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Bridging care

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Patients with congestive heart failure were the first to benefit from RPM efforts at the University of Pittsburgh Medical Center, which has grown its program to target those with COPD and postpartum hypertension. It is also used in a hospice setting. Connected healthcare peripherals in the UPMC stable include scales, blood pressure cuffs, and pulse oximeters. Used in combination with a patient’s smartphone or tablet, they track patient metrics such as weight and blood pressure. One goal is to help prevent readmissions and ER visits. But another goal is to help those patients better manage their conditions on their own.

Results are transmitted to a call center staffed by eight UPMC nurses, who monitor the incoming metrics on HP desktop computers and Dell laptops. Then, they discuss the findings with patients via phone or video calls. 

“One goal is to help prevent readmissions and ER visits,” says Kimberly Armahizer, clinical supervisor for innovative homecare solutions at UPMC. “But another goal is to help those patients better manage their conditions on their own. The programs are for 60 or 90 days, and afterward, patients are more aware of their symptoms and can better assess themselves daily.” 

The call center serves as a bridge to determining patient needs and appropriate care. Nurses often reach out after RPM tools detect a sudden spike in a user’s weight. Sometimes, it will turn out that a pet jumped on the scale. But other times, patients will confess they ate something not included in their care plan; nurses will reeducate them on the value of a healthy diet. 

That approach recently helped one patient avoid rehospitalization. “There were medication adjustments, we followed that patient through the rest of the day, and the next day, their weight returned to normal,” she says. “That prevented the patient from going to the ER. They were very thrilled just to be able to stay at home.”vi