title: Telehomecare Reduces ER Use and Hospitalizations at William Osler Health System.
abstract: The Ontario Telemedicine Network's Telehomecare initiative brings together specially trained clinicians and technology to coach patients with COPD and/or heart failure to monitor vital signs and manage their health at home. The objective of the study was to evaluate pre- and post-enrollment and post discharge data captured by Telehomecare host William Osler Health System (WOHS). Results demonstrate a 46% reduction in emergency department use and a 53% reduction in hospitalizations post-enrollment compared to pre-enrollment. Average length of stay (LOS) dropped by 25% of a day compared to pre-enrollment. In addition, six months after Telehomecare discharge, inpatient admissions and emergency department visits continued to decline, by 65% and 57% respectively, compared to pre-enrollment. While average LOS increased between pre-enrollment and post-discharge, the reduction in acute inpatient episodes created a net reduction in accumulated inpatient days of 563.16 days (63% reduction). The WOHS Telehomecare results strongly support the positive influence of the program on health system utilization and the development of effective long-term self-management skills. Next steps could include reviewing, more closely, the reasons for hospital utilization and undertaking a cost-benefit analysis to support further expansion of the program to address other chronic illness and care needs.
authors.affiliation: Telehomecare, Ontario Telemedicine Network, Toronto.
authors.forename: Sandra
authors.initials: S
authors.lastname: Mierdel
authors.affiliation: Decision Support, William Osler Health Services, Brampton.
authors.forename: Kirk
authors.initials: K
authors.lastname: Owen
mesh_terms: D000368:Aged; D015897:Comorbidity; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006333:Heart Failure / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy*; D006699:Home Care Services / Q000706:statistics & numerical data; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D009864:Ontario / Q000453:epidemiology; D015995:Prevalence; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy*; D012307:Risk Factors; D012648:Self Care / Q000706:statistics & numerical data; D017216:Telemedicine / Q000706:statistics & numerical data*; D016896:Treatment Outcome; D014600:Utilization Review