title: The impact of remote patient monitoring (telehealth) upon Medicare beneficiaries with heart failure.
abstract: OBJECTIVE
  To study the impact of remote patient monitoring (RPM) upon the most frequent diagnosis in hospitalized patients over 65 years of age-heart failure (HF). We examined the effect of RPM on hospital utilization and Medicare costs of HF patients receiving home care.
  
  
  METHODS
  Two studies were simultaneously conducted: A randomized and a matched-cohort study. In the randomized study, 168 subjects were randomly assigned (after hospitalization) to home care utilizing RPM (live nursing visits and video-based nursing visits) or to home care receiving live nursing visits only. In the matched-cohort study, 160 subjects receiving home care with RPM (live nursing visits and video-based nursing visits) were matched with home care subjects receiving live nursing visits only.
  
  
  RESULTS
  Regardless of whether outcomes were being analyzed for all subjects (intention to treat) or for hospitalized subjects only, hospitalization rates, time to first admission, length of stay, and costs to Medicare did not differ significantly between groups in either study at 30 or 90 days after enrollment. A notable trend, however, emerged across studies: Although time to hospitalization was shorter in the RPM groups than the control groups, RPM groups had lower hospitalization costs.
  
  
  CONCLUSIONS
  RPM, when utilized in conjunction with a robust management protocol, was not found to significantly differ from live nursing visits in the management of HF in home care. Shorter hospitalization times and lower associated costs may be due to earlier identification of exacerbation. These trends indicate the need for further study.
authors.affiliation: Population Health, North Shore-LIJ Health System, Great Neck, New York 11021, USA.
authors.forename: Renée
authors.initials: R
authors.lastname: Pekmezaris
authors.forename: Irina
authors.initials: I
authors.lastname: Mitzner
authors.forename: Kathleen R
authors.initials: KR
authors.lastname: Pecinka
authors.forename: Christian N
authors.initials: CN
authors.lastname: Nouryan
authors.forename: Martin L
authors.initials: ML
authors.lastname: Lesser
authors.forename: Meryl
authors.initials: M
authors.lastname: Siegel
authors.forename: John W
authors.initials: JW
authors.lastname: Swiderski
authors.forename: Gregory
authors.initials: G
authors.lastname: Moise
authors.forename: Richard
authors.initials: R
authors.lastname: Younker
authors.forename: Kevin
authors.initials: K
authors.lastname: Smolich
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002309:Cardiology / Q000191:economics / Q000295:instrumentation*; D003266:Continuity of Patient Care; D005260:Female; D006333:Heart Failure; D006699:Home Care Services / Q000191:economics / Q000458:organization & administration*; D006801:Humans; D008297:Male; D006278:Medicare / Q000191:economics / Q000706:statistics & numerical data*; D008875:Middle Aged; D018709:Statistics, Nonparametric; D017216:Telemedicine / Q000191:economics / Q000458:organization & administration*; D014481:United States