Tuesday, October 18, 2011

Skype As An Innovative Solution to Reducing Hospital Readmissions

October 18, 2011 - I recently installed Skype, an online software application in order to talk regularly to my son, Spencer, who is now functioning as an Episcopalian Priest in Madrid Spain.

To do this, I simply bought a Skype camera and audio device for $43 to attach to my personal computer. Now I can dial my son’s number and talk to him free of charge, with full visual and audio contract by simply clicking in his Skype number.

When you talk of innovation, it is important to be specific. Otherwise what you say falls on deaf ears. To speak of innovation is easy, to give specific practical solutions is more difficult.

Here I will suggest that Skype, an online service now operated by Microsoft, offers a specific solution to the problem of hospital readmissions, which cost hospitals, Medicare, and Medicaid a bundle. As of September 2011, Skype had 663 million users, which means it is practical for almost anyone to use.

Because of government regulations limiting payment for DRGs (Diagnosis Related Groups), CMS pays only for a limited number of days for a given diagnosis. To avoid being penalized for overstays, hospitals may discharge patients “quicker and sicker” to avoid Medicare payment penalties.

Unfortunately, some 20% of these patients are readmitted. Medicare and Hospitals have to swallow the costs of readmission and more extended hospital stays.

These readmissions are avoidable. I pointed this out in a blog describing an innovative program developed by a company in Minnesota, whose CEO is an internist named Randy Moore.

Randy Moore, MD, CEO of American Telecare, Inc, in Eden Prairie, Minnesota, whose firm has placed audiovisual devices connected by ordinary phone lines at the bedside of chronically-ill, home bound patients.

Through these devices, doctors and nurses can monitor weight, blood pressure, blood oxygen, listen to the heart and lungs, and observe the patients. Patients control the devices and have proven to be extraordinarily adept at learning and spotting their own complications.

The result? Readmissions to the ER and the hospitals have dropped dramatically. These audio-visual devices, which carry data over phone lines, could installed in the homes of millions of people with heart disease and chronic obstructive lung disease, the #1 and #4 causes of death in America, and leading causes of hospitalization. Experience has shown patients equipped with these devices next to their bedside become extremely adept at recognizing those signs and symptoms that lead to ER visits or hospital admissions.

Why not have hospitals and their doctors and nurses buy laptop computers, which now routinely have Skype audio and visual attachments, for patients discharged with diseases, such as congestive heart failure and COPD, to take home with them?

Patients could keep these laptops near their bedside. When patients feel they are developing a complication, they could use Skype to call the hospital. Hospital personnel could then judge the situation with a full view of the patient and take appropriate action. It’s not the same as a physical face-to-face evaluation, but it’s close and it’s much less expensive.

Tweet: Homebound chronically-ill patients could use Skype to notify hospital personnel of complications and prevent readmissions.


BobbyG said...

You ought check out Apple's "Face Time" app. 99 cents. HIPAA compliant. Not kidding. I just installed it.


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