“Case Studies of Telehealth Programs in New York” published by the Center for Health Workforce Studies at the School of Public Health at the University at Albany, State University of New York, brings up several relevant points related to the implementation and use of telehealth programs.
New York City Health & Hospitals Corporation (HHC) serves 1.4 million patients annually. https://www.nychealthandhospitals.org. HHC has 4,500 acute care beds in eleven hospitals, 3,000 long term care or skilled nursing facility beds in a four long term care facilities, six diagnostic and treatment centers, and 80 community health clinics.
Today, it is estimated that two million people in New York State or 12.3 percent of the population have diabetes. In addition, it is estimated that more than 500,000 have diabetes but are unaware of their status. HHC’s network serves more than 50,000 adults with diabetes as well as many children and adults that are at risk of developing the disease.
The Center for Health Workforce’s report refers to the “House Calls Telehealth Program” to help chronical ill diabetic patients as being successful. HHC initiated their telehealth program” to help chronically ill patients effectively manage their health issues and helps patients with diabetes manage their medical issues efficiently and effectively.
Telehealth team members teach patients to make gradual, sustainable changes over time concerning their needs for diet, medication, and activity levels which hopefully will achieve permanent and positive health outcomes.
The House Calls program has been sustained since 2006 by a local service contract negotiated by HHC with their own health plan called “MetroPlus” www.metroplus.org. This enables HHC to be paid to manage the participating patients and facilities where HHC is in charge of related reimbursement costs.
Obtaining funding to support service delivery would be challenging if the program admitted patients who were not covered by MetroPlus. However, as of this date, only MetroPlus Medicaid or Medicare patients are able to participate in the telehealth program.
Both HHC and MetroPlus have benefited from the House Calls Telehealth program. In-house tracking data mined from EHRs and patient registries indicates success through reduced inpatient visits, reduced ED visits, improved medication adherence, and improved patient engagement with providers.
While the telehealth program has been positively received, some HHC providers are still hesitant to become involved. Some clinicians do not want to participate in the telehealth program because they believe that involvement will mean they are always on call and have expressed concern that they would not be readily available to respond to emails sent through the telehealth network.