Update

Becky and Jessica have been drafting out a guide for inventory management.  Specifically, like the status given equipment in its different return state and what happens when the equipment leaves Mosaic’s possession along with where equipment is in the inventory workflow.  The inventory management workflow will be placed into Mosaic’s workflow in the coming weeks to increase their oversight and insight into controlling the inventory 

Current enrollment is around 70 patients.  There is more equipment out than what we are receiving readings for so Aimee is going to follow-up to determine whether or not these patients graduated the program.  There has also been some conversation surrounding reading compliance to determine if there may be a better way to motivate the patients.

Lots of continued discussion surrounding changed to program delivery once integration has occurred.  Such items include whether or not data collection will change.  There has been additional conversations regarding the benefits and efficiency of having RCCHC patients use of Remote Monitoring Kiosk to take vitals at time of clinic check-in.  Initially the RCCHC would implement this process then perhaps send a kiosk to Mosaic for use if it proves sustainable and efficient.  Target would be spring 2016.

Challenges

There are still ongoing challenges regarding resource and workload management.  There will be another per diem nurse joining the team in September.  After OCHIN interface is fully integrated, Aimee will be working on refining the resource needs list.

Successes

Aimee has been making visits to the two newest sites, Redmond and Madras, based partly on feedback provided during an informal team interview.  We have a newly trained RNCC in Redmond who is fully onboard and excited about the program. We have a .3 employee who is assisting with the equipment cleaning and reset.  This is a great benefit.

Building and testing OCHIN interface is progressing.  We are looking to enroll active patient information into the system for testing purposes on or about 8/17/15.

Opportunities

Andy Eck is continuing to pursue opportunities available to expand the program.  Specifically targeting the St. Charles Medical system.  Andy has provided items to the executive for consideration and will be following-up once we have a better handle on the training manual, ideal life interface, etc.

Successes

80 patients enrolled in the program as of 6/4/2015 and referrals are increasing!  Andy is meeting with ancillary Service Director for medical clinics to determine whether or not the RPM program can be expanded in year three to St. Charles Medical.  

Thanks to  Aimee, all non-compliant patients and their providers have been contacted.  The patients have either come into compliance (actively participating) or the equipment has been recovered.

Celebrations!!

New per diem nurse has been trained by Aimee; this will assist with workload overflow and vacation coverage. 

OPPORTUNITIES

Andy Eck (Regional Director of Operations, Prineville) is making progress in coordinating with the CCO board regarding expansion of the RPM program outside Mosaic during year three. 

 

SUCCESSES

Andy Eck  (Regional Director of Operations, Prineville) has been asked to attend the upcoming Oregon Health Authority conference in June.   This governing body for Medicare want to know more details about our program, so Andy will give a mini presentation and lead a forum regarding the program.  The networking that this conference, the one in Seattle recently and others is wonderful. 

 

MOSAIC MEDICAL IN THE NEWS!

 Exciting news article published in our local paper; follow the link to see!

          On the job: Community health worker |

 Specialized outreach worker reduces barriers to care

http://www.bendbulletin.com/health/3004536-151/on-the-job-community-health-worker#

More NRTRC Annual Conference Notes

In addition to the presentation by our team going extremely well, there were many attendees discussing what role telehealth can and does play in behavioral health. It was encouraging to realize how long the concept of telehealth has been in practice and to see how its grown as technological advances have grown to support it. There are some thoughts on how this might implemented into our current program; early stages as of yet, but certainly something to look into.

 

FUTURE GROWTH

We continue to investigate partnering with the larger care organizations in our area to see where this program might fit to support their patients. Identifying the population and how to tap into is remains a high priority. The idea behind it always being continuity of care, patient engagement and supporting patients in a way that will encourage their engagement.

Observations

What are the staffing needs for a program like this? Based on best practices to date, this largely depends upon the number of patients brought onto the program at one time. The ideal manageable number for our locations and patient population 1 RN for every 75-100 patients. Ideally during the first year of implementation there should be at least one fulltime employee dedicated to the program then once it is in place 1 RN with 1 Per Diem Nurse seems to be sufficient.

Catching Up: Successes and Celebrations!

Patient participation grew from 67 patients in early December to 85 patients in mid-March for a total of 220-225 since the start of the program. Interpreters needed for certain demographics, this continues to be successfully managed as of December 18, 2014.

New per diem nurse hired for rural clinics to assist as back-up when primary RN is unavailable. This will ensure program continuity and reduce workload on primary RN. We continue to look for opportunities to support the local healthcare community as well as provide patients in rural areas with the monitoring care they need. To this end, we are researching possible partnerships with healthcare providers outside the Mosaic Medical arena.

 

Pros and Cons of Kits

Sending equipment kits home with patients versus completing individual in-home installments has proven to be a successful and effective model.  Since switching to kit installations, the COTN team is able to utilize their time more efficiently.  This method ensures that in the future, as enrollment rises, they will be able to accommodate larger numbers of patients, keeping up on readings and ensuring adequate communication with patients and providers.

The only drawback to this strategy thus far is a decrease in the level of personal connection between the COTN team and the patients whose health they monitor.  Meeting the patients in their home environment provided an opportunity for the team to get to know the patients better and learn more about their lifestyle.  Though still more efficient, it is now sometimes necessary to spend a little more time examining patient charts, or speaking on the phone with patients in order to create a clear picture of what is happening for them health-wise, the effectiveness of their medications, and what habits or activities may contribute to the state of their health.

The COTN program RNCC states that since switching to the kit method, the level of care provided to patients remains comprehensive, though the level of personal connection is not the same.

COTN Highlighted in Regional Newspaper

The launch of Telehealth in Prineville and Redmond has created a buzz around Central Oregon.  On October 8th, COTN was featured in the health section of the Bend Bulletin.

The article provided an overview of the Telehealth program, including the successes of the project thus far.  Two currently enrolled Telehealth patients were interviewed, and lent their opinions regarding their participation in the program.  Andy Eck, Clinic Manager of Mosaic Medical Prineville, and Aimee Priest, Mosaic's RN Care Coordinator, were also interviewed.

The following link will direct you to the Bend Bulletin website, where the article may be read online:
http://www.bendbulletin.com/health/2465399-151/patients-learn-to-monitor-own-vital-signs?entryType=0

Increase in Patient Contact

Telehealth monitoring has given us the opportunity to be in more frequent contact with our patients and the ability to recognize their needs in a timelier manner.  This has enabled us to make more referrals and obtain equipment that the patient may have needed. Meeting the patients’ needs leads to better health care and patient satisfaction.