WHAT IS THE UNIT OF ANALYSIS OF YOUR EMPIRICAL STUDY; WHICH VARIABLES ARE STUDIES.This section will provide an overview of the collected information. The following information is divided into six sub-sections each corresponding to a different case study.
This section will provide an overview of the collected information. The following information is divided into six sub-sections each corresponding to a different case study. For the overview of each case study, a framework for the analysis has been created. All six case studies will have the following descriptive parts: Aim of the study, how the study was conducted, what were the tools that were used in the process, what where the experienced challenges/barriers during the implementation process, and what were the following outcomes of each study. All six case studies have been carefully handpicked in order to comply with the latter research method.
4.1 Case Study 1 – Improving Health at Home: Remote Patient Monitoring and Chronic Disease for Care Transition Intervention Program at CHRISTUS St. Michael Health System
Aim and details: CHRISTUS St. Michael Health System includes more than 40 health institutions and facilities in seven states in the USA and six states in Mexico, with assets above 4.6 billion US dollars. The hospital system in Texarkana, Texas needed to enhance its current Care Transition Intervention program and to reduce hospital readmissions of high-risk patients suffering from specific chronic diseases such as congestive heart failure and coronary artery pulmonary disease by integrating a Remote Monitoring Solution. Furthermore, the hospital needed this solution as the latter illnesses were resulting in large number of complications and large increased readmissions rates within 30 days after the discharge of the patients. The program wanted to “help patients both learn and apply self-care skills to help them assert a more active role during care transitions”.
How: The program relies on a trained certified Care Transition Nurse(CTN) who ID’s, enrolls and begins care cycles for underinsured patients prior to discharge in order to successfully start the process of transition from hospital to home. Apart from this a medication review and preparation of the patient to self-management is also provided. Post discharge, the nurse makes an preliminary visit to the home of the patient to review medication orders, to educate him/her about their condition and the possible warning signs that might occur, reviews the Personal Health Record, and communicates with family caregivers.
Internet of Things tools: A RPMS cloud based (SaaS) Remote Care Management Platform provided by Vivify Health using the following devices: Android Tablet, Bluetooth enabled personal health devices: weight scale, blood pressure monitor and pulse oximeter. Customizable protocols and care plans with user-friendly interface for all users were preloaded to the tablet. Furthermore, educational videos were available to the patient and video conferences with caregivers was enabled as well. Surveys for patients to fill in to provide better data were also provided to follow consumer satisfaction. The wireless connectivity and cloud usage was provided by AT&T to send data from the personal health devices to be shared with the hospital in a very secure way.
Challenges/Barriers:
-Patients were reluctant to invite the initial CTN to their homes.
-Some patients were living in rural areas thereby reducing the time for actual patient care, because of the time spend on traveling to patient homes.
-the CTN has limited contact time with enrolled patients because of the time spent driving to and from the initial home visit, as a result limiting patients engagement and satisfaction.
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