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Industry Insight

Heart Failure Telemedicine Programs Prove Effective Six Months After Discharge

Home telemedicine programs for heart failure are effective at preventing death for at least six months after hospitalization, but generally lose any benefit after one year, according to a meta-analysis of clinical trials. These findings, recently published in Health Affairs by a study team led by Feinstein Institute for Medical Research Professor Renee Pekmezaris, PhD, help educate health care professionals how to refine heart failure telemedicine programs and about who most benefits from these programs.

Heart failure occurs when the heart muscle does not pump blood as well as it should. An estimated 6 million Americans have heart failure, one-half of whom die within five years of diagnosis. One way to decrease heart failure mortality is to be cognizant and proactive about symptoms post hospitalization. It is challenging for patients to continuously monitor symptoms and notify professionals, but this is a critical step for the patient’s health because medications and diet may need to be adjusted.

Home telemedicine programs offer a solution. They comprise health care professionals monitoring important vital signs and teleconferencing with patients on a regular basis to discuss their symptoms with the goal of identifying issues sooner and preventing rehospitalization. Pekmezaris’ analysis of 26 telemedicine programs in randomized controlled trials for heart failure found the programs are effective but lose their effectiveness over time.

“We found that while home telemonitoring or telemedicine decreases mortality six months after a hospitalization for heart failure patients, this benefit does not continue a year after hospitalization,” Pekmezaris says. “There may be several reasons for this. Patients may become less adherent to monitoring their vital signs, like weight and blood pressure, over time. Whether they are too sick to adhere, or they just don’t make it as much of a priority as they did right after their hospitalization, we don’t know. But, these findings are important because, as scientists and providers, we need to understand when to rely on telemedicine, and how to create a program that most benefits patients.”

Another interesting finding from the analysis was that despite industry expectations, home telemonitoring doesn’t necessarily stop hospitalizations—in fact, it increases the odds of all-cause emergency department visits. This is actually a good thing because if the patient is determined to be experiencing a serious episode, the emergency department is the right place to be.

“Dr. Pekmezaris’ important new findings are critical to saving lives by harnessing new technologies to assist patients even after they have returned home,” says Kevin J. Tracey, MD, president and CEO of the Feinstein Institute.

— Source: The Feinstein Institute for Medical Research


NCPDP Members Vote to Support Patient Identity Solution

The National Council for Prescription Drug Programs (NCPDP) voted to support the LexisNexis Risk Solutions LexID as a universal patient identifier (UPI) at its recent workgroup meeting. This is an important step for the health care industry to address preventable errors by helping to ensure accurate identification of patients using a UPI. It assists in uniquely identifying each patient throughout disparate health care systems.

By approving the UPI as a recognized patient identifier, industry partners will be able to use the LexID as the UPI in their pharmacy billing and ePrescribing transactions. LexID uses a proprietary linking technology in combination with a unique identifier to resolve, match, and manage identity information.

“Implementing a universal patient identifier was a significant step, not just for pharmacy but for all of the health care industry,” says Craig Ford, vice president of pharmacy at LexisNexis Risk Solutions. “It is imperative that we have the capability to link an individual patient between disparate health information systems. From a patient safety standpoint, accurately identifying each patient is a must for optimal patient engagement.”

NCPDP supports the UPI value being used as a patient identifier within the pharmacy billing and ePrescribing transactions. Currently, the UPI can be used only to validate a patient’s dual eligible status by state, federal, or regulatory programs.

In January, LexID joined the NCPDP Experian UPI as the UPIs available for use for this purpose. With the new HIPAA billing standard expected in 2022, the UPI’s defined use as a patient identifier will be greatly expanded to “enhancing the accuracy of patient data exchange,” which will allow industry partners to use the designated UPI values for most of their pharmacy billing transactions.

NCPDP is a not-for-profit standards development organization within the pharmacy services industry. It works with its members to develop and promote industry standards and business solutions that improve patient safety and health outcomes, while also decreasing costs.

— Source: LexisNexis Risk Solutions