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NVNA and Hospice Expands Telehealth Pilot Program and Reduces Hospital Readmissions by 40%


In September of 2018, NVNA and Hospice (Norwell Visiting Nurse Association in Massachusetts) partnered with Health Recovery Solutions (HRS) for a pilot program to offer telehealth and remote patient monitoring. Following its full-scale launch in March, we expanded our program with HRS to provide telehealth services to over 120 patients a month.


We monitor various patient populations through the telehealth program and will extend telehealth care, regardless of diagnosis, to patients identified by nurses as those that would benefit from the education programs and increased engagement that the program offers. Most patients monitored have primary diagnoses of COPD, CHF, and diabetes. As well, palliative care patients, patients with anxiety, and hospice patients as of July 2019, are placed in the telehealth program.


Patients placed in our telehealth program receive a 4G tablet preloaded with HRS’ remote patient monitoring platform, along with an array of Bluetooth monitoring devices with which to take their vital signs. In addition to recording their vitals, patients receive medication reminders, have access to educational videos and quizzes, and can communicate with clinicians and caregivers via text messaging, voice calls, or video conferencing. All patient information, including medication adherence, vital signs, and daily survey answers, are uploaded in real-time to the clinicians’ dashboard to be monitored. All data also flows into our agency EHR for all involved staff to see.


To enhance our care program, NVNA operates as a centralized telehealth model with a principal clinician monitoring patients across disease populations and NVNA branches at the main NVNA office. NVNA telehealth clinicians contact patients directly to intervene after noticing a change in health status, alerting all relevant clinicians of the status change and the referring physician if need be. The centralized model and seamless flow of information from the patient platform to the clinician platform enables NVNA’s clinical staff to respond to high-risk patients quickly.


Although we have utilized telehealth for several years, we selected HRS to relaunch our telehealth program and assist our clinician staff in increasing patient engagement in their care plan and the telehealth program. Since launching the pilot program last August, our clinicians have drastically increased their use of text messaging and video visits to increase patient engagement. As of May 2019, NVNA’s clinical staff has conducted over 500 virtual visits with patients.


Not only has NVNA’s dedication to patient engagement contributed to a 40% reduction in hospital readmissions but it has also resulted in 100% of the patients stating that they are more involved in their care now than they were before using telehealth. In addition to their marked increase in patient engagement, last month, 100% of patients on the telehealth program stated they would recommend the use of telehealth to a friend or family member.

As a long-standing nonprofit agency with a strong community focus on health literacy and support for those living in our service area, we could not be happier with our partnership with HRS. More and more, changes in the delivery of healthcare services have resulted in patients coming home faster, with higher level services and more focused care than ever before. We have found, even with the most complex cases, telemedicine adds such value and support to those we serve. Our goal, as well as our patient’s, is to make sure they can stay home and have the tools to help themselves stay out of the hospital.

In July, NVNA will expand their telehealth program further to provide HRS’ PatientConnect Core, a tablet-only program, to hospice patients in the community. Through the new program, NVNA will offer hospice patients and caregivers educational videos, 24-hour access to a nurse, and peace of mind.


About NVNA and Hospice:

NVNA and Hospice provides the full continuum of care from home health, palliative, and hospice to private pay services (NVNA WORKS) to help patients and families. We own and operate the Pat Roche Hospice Home in Hingham, MA, the regions only non-profit residence. As an independent non-profit, we also provide wellness and public health services through NVNA SUPPORTS in 27 South Shore communities from Milton to Plymouth, Massachusetts. To learn more visit http://www.nvna.org or call (781) 659-2342.


About Health Recovery Solutions (HRS):

Health Recovery Solutions (HRS) supplies leading home care agencies with the most advanced remote monitoring platform focused on changing patient behavior to reduce readmissions and improve clinical outcomes. HRS’ disease-specific engagement kits are customized with educational video, care plans, medication reminders while integrated with Bluetooth peripherals to engage clients. For clinicians, HRS’ software allows for the management of high-risk clients and provides seamless communication with them through video chat, wound imaging and text messaging. For family members and caregivers, HRS’ software gives them the ability to be fully involved in their family member’s care and well-being. To learn more about Health Recovery Solutions, visit https://www.healthrecoverysolutions.com/ or call (347) 699-6477.


Guest post written by:

Daniel Casey PT, COS-C, COQS, CDP, CHHCM, CHCM

Director of TeleHealth and Clinical Support Services




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