Technology has been the backbone of medicine since the beginning and its prevalence in medicine today is far reaching and wide spread. Due to research and ingenuity, medical breakthroughs via technology may be credited for many of the life saving techniques used in medicine today. Likewise, technology may also be credited with much of the expense of healthcare, including the growing baby boomer population and their chronic conditions. Of interest, telehealth has been an impetus for research over the last decade due to its promise of increasing efficiencies, quality of care, and decreasing cost. In spite of this research, one of the most expensive of chronic condition, cancer, is severally ...view middle of the document...
The use of telehealth and telemonitoring has been identified as a way to increase patient satisfaction, increase quality of care, and reduce cost. An exploration of these benefits should be applied to the cancer population.
An extensive review of 30 days readmissions and telehealth was conducted utilizing the Research Medical Library at The University of Texas MD Anderson Cancer Center and the Francis A. Drexel Library at Saint Joseph’s University. Many observations were noted in the literature including readmission rates in the Medicare population, the lack of policy supporting reimbursement, definitions of telehealth, the cost of telehealth, as well as the challenges and benefits of implementing telehealth.
Although a review of the literature revealed a multitude of research articles regarding readmission rates, there is scant mention related to the cancer population or their care. Of note, the Medicare population is given considerable attention in the literature due to their high rate of chronic condition, as well as their high rates of readmissions. One study published in 2009 revealed that approximate 20% of Medicare beneficiaries with an inpatient hospital stay was readmitted to the hospital within 30 days of discharge (Jencks, William, & Coleman, 2009). It is noted that in over half of the cases with readmissions within 30 days, “there was no bill for a visit to a physician’s office between the time of discharge and rehospitalization” (Jencks et al., 2009, p. 1418). Moreover, a study published in the New England Journal of Medicine compared readmission rates in Medicare beneficiaries between two major cities and found higher readmission rates among hospitals with more hospital beds (Fisher, Wennberg, Stukel, & Sharp, 1994). This observation raises the questions: are the readmissions due to bed availability, or are the improved rates credited to better follow up care? Interestingly, the relationship between follow up care and 30 day readmission rates was studied in the Medicare population with recent hospitalizations due to heart failure. This 2010 study demonstrated a clear correlation between higher outpatient follow up rates and lower readmission rates (Hernandez et al, 2010). Finally, a study published in 2011 identified racial disparities in readmissions of black Medicare beneficiaries. According to Joynt, Orav, and Jha (2011), “black patients had a 13% higher odds of readmission than white patients” and the quality of care received during and after admission is a contributing factor in this trend (p. 680).
The Medicare population is known for its draining expenditures, and policy makers are developing legislation to combat this trend. CMS has teamed up with the National Quality Forum (NQF) to develop a way to measure quality care and rehospitalization is being used as a way to measure quality resulting in reduce payments for inadequate care (Jencks et al., 2009). A key recommendation...