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.

Update

As of June 18, we had 78 active participants with a total of 90 units in the field.  We will be looking into the discrepancies.  We are still looking into the Glucometer enabler issue presented previously. the Glucometers are less cumbersome for the patients and may be more efficient than enablers due to the communication issues presented. Due to these factors, it is likely data collection will be more consistent if supported by the Glucometers.  Currently we are also working on completing drafts of procedure manuals focusing on the remote RN support.  This would provide a guide for any nurse to step into the support function with ease as well as provide information for other locations that are interested in starting a similar program. 

Successes

Andy Eck is still working closely with St. Charles Medical System to explore expansion of the program.  Networking through this channel and the recent regional meetings has made state level agencies more aware of what is happening in their own "back yard", so to speak.  Wonderful awareness!

Challenges

OCHIN interface still in process; completion target dates have come an gone.  Resources at our end are needed to support testing, yet as of June 18 there is no definite test date confirmed. We still don't have a committed resource to back-up our Regional RN, Aimee Priest.  While we did finish training a per diem nurse, this resource may not be sufficient to cover all needs.  

CHALLENGES

OHCHIN interface software testing and implementation continues to be a challenge.  Reports from developers do not coincide with actions noted those involved in launch at sites.  This translates into continued inefficiencies based on the need to maintain records in two seperate EMR systems. 

 

PAM Scores

As per the HERSA grant which is funding the expansion of Telehealth into Central Oregon, patients are required to complete pre- and post- Patient Activation Measure scores.

One challenge with this process is that some patients are reluctant to complete the surveys.  Others fail to return their completed surveys.

A second hurdle has been sorting out how to keep track of the scores.  When COTN first launched Telehealth in Prineville in 2013, the process involved scanning the completed forms so that they were accessible electronically.  Once scanned, the forms were saved in in “other orders” – this was prior to there being a specific place in EPIC for the forms to call home.

Heading forward, the scores will be saved in the “referral” section in EPIC, and pre- and post- scores will be entered into an Excel Spreadsheet as they are collected.