By Northwell Health is the largest health network in the state of New York, and today, the organization is celebrating a milestone. The company says its recent telehealth program cut readmission rates in half at two local nursing homes. Now, they are planning to offer their services at additional facilities across the state.
The coronavirus pandemic has had a chilling effect on the nursing home industry across the U.S., including New York. As of September 14th, there have been 6,651 reported COVID-19 deaths at long-term care facilities across the state.
Nursing homes and LTCs often have to send residents to hospitals for complex healthcare procedures, but this can be costly to facilities and patients. If the resident is sent back to the hospital after they’ve been discharged, it can be a drain on valuable resources and staff.
That’s why this new ICU telehealth program is being hailed as such a success. Iris Berman, Northwell’s vice president of telehealth services, is a registered nurse who has been perfecting the new program for some time. Find out how the state is using this program to its advantage at the height of the pandemic.
The Risk of Readmission
For nursing homes across the country, readmission rates are considered a key performance indicator. When residents have to go back to the hospital, it usually means either they shouldn’t have been discharged in the first place or that the nursing home isn’t taking proper care of them. Transferring residents can easily cost thousands of dollars, while increasing vacancy rates at nursing homes. This process can also put patients at risk, especially if they are frail or have a vulnerable immune system.
According to recent statistics from the National Institute of Health, out of 1,530,824 discharges to senior nursing facilities, 321,709 were followed by readmission within 30 days, and 72,472 were followed by death within 30 days.
Facilities may be penalized by the federal government for readmitting residents to hospitals on short notice. Under the Skilled Nursing Facility Value-Based Purchasing (SNF VBP) program, the Centers for Medicaid Medicare Services may withhold funding to these facilities if they do not meet certain readmission requirements.
Insurance companies and provider networks may also refer to these statistics when deciding whether to include a facility in their coverage plan. For some facilities and care centers, losing out on this funding or not being included in a coverage plan can be fatal.
However, the coronavirus pandemic has pushed many facilities near the breaking point. Staff and PPE shortages have increased the chances that these facilities will send residents back to hospitals for complex care.
A Successful Launch
These are the issues Northwell Health was hoping to address when it launched its new telehealth program. The system connects top-level care providers, including specialists, doctors, and nurse practitioners, to nursing homes and long-term care centers, so these teams don’t have to send the resident back to the hospital if an alternative can be found.
Northwell Health oversees 23 acute-care hospitals and nearly 800 outpatient care sites across the New York City metropolitan area. The company recently implemented the program at two internal facilities, the Stern Family Center for Rehabilitation in Manhasset, NY and the Orzac Center for Rehabilitation in Valley Stream, NY. Thanks to this new system, both facilities were able to reduce the rate of readmission by around 50%.
Now, Northwell is extending the program to facilities outside its network, including Glen Cove Nursing and Rehabilitation in Glen Cove, NY, and the non-profit Methodist Home for Nursing and Rehabilitation in the Bronx.
Commenting on the success of the program, Berman says, “What we found is that we decreased by 30% to 50% — in some cases even more — the unnecessary or avoidable hospitalizations, which translates into dollars.”
As the first VP of telehealth at the company, Berman says telehealth has proven to be remarkably effective when it comes to curbing readmission rates. It increases access to care when there isn’t an alternative. “The only other alternative would be for the doctor to get in the car and drive there,” Berman said. “They weren’t going to do that, so the patient just got sent to the ED regardless.”
Overall, this program is improving the patient experience at nursing homes across the state. Staff members can use this technology to reach specialists and providers outside of normal working hours, especially in the dead of night when residents may need urgent care. These tools can also help expand the knowledge and experience of providers on the ground. Instead of sending residents away in an ambulance, nurses and staff can use telehealth to perform procedures and medical tasks in-house.
Berman is using her experience as an RN to her advantage in her new position. While focusing on reducing readmission rates, she’s also sensitive to the needs of providers and residents. She says every facility is different, and organizations need to share information with the technology manufacturer in order for these programs to be successful. “What technology allows you to do is amplify resources that are out there,” Berman said. “I can be in more than one place, essentially.”
Hopefully more facilities will consider adopting similar programs in the future. We can’t wait to see what Northwell Health does next with this technology.
