The Benefits of Telehealth for Post-Discharge Care
A scalable solution for tackling readmissions
The transition of care from hospital-to-home (or another health facility) is a crucial part of a patient's journey. When done well, it can boost patient health outcomes and provide cost savings to healthcare systems. However, therapeutic errors, failed hand-offs and poor follow-up, for example, can lead to preventable readmissions soon after discharge.
Fortunately, one way that medical organizations and health plans can help combat these avoidable readmissions is telehealth. Below, we’ll unravel five benefits of utilizing post-discharge telehealth services so you can assess if it's something your company should implement, too.
1. Improves patient compliance
One major reason for preventable readmissions is patient non-compliance. Some patients intentionally ignore their discharge instructions because they disagree with the recommendations. Then, there are others who may not fully understand their new treatment plan. Patients are often sedated and tired at discharge, and healthcare literacy could be a concern, too.
Therefore, to help improve patient compliance issues, some hospitals have put transitional care plans in place. This low-cost strategy involves having nurses make a post-discharge phone call, where they can ask questions to detect clinical problems and offer resources.
Current research suggests that these phone calls, which are a form of telehealth, are associated with decreased readmissions. One study found that making two to three post-discharge calls per patient is ideal for the best results.
2. Addresses patient access to care issues
After a patient leaves the hospital, they’re expected to make a follow-up appointment with their primary care physician. This step is crucial for proper continuity of care, as a patient’s primary care doctor can best discern if the treatment plan provided at discharge needs to be altered.
However, disparities in access to primary care exist, and they can have serious repercussions.
Some of these barriers include:
Inability to take time off
Language barriers
Transportation difficulties
Physical disability
Shortage of primary care doctors
Patients with no medical support during their post-discharge recovery are more likely to return to the hospital for additional care.
However, telehealth can help bridge the gap. It has the ability to expand care services to those in rural areas, locations where provider shortages exist, and more.
Telehealth also has the potential to promote health equity by providing access to historically marginalized populations. This, in turn, helps prevent unnecessary emergency department visits and prolonged hospitalizations, especially among those most at risk.
3. Provides cost savings
It almost goes without saying, but hospital readmissions are expensive.
Patients end up with significant out-of-pocket costs, and some sources state that 30-day readmissions cost hospitals over $16,000 each. In addition, hospitals get hit with penalties from the Hospital Readmissions Reduction Program (HRRP) created by the Centers for Medicaid & Medicare Services (CMS). Currently, CMS can withhold up to 3% of reimbursements for readmissions within 30 days, which can be financially devastating for hospitals.
However, CMS isn’t just imposing fees for no reason. The cost of Medicare hospital readmissions was nearly $30 billion in 2013 alone, so they’re looking to reduce spending.
Employers, who make up the majority of private healthcare spending, also feel the financial impact of readmissions. Unfortunately, though, they themselves and the insurance carriers they work with don’t have similar initiatives as CMS to mitigate costs. As a result, post-discharge interventions, like telehealth, are needed to help tackle these issues.
Studies suggest a positive ROI
For example, one study found that behavioral and contextualized support via phone, video or web chat following discharge was linked to a reduced total cost of readmissions. The reduced fees are likely attributed to medical professionals encouraging patients to seek medical attention before their condition worsens.
Another study assessed the impact and outcome of patients participating in virtual post-discharge visits in the early-pandemic timeframe. Researchers discovered that the expansion of virtual post-discharge visits didn’t negatively affect impact rates of 30-day post-discharge hospital encounters. These telehealth options also didn’t seem to negatively impact healthcare utilization.
4. Fosters better provider-to-provider communication
Written discharge summaries may not be enough when dealing with medically complex patients, even between providers. Explaining and interpreting the nuances during hand-off is often challenging, which can cause issues later.
Plus, there’s often ambiguity at this stage regarding who actually owns the care of the patient between discharge and the patient's initial appointment with a doctor. Coupling that with hospital systems and primary care doctors using different health information systems, it’s a recipe for gaps in care.
Let's look at an example: Medically complex infants
Statistics show that up to 50% of preterm NICU graduates visit the emergency department within three months of discharge. They also have the highest risk of readmission two weeks after discharge. This population often involves several medications, different types of medical equipment and abnormal exams. Thus, making hand-off difficult.
Therefore, one study sought to review the use of telehealth to better hand-offs between neonatologists and primary care providers for medically complex infants. They evaluated four cases in total, and all demonstrated telehealth’s benefits. In fact, one primary care provider stated that without the telehealth hand-off call with the neonatologist, she would’ve had to send the baby to the emergency department. Instead, the baby was able to remain home and didn’t need hospitalization later.
5. Post-discharge telehealth can be scaled efficiently
Current evidence suggests that care coordination is linked to improved clinical results and, in some cases, even better cost outcomes. In terms of post-discharge specifically, care coordination is considered a cost-effective approach, as it decreases readmissions and emergency department visits.
To assess this, a study was done on one hospital to observe the effect of scaling coordination when implementing a patient post-discharge digital engagement program. They used a remote patient monitoring system, where patients and clinicians could connect via a web or mobile application.
Researchers discovered that, while this program didn’t profoundly affect readmissions, the technology did boost health access to patients who were typically restricted by resource-limited healthcare.
Study limitations, such as this study being done during the pandemic, which impacted readmissions, likely played a role in the results.
In addition, offering this service didn’t have an adverse effect on healthcare utilization. This is important, as it’s often believed that telehealth may lead to patients over-utilizing health services.
Optimize care programs with post-discharge telehealth care
Hospital readmissions are a big problem in our healthcare system, creating challenges for all stakeholders. They are a substantial financial burden and impair effective resource allocation and patient confidence in the healthcare system.
In the last decade, several strategies have been introduced to mitigate readmissions, such as better patient education and engagement, improved care coordination, medication reconciliation, and more. Post-discharge telehealth services can play a role in each of these initiatives, as explained in some examples above.
At OpenLoop, our white-label virtual care infrastructure solutions have decreased client re-admittance rates by as much as 30%. Our full suite of customizable services provides everything you need to scale and optimize your patient care delivery.
Are you interested in learning more? Contact us today!
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