Reduction in Heart Failure Readmissions Using Mobile Technology

Abstract

Objective: In an effort to reduce 30 day readmission rates for heart failure patients through timely post discharge follow-up appointments, we piloted a cloud based, mobile reminder system to text, email and phone patients, family and friends incorporating their smartphones and languages of choice. Methods: Unlike existing appointment reminder techniques, the Mobile Patient Reminder Program enables personalization for each patient, their family and their friends to be notified by the method of choice (text, email, phone), the platform of choice (smartphone, tablet, PC, home phone) and language of choice. All appointments allowed the patient and their families to confirm in real-time to allow clinicians to track confirmations rescheduling needs. Additionally, PCPs and others in the clinical care team can receive notifications featuring a direct link to HIPAA compliant, relevant clinical information. To reduce privacy and security risks, the system has been designed and is managed in HIPAA compliant secure cloud based architecture. Patients and their families were enrolled pre-discharge, capturing communication preferences and relationships to the patient. Follow-up appointments were entered into the system, which then coordinated the notifications reflecting each individuals' preferences. For purposes of the study, follow-up adherence, rescheduling and no shows were tracked as well as readmission occurrences back to the same facility. The 95% confidence level was +/-4%. Results: Patients and their families who were mobile messaged showed a 40% decrease in heart failure readmissions from a baseline readmission rate of 26.7% to 16%. Patients who were not mobile messaged showed a 19.9% decrease in heart failure readmissions from a baseline readmission rate of 26.7% to 21.3%. Conclusion: Mobile messaging has improved the effectiveness of existing ongoing readmission reduction efforts. This project is being scaled up for our entire hospital and to support Chronic Care Management initiatives as well as Community based Collaboration care across a longitudinal care model.