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• W2891858408 abstract "The aim of this pilot was to implement a telemedicine program in the nursing home setting and to measure the effect of telemedicine in reducing preventable hospital transfers. Our data reports on a pilot initiated at a skilled nursing facility in Staten Island, New York participating in the Delivery System Reform Incentive Payment (DSRIP) program. Starting January 2016, we implemented a 3-month pilot telemedicine program at a 300-bed skilled nursing facility in Staten Island, New York. A board-certified emergency physician was available via telemedicine video conferencing for consultation over each weekend from 5 P.M. Friday until 7 A.M. Monday. The telemedicine physicians were granted clinical privileges at the facility. A comprehensive telemedicine technology system using the Medisprout telemedicine software platform as well as a tele-stethescope was implemented at the pilot site. Skilled nursing facility registered nurses were trained in the use of the telemedicine equipment and software. Pursuant to agreed upon criteria, facility staff contacted the telemedicine physician team when a change in condition was identified. The baseline transfer rate from January through March 2015 was 2.93 transfers per 1,000 resident days. During the pilot period which ran from January through March 2016, the transfer rate was 1.83 per 1,000 resident days, a 38% decrease. Using the paired t-test, we compared transfer rates from the baseline period to the pilot period yielding a statistically significant reduction in transfers (p=0.004). When excluding the first month’s performance to account for staff adjusting to the new process, there was a 50% decrease in transfers from 2.93 transfers per 1,000 resident days to 1.47 transfers per 1,000 resident days. Similarly when comparing the 3 months that immediately preceded the pilot, the transfer rate declined 31%, from 2.64 per 1,000 resident days to 1.83 per 1,000 resident days (p=0.02). Telemedicine is a valuable tool to decrease hospital transfers from skilled nursing facilities. We hypothesize that the telemedicine consultation and ensuing clinical orders allowed the skilled nursing facility to utilize their clinical capabilities to their fullest capacity by managing medically complex patients on-site as opposed to initiating preventable hospital transfer. The Minimum Data Set scores derived from comprehensive quality assessments were unchanged during the pilot period. When averaging the top 3 re-hospitalization admission diagnoses, this reduction has the potential to save $65,000 per 100 patients per month or $2.4 million for this facility." @default.
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• W2891858408 date "2018-10-01" @default.
• W2891858408 modified "2023-09-26" @default.
• W2891858408 title "292 Assessing the Impact of Telemedicine on Nursing Home Transfers" @default.
• W2891858408 doi "https://doi.org/10.1016/j.annemergmed.2018.08.297" @default.
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