Effects of Home Self Management and Medication Adherence Evaluations by Telemedicine Interventions in Chronic Heart Failure (CHF).

Project Summary

To improve compliance to self care and persistence with medication regimens by diffusing telemedicine and medication adherence interventions (Health Buddy and Medication Possession Ratio (MPR) evaluations).

Technology

Health Buddy® and Medication Possession Ratio (MPR) evaluations

Targeted Locations

Large geographical area that includes five counties in Central CA that are designated as “Rural” and “Medically Underserved.”

Collaborators

• Intra-organizational VACCHCS collaboration.

12-Month Goals

• Successfully diffuse the medication management program utilizing PMD machines to four different provider types in four new geographic locations in California.
• Improve access to cost-efficient quality healthcare delivery method using available Telemedicine technology.
• Improve medication reconciliation and medication adherence.
• Decrease inpatient admissions/ bed days used (acute/ semi acute/ nursing home) and mortality.
• Improve patient satisfaction.

Older Adult Population

1st year: 200 (100 study, 100 control) older veterans with a diagnosis of CHF who had >1 hospital admission or ER visit in the previous 24 months. Patients will be identified from the VACCHCS Heart Failure Registry.
5th year: Potential to apply this “system re-design” to 2000 CHF patients at VACCHCS (1 out of 15 veterans at VACCHCS were diagnosed with heart failure in the past 2 years), plus thousands of veterans seen at the other VA medical centers.

Setting/Provider Type

Internal Medicine practice augmented by care coordination and telehealth services.

Measurable Outcomes

Number of hospitalizations, average inpatient bed days used, number of emergency room visits, number of deaths, compliance & adherence to medication, quality of life and satisfaction index (SF-36), and estimated cost of healthcare.

Replication, Dissemination Plan

VA is the nation's largest integrated health care system that operates over 1,400 sites, including hospitals, clinics and nursing homes. Successful quality improvement projects are rapidly communicated and frequently shared between sites. Data from the proposed program will be analyzed and presented to local, regional, and national leaders in the VA system.

Sustainability Plan

The physicians involved in this program plan to continue using these “best practices” beyond the 12-month grant period. This decision does not depend on continued grant funding.

Funding Request

$100,000

Matching Funds

$147,500