible problems.
“So like when they are having a little bit of an elevated temperature, we’ll go out and check and see if the wound looks different, if we’re noticing any other symptoms, and then see if the patient can go to the doctor.”
Even if things appeared to be fine, Slate made sure Yowell kept follow-up appointments.
“When they go home from the hospital and they don’t see a physician in the next few weeks or so, that’s when they’re so much more likely to end up being re-admitted.”
And today, hospital administrators are happy to report re-admissions are down overall.
“ We’ve seen a 45% decrease in their re-admissions.”
UVA’s Maggie Short says the numbers were even better for joint replacement surgery.
“In the 8 months that we’ve measured, we’ve seen a 75% decrease.”
In addition to joint replacement, the program is centered on patients with congestive heart failure, chronic obstructive pulmonary disease, pneumonia, heart attack, stroke and coronary bypass - conditions most likely to involve a return to the hospital.
That’s a stressful prospect for patients and an expensive one for hospitals that may pay fines of up to $200,000 each time someone must be re-admitted. UVA has enrolled about 1,500 patients annually in the home monitoring program and hopes to increase that number in the years to come.
