“People are living longer, but they’re living sicker longer. Our mission is to keep these patients stable, satisfied and comfortable, and possibly keep them out of the hospital when it’s necessary.” — Alex Binder
Binder, Vice President of the Advanced Care Institute for the New Jersey-based VNA Health Group, recently joined MGMA senior editor Daniel Williams on the MGMA Insider podcast to talk about the future – and the challenges – of mobile health solutions.
Binder said a key objective of any mobile health regimen is avoiding “windshield time” – the wasted downtime physicians spend on the road as they reach out to interact with patients. Unfortunately, as he noted, the industry so far has been slow to adapt and implement telehealth technology, as a mix of confusion about costs and regulations has slowed deployment. Binder hopes to change that, with solutions that save money and prioritize care.
“It’s really about putting money where there’s value. We’re hoping that you can measure the value of what we provide in terms out outcomes of patient comfort and satisfaction, and in reducing the overall expense of these patients,” and then prove that to the payer, he added.
And while end-of-life expenses typically run as high as $40,000 per year, Binder says his telehealth solutions have reduced that to as little as $24,000. “Once we get some properly-attributed, properly risk-adjusted analysis of our patient population, we will be able to prove our value significantly. And we still think there’s room for improvement.”
Binder cited the example of New Jersey’s PatientPing, a national care coordination solution which offers doctors, emergency personnel and healthcare managers with instantaneous data about patient admissions, discharges and transfer information, working in cooperation with telematics provider ADT.
“It was news to me that every hospital has real-time data that they’re required to collect, so PatientPing becomes an aggregator of that. We cover a large geographic area, with probably 20 different hospitals, and for us to know that one of patients has shown up, then we can support the process from there – we can contact the hospital and the family.”
That data interconnectivity can also help providers (and insurers) cut down on so-called “frequent fliers,” identifying patients who are often needlessly readmitted, and provide them more cost-efficient home or alternative care.
“We make sure that when we get a ping that the patient’s being discharged again we get in touch with the family and we schedule a visit, and make sure that someone is going to go out there and look at the medications and reconcile everything,” he said. “When they’re hospitalized, it’s also a way to monitor where our patient is and stay in contact with them and oversee the coordination of care, back to the home.”
Solutions such as PatientPing will, Binder said, may help prove the value and drive further acceptance of telehealth protocols and tech tools. It’s been a slow climb so far, he admitted.
“When I go to give a presentation or talk to patients and family and ask if anyone has ever experienced or performed a virtual visit, the numbers are still very low. We haven’t seen that tipping point, but we know it’s right around the corner. We’re in an environment society needs, as consumers are demanding very quick response times.”
Binder said that the new world of electronically-curated home care also comes with its own challenges, as providers need to balance patient privacy and confidentiality with issues as real as coping with family members and addressing their own safety while making house calls.
“Part of our protocol is ‘we need to meet you before you treat.’ They need to walk into the house, introduce themselves and understand who else is there, and their level of involvement with the patient care. There are situations where there are very difficult conversations we need to have with patients, but we may not want to discuss in front of the whole family – or ask people to leave the room, if we’re doing an examination. We just try to establish a relationship with these families and these patients – that really is the key to respecting their privacy and getting the involvement that they would prefer.”