Nyack Hospital Studies Use of Telemonitoring to Measure Post-Discharge Medication Compliance

Telemonitoring may help patients transition from hospital to home, reducing hospital readmissions

NYACK, NY - A clinical study is underway at Nyack Hospital to evaluate the use of telemonitoring to monitor medication adherence in discharged heart failure patients. The purpose of the study is to assess the use of cellphone-based telemonitoring to help patients transition from the inpatient to outpatient setting.

“Hospital readmission of patients within 30 days of discharge is a major issue,” explains Nicholas Tsirkas, Director of Clinical Research at Nyack Hospital. “According to Medicare claims data, 19.6% of Medicare beneficiaries who had been discharged from a hospital were re-hospitalized within 30 days, and 34.0% were re-hospitalized within 90 days.”

The Medicare Payment Advisory Commission estimated that approximately three-quarters of readmissions were preventable, amounting to $12 billion in annual Medicare spending. Solutions that Medicare is exploring to reduce such readmissions include better communication and coordination of care during and following hospital stays, as well as redesigning financial incentives to keep patients out of the hospital and achieve better outcomes.

More than Medication Reminders

Multiple clinical studies have reported that more than 50% of heart failure patients do not receive guideline recommended therapy, and of those that do, only 40-60% adhere to the regimen.

Nyack Hospital will use a technology known as eMedonline, a cellphone-base, personalized drug management system with web-based services that collect and distribute information between the patient and the clinician. The system was developed under a grant from the National Institute on Aging and a contract with the National Cancer Institute.

“The system goes beyond reminding patients to take their medications,” explains Barbara Rapchak, Founder of Leap of Faith Technologies, the company that developed the system. “It also helps them monitor their symptoms, side effects, and overall well-being using technology that integrates seamlessly into their lifestyle.”

A Systems Innovation in Behavior Change

eMedonline represents a systems innovation in behavior-change science and technology. It integrates smartphones, radiofrequency identification (RFID), and behavioral informatics. It consists of a software application that runs on the cellphone, and a software application that runs on a remote server and collects data sent to it by the phone about patient-specific dosing events.

In the Nyack study, eMedonline is implemented as a “smart service” that leverages the wireless capabilities of RFID and cellphone technology by turning a cellphone into a medication sensor. Medication data read from a smart label (a label with RFID inlay) on the medication package is collected wirelessly by the phone in real time and helps verify that patients are taking the right drug at the right time while monitoring patient reported outcomes.

All data collected from the phone is sent wirelessly to a secure server where it is available for clinical review and analysis. Alerts can be triggered, enabling intervention in the case of missed medications or adverse events before they become a significant health risk.

More Effective Care Transition

“We know that 26.9% of heart failure patients are readmitted within 30 days of discharge,” said Tsirkas. “Will an improved follow-up program reduce rehospitalizations?” he asked. “That’s what we’re trying to find out.”

The data from the study will be compared against historical readmission rates and hopefully provide a basis for submitting a protocol for a larger, more rigorous study.

Nyack Hospital is a 375-bed community acute care medical and surgical hospital located in Rockland County, NY.  Founded in 1895, it is a member of the NewYork-Presbyterian Healthcare System. For additional information, please visit our web site at www.nyackhospital.org.

Leap of Faith Technologies, Inc. is a privately-held companypioneering real-time ehealth, disease management solutions for eliciting behavior change and providing timely clinical information. Leap of Faith's initial efforts are focused on medication compliance for patients with chronic disease through use of the company’s proprietary eMedonline platform. More information can be found at http://www.emedonline.com.

Additional Contact:

                  Nicholas Tsirkas

                  Director, Clinical Research, Nyack Hospital

                  845.348.2236

TsirkasN@nyackhospital.org