Care Coordination and Technology
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Transcript of Care Coordination and Technology
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Care Coordinationand
TechnologyRita Kobb MS, MN, GNPLead Care Coordinator
Tech Care Coordination [email protected]
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VA InitiativeCommunity Care
Coordination Service
Implemented April 2000Served over 2000 veteransHome is site of careRight care, right place, right timeCoordination not care provisionPatient not problem focused
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Why Use Technology?
Increases access to care Improves communication Promotes healthier behaviors Promotes self-care Reduces healthcare consumption Reduces healthcare crises
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Types of Technology
Disease management tools Messaging devices Real time video monitors Computers with chat rooms Instamatic cameras
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Technology Devices
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Risk Management Software
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Case Study 1-Telemonitor77 y/o WW II VeteranLung Disease from Smoking
12 mos Pre-enrollment– 9 admissions– 97 days in hospital– 48 ER visits– unable to leave home
12 mos Post- enrollment
– 2 admissions– 7 days in hospital– 5 ER visits– Army reunion
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Case Study 2-In-home messaging80 y/o WW II VeteranHeart Failure
12 mos Pre-enrollment– 10 admissions– 113 days in hospital– 37 ER visits– no activity– wife at home
12 mos Post- enrollment
– 0 admissions– 0 days in hospital– 2 ER visits– gardening– wife out shopping
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Case Study 3-Camera64 y/o Korean War VeteranDiabetes
12 mos Pre-enrollment– 5 admissions– 36 days in hospital– 12 ER visits– wound for 16 mos– on surgery schedule
12 mos Post- enrollment
– 0 admissions– 0 days in hospital– 0 ER visits– wound healed 6 wks– no surgery
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Lessons Learned
• Patients embrace technology• Patient needs/coordination not
technology drive care Always include caregiversDon’t use the word computer to explain what technology is
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Where Do We Go From Here?
• 5 Networks (14 states) active• 6 more to begin this Fall• Final 10 Networks Fall 2004• National training center to teach
staff how to use technology and do care coordination opens 2004