Today I had the good luck to happen upon a #HIMSS15 session entitled “Improve Patient Engagement, Lower Readmissions with #mHealth.” I thought that was a bold statement to make on behalf of #mHealth. Since I’m a big sucker for a bold statement, I found myself drawn to the session like moth to flame.
The session was hosted by Richard Imbibe, CFO, and Dr. Thompson Boyd, MD at Hahnemann University Hospital in Philadelphia (approximately 300 staffed beds). Since Hahnemann was facing the same readmissions issues that all hospitals face, they wanted to experiment with the patient discharge processes with the goal of reducing readmissions. They faced a baseline readmissions rate of 26.7%, and they wanted to know what would happen if they messaged their patients post-discharge with reminders of post-discharge instructions. More specifically, they wanted to remind patients to attend their follow up appointments, which were a notable factor in whether or not a patient would be readmitted.
How the Study Worked
Hahnemann studied 368 heart failure patients because they were the “sickest of the sick”. The initial study period was 10 months in duration, and they deployed a cloud based HIPAA compliant platform to manage messaging across devices and roles. On the ground, social workers were trained to meet with patients to enroll them in the program. Initially, the patient was able to opt-in to the program. As is shown in similarly organized 401(k) opt-in programs, Hehnemann found that making the program “opt-out” increased participation dramatically. They also found it helpful to improve their “sales pitch” as well.
Once enrolled in this program, the patients would receive post discharge instructions via text message. No PHI was transmitted during these communications. These messages included reminders of follow up appointments. Hahnemann found that the number of days between discharge and follow-up appointment was the most important factor for readmissions during the delicate time post discharge.
How Did They Do?
Hahnemann found the program to be successful for not only decreasing readmissions but also through lowering the cost associated with managing discharged patients. Overall, those that were messaged had a readmissions rate of 16%. For those patients that participated in the program and came back within a week for their follow-up appointment, the readmission rate was an incredible 11%. Those in the control group, which were actually subject to other measures towards reducing readmisisons, were at 23%.
Some of the more interesting information shared during the study was data around income variation of participants. I often hear health systems say, “I would love to have an mHelath program, but then I wouldn’t be reaching our patients with lower income.” In fact, Hahnemann found that lower income patients were more likely to participate in the program and those lower income patients had incredible reductions in readmissions as can be seen in the slide from the session below.
Ultimately, we have 91% U.S. adult adoption of mobile technology. Text messaging programs have proven to be effective to keep low income mothers and babies healthy (Text4Baby), reduce diabetes patient reliability on the ER (Los Angeles Hospital), and now to reduce readmissions of the “sickest of the sick.”
Click here for the slides to the presentation.