Remote patient monitoring to reduce readmissions and improve patient satisfaction

Originally posted by Roche on HealthcareTransformers, here.

25 June 2020

Quick Takes

  1. The care management of chronically ill patients greatly influences the quality of life that these patients have.
  2. Digital technologies enable remote access to services, resources, and information, which can lead to improved patient outcomes as shown by Veta Health’s pilot solution in heart failure management.
  3. Healthcare organizations are maturing digitally, paving the way for startups in the field to become key partners for expansion into new markets and opportunities.

Dedicated to putting patient well-being and experience at the center of care delivery, Veta Health is transforming chronic disease management with user-friendly, digital care plans for remote patient monitoring.

We talked to the cofounders, Tanvi V. Abbhi and Nora Zetsche, about the power of data-driven insights combined with intuitive technology to transform healthcare. They also reveal the main challenges faced so far as they work on lessening one of the biggest burdens in healthcare today: heart failure, and offer key takeaways on what it takes to be successful in the digital health space.

Bettering patient engagement and experience with remote patient monitoring solutions

HT: What are the main advantages of digital technologies for the healthcare system and for patients? 

Veta Health: Digital technologies enable remote access to services, resources, and information in an efficient manner. Disease management systems can serve as initial triage points to give patients feedback on whether they should seek medical help or not, which is especially beneficial now, when the world is collectively fighting a pandemic.

Healthcare systems have always had a cost and accessibility problem, but never has it been as apparent as during the COVID-19 crisis. Yet, even before COVID-19, we’ve seen a significant increase in adoption of digital technologies to improve remote patient monitoring and care delivery. However, as a consequence of the current stress on the system, it will no longer be a question of if these technologies will be implemented, but rather when. Much like we are no longer talking about “colored” TV, we will also no longer have to specifically call out the “digital” in medicine.

For patients, the ultimate advantage that we strive for is improved health outcomes. The time a patient spends with a practitioner in an office or hospital is often a tiny percentage of their entire care journey. As soon as a patient walks out the door, it is up to them to implement the recommendations suggested by their healthcare professionals. So, in essence, patients already play a huge part in self-managing their own care— it’s more a question of whether they’re able to do it well.

By embracing patient self-management with digital technologies, doctors have the opportunity to proactively provide their patients with the resources necessary to ensure successful care outside of the office. Technology makes it easier than ever for doctors to collaborate with patients— why not use these capabilities to offer curated content that will help a patient get better even when they’re no longer at a care facility?

Delivering remote patient care solutions – COVID-19 reflections

“Due to the COVID-19, we as clinicians, realize that the way we deliver our care can be – and has to be – changed. As an example, for the last few months we have been doing 80% of our outpatient clinic by phone. Digital solutions help us to deliver the care more at home instead of in the hospitals or outpatient clinics. This new way of working helps the patient (and us healthcare professionals) to better deal with managing the treatment of their chronic disease. It increases the patients` empowerment if we use it in a transmural care pathway. To be able to guarantee the best care and a transmural care pathway, the patient also plays an important role. We as healthcare providers educate the patient about their disease(s). In the coming years the number of patients with chronic conditions like heart failure will keep rising enormously. If we want to take care of all those patients at acceptable costs, and with a limited number of healthcare providers, we need care pathways with well-designed digital solutions and support.”

 

Ramon van de Ven, Cardiologist St. Anna Hospital, The Netherlands

HT: What value does remote patient monitoring for care management offer to chronically ill patients? And, why in particular, did you develop a solution that targets chronic heart failure patients?

Veta Health: Chronically ill patients, as the name suggests, can’t be cured from their illness but how that illness is managed greatly influences the quality of life that these patients have. At present, approximately 25 million people are living with a heart failure (HF) condition worldwide. It is a condition that places great stress on patients, caregivers and the healthcare system. Healthcare systems in particular are expected to experience increased demands, as the rising prevalence of chronic diseases is projected to continue well into the future. Compliance with clinical protocols can improve outcomes for patients with HF, but patients have largely not been set up for success in managing their conditions on their own.

The severity of HF is categorized by the New York Heart Association (NYHA). There are a total of four NYHA classes that range from I to IV. NYHA class I patients are least impacted by heart failure (HF) symptoms, while NYHA class IV patients are the most severely affected. We chose to work with NYHA class II patients because they represent a subgroup of patients where better self-management can have a significant impact on delaying disease progression.

Care4Hearts: aiming to reduce hospital readmission for chronic heart failure patients

HT: What is Care4Hearts and what is the aim of the project?

Veta Health: Care4Hearts is Veta Health’s first engagement in Europe as part of a collaborative project between Roche and the Netherlands Heart Network (NHN) to determine the effectiveness of implementing a standardized heart failure care protocol across NHN.

Veta Health’s disease management platform is used to capture and manage the longitudinal care journey of heart failure patients outside of the clinical settings; data is collected and integrated from patients, physicians, and caretakers.

The aim is to reduce 30-day readmission rates for NYHA class II patients with chronic heart failure by applying interventions before discharge from the hospital, during discharge from the hospital, and in the home. It also aims to evaluate the benefit of a standardized care pathway for heart failure patients in a value-based care approach.

HT: Has the Care4Hearts project so far been a success?

Veta Health: The goal of the pilot, which is scheduled to be completed summer 2020, is to test the usability, workflow integration, and patient engagement capabilities of the Veta Health solution. If successful, the parties will align on extending the project to show improved patient outcomes, focusing primarily on reducing hospitalization rates and improving quality of life for chronic heart failure patients. We are now roughly halfway and we are already seeing strong engagement by the managed patient populations with successful integration and continued evaluation of a variety of important health indicators that provide transparency into the patients treatment journey. A very positive sign for the future.

Previous success of the Veta Health remote patient monitoring platform was also demonstrated at Cardiology and Vascular Associates (CAVA), a private practice affiliated with St. Joseph Mercy Oakland in Pontiac, Michigan. Patients diagnosed with NYHA class III or IV congestive heart failure were identified and enrolled in the Veta Health platform upon or soon after hospital discharge with the goal of measuring the impact on 30-day hospital readmission rates. Following 45 days, patients enrolled in the Veta Health platform had 75% reduced hospital readmission compared to the control group and patient satisfaction also improved by 70.1

The pathway to success for remote patient monitoring solutions

HT: Having been successful in offering digital solutions, what insights can you share to healthcare executives in this space, or who want to integrate digital technologies to further grow their business?

Veta Health:

1

Put patients at the center
In patient self-management, the focus shifts to educating the patient about their disease and the options that they have. More power is in their hands to decide what course of treatment they want to pursue, allowing them to take into account what feels possible in their lives.

2

Transparency is key to build trust with the end users of the tool – our patients
The development and use of mobile health tools provides an opportunity to connect patients with healthcare providers outside of the clinical setting, creating a transparent partnership towards chronic disease management. For example, when patients feel comfortable talking to their providers, the chances of them forgetting to pick up refills are reduced and they’re less likely to skip doses. They can better understand the importance of taking their medication and the implications if they don’t. In addition, digital health technologies can monitor patient results and assist providers in making better and quicker decisions about doses and scheduling. The more than 90 million patients who struggle to understand and act on the health information they’re provided can play a more educated, engaged role in their health, and therefore more likely adhere to their care plan.

3

Look beyond provider-patient relationships and provide opportunities for patients to participate in their health journey
If the patient feels like they’re just following orders from a doctor, they might feel less invested in actually doing it (or worse, feel rebellious against it). But if they’ve played an active part in determining their treatment plan, suddenly the motivation is coming from within. The self-management model is all about improving a patient’s sense of self-efficacy—showing them that they are capable of taking care of themselves. By improving their confidence in themselves, you start to improve their confidence that they will be able to get better.

 

HT: What were two main challenges faced by Veta Health in your success journey and how were these overcome? 

Veta Health:

  • Introducing change in healthcare systems. Front-line healthcare workers are already overburdened with their workload and very reluctant to introduce changes to the workflow, so new technologies are not met with enthusiasm. We integrate our solutions into the clinical workflows & electronic health records to reduce the friction and we use clinicians feedback to understand the value they are looking to gain with the least possible disruption to their day-to-day work.
  • Penetrating the market as a startup. Sales to hospitals and health systems are not scalable when you are a startup. While that is still an important ecosystem for us we looked for channel partners to facilitate scaling across providers and we identified new access points along the patient journey where we could engage the patient directly, for example, at pharmacies.

Leveraging the “digital” to improve healthcare

HT: How can digital health startups position themselves as key healthcare industry players?

Veta Health: Previously, especially in the healthcare industry, some of the stakeholders (ie. life sciences) were kept somewhat apart from the consumer. Life sciences would interact directly with the providers and the providers could choose what would be prescribed to, or ordered for, the patient. With the digital transformation, life sciences have an opportunity to carve out a new role for themselves within the ecosystem, getting closer to the empowered patients than they ever had before. And digital startups help them achieve this more rapidly.

Nowadays, larger corporations have realized that they can truly leverage the agility and speed of their small startup partners to explore new markets and business opportunities. Startups are now being supported by these flagship corporations to actively contribute to their ecosystem, adding value and scale.

HT: How do you see the digital maturity of stakeholders influencing healthcare delivery?

Veta Health: “Digital” is here to stay. More and more companies are moving from dabbling in innovation projects to making it a more central strategic element of their companies. If we consider hospitals as a stakeholder too, it’s clear that their view on technology is changing too. More and more, the benefits of being able to care for patients without needing to use resources within a clinical setting outweigh the initial skepticism and concerns of such innovation.

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Tanvi Vattikuti-Abbhi Veta Health was founded by both Tanvi V. Abbhi and Dr. Nora Zetsche out of a shared aim to deliver greater transparency to healthcare. Prior to co-founding Veta Health, Tanvi worked with high-growth companies and social enterprises across emerging markets. Most recently, Tanvi was with Endeavor Global, an internationally renowned global organization that catalyzes economic growth through entrepreneurship. She was selected to Business Insider’s 2018 “30 Under 40” digital health experts list. She holds a Bachelor’s degree from New York University.

Dr. Nora Zetsche, MD Before co-founding Veta Health in 2015, Dr. Zetsche was conducting her residency in radiology at Radiologicum München in Germany, after completing her diploma thesis at the Mayo Clinic Cancer Center in Rochester, MN. Dr. Zetsche was selected to Business Insider’s 2018 30 Under 40 in health tech and Bertelsmann foundation’s 2019 “30 under 40” digital health experts list. She is a graduate of Paracelsus Medizinische Privatuniversität, a Mayo Clinic-affiliated medical university in Salzburg, Austria.

To learn more about Veta Health’s digital disease management solutions, please contact us here.