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Lessons Learned from the Mississippi Delta, Tackling Chronic Disease Through Remote Monitoring Technology

June 6, 2016
by Heather Landi
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Michael Adcock, administrator for UMMC's Center for Telehealth, discusses UMMC's successful telehealth and RPM model to enhance care coordination and improve health outcomes for chronically ill patients.
The University of Mississippi Medical Center in Jackson, Miss.

Two years ago, Jackson, Miss.-based University of Mississippi Medical Center (UMMC) deployed an innovation remote patient monitoring pilot project, as part of a public-private partnership, to address the growing diabetes crisis in the state, specifically focusing on the rural, underserved population in the Mississippi Delta region. The strong results from that pilot project, called the Diabetes Telehealth Network, prompted UMMC to expand the program to serve thousands of chronically ill and underserved patients across the Southeast.

Mississippi health leaders have been faced some with grim statistics. Mississippi has the third highest diabetes prevalence in the country, with 12.9 percent of Mississippi adults living with diabetes, according to 2013 statistics. In 2012, diabetic medical expenses in Mississippi totaled $2.74 billion, according to the American Diabetes Association. And, 12.1 percent of adults In the Mississippi Delta, among the more underserved and impoverished regions in the nation, reported being diagnosed with type 2 diabetes and 293 died from complications related to the disease. As previously reported by Healthcare Informatics, at the time of the pilot project, the tiny city of Ruleville (pop. around 3,000) had one of the highest rates of diabetes in the country at 13.2 percent.

To launch the Diabetes Telehealth Network back in 2014, UMMC worked with the State of Mississippi, rural-based North Sunflower Medical Center, health IT vendor Intel-GE Care Innovations and telecommunications provider C Spire to coordinate the deployment of remote patient monitoring technology with the aim of improving health outcomes and reducing the cost of care. The pilot project enrolled 100-plus Mississippians living with diabetes and enabled those patients to have timely and consistent access to clinicians through technology in their homes. In the first six months of the project, there was a 1.7 percent average A1C reduction among the enrolled patients and also within that first six months there were zero hospitalizations and no ER visits. While the health outcome improvements are impressive, the program also resulted in cost savings of $339,000 in the first six months due to the reduction in hospital readmissions.

The only academic medical center in the state of Mississippi, UMMC has a history of creating sustainable telehealth models. The organization has been providing telehealth services, via clinician to clinician, since 2003, beginning with a tele-emergency program that connected UMMC Level 1 trauma center physicians with rural emergency rooms. UMMC established the Center for Telehealth in 2013, providing telemedicine services in 35 different specialties in 213 clinical sites across the state, according to Michael Adcock, R.N., administrator for the Center for Telehealth at UMMC. However, the Diabetes Telehealth Network was UMMC’s first program to use remote patient monitoring (RPM) technology to engage patients in their own homes with the aim of connecting the care continuum.

UMMC has extended its collaboration with lntel-GE Care Innovations and will use the vendor’s Health Harmony telehealth solutions platform to serve patients across the Southeast living with chronic conditions, such as diabetes, heart failure, COPD, asthma and hypertension. UMMC’s goal is to enroll 1,000 patients each month both in and out of state by the end of 2016. UMMC officials are anticipating that the remote management programs will save $189 million in Medicaid each year just with the diabetic population.

Healthcare Informatics Assistant Editor Heather Landi spoke with Adcock about UMMC’s successful use of remote patient monitoring technology to improve health outcomes for patients living with chronic disease and the lessons learned from the pilot project as the organization works to expand the program.

The remote management pilot project resulted in impressive health outcome improvements and cost savings. To what would you credit the success of the initial program?

One is obviously having technology that works in places like the Mississippi Delta with patients who don’t have a lot of technical experience, so technology that’s easy to use is certainly a huge piece of how the program works successfully. The patients are given a mini iPad or tablet and peripheral devices, such as glucometer, and they have daily healthy sessions. They are asked a series of questions and they take their biometrics and its uploaded automatically, so the patients don’t have to enter data, and it’s sent to clinicians at the Center for Telehealth. The patients enrolled in the program get small daily doses of education about their disease state that allows them to absorb that knowledge and practice it and use it. The patient can also talk to a clinician or do video visits if there is something they want the clinician to see, for example, there was a patient that had a foot ulcer and, through a video visit, they were able to avoid an ER visit.

Michael Adcock, R.N.