American Homecare Health Services (AHHS), a Medicare-certified home health provider in Southern California, has announced a Telehealth and Remote Patient Monitoring program in partnership with Health Recovery Solutions (HRS). With the resurgence of COVID-19 across California, AHHS has turned to telehealth to provide symptom screening, 24/7 monitoring, and virtual visits to high-risk patients in their communities. In the coming months, AHHS will expand their Telehealth program with the aim of reducing costly hospital readmissions.

AHHS will utilize telehealth and RPM to quickly identify potential COVID-19 patients through their recorded symptoms and vital signs. Clinicians can then triage patients through virtual visits, available via the telehealth platform. Telehealth patients will receive a COVID-19 Care Plan with specific educational videos and symptom assessment surveys, as well as a mental health questionnaire to ensure patients are recovering safely and successfully from home. 

Beyond the COVID pandemic, the Telehealth program aims to reduce hospital readmissions and ED visits, helping patients transition from hospital to home. For many patients, round-the-clock care is provided throughout their hospital stay. However, upon discharge, that continuous care is abruptly cut and patients and their families are left to navigate their condition and recovery. Through telehealth, AHHS' nursing team can support patients and families with continuous monitoring, educational resources, virtual visits and more. 

Patients with low health literacy, chronic conditions, or multiple comorbidities are at the greatest risk for hospital readmissions. As such, AHHS' Telehealth program is taking a targeted approach to reducing readmissions, enrolling high-risk patients with CHF, COPD, hypertension, and diabetes. In addition, AHHS' hospice branch, Tranquil Care Hospice is piloting the Telehealth program to expand access to end of life services.

"To me, the why behind what we do is the most important thing," said Reggie Rodriguez, Vice President American Homecare and Tranquil Care Hospice. "That 'why' is to improve a patient's health, to objectively improve their functionality and independence, and to reduce emergency room admissions. Teaching patients how to manage their health and understand their conditions is another big piece of the puzzle. This Remote Patient Monitoring system effectively works to address and solve each of these issues giving us the capacity to take our care to the next level thus fulfilling our 'why' more completely."

Eligible patients are enrolled in the Telehealth and Remote Monitoring program upon discharge from the hospital. Patients receive a 4G tablet and Bluetooth biometric monitoring devices with which to record their daily vital signs and access custom care plans. Included in their custom care plans, patients have access to medication reminders, symptom surveys, educational videos and teach-back quizzes. Throughout their time on the Telehealth program, patients can use the educational resources on the Telehealth platform to learn about their condition and improve their quality of life. The tablet and software, biometric devices, and clinician dashboard are provided by AHHS' Telehealth partner, Health Recovery Solutions.

Once recorded in the tablet, patient data transfers in real-time to the clinical dashboard accessible to American Homecare and Tranquil Hospice nursing teams via their desktop or mobile device. Risk alert notifications are sent to the nursing teams when a patient's recorded information signifies a drastic change or deterioration in their health. Risk alerts allow the AHHS nursing teams to quickly respond and triage patients through virtual visits, preventing potential hospitalizations and dispelling any fears of the patient or family. 

For hospice patients and their loved ones, the Telehealth program provides an additional layer of support, providing a platform for virtual counseling sessions, enhanced pain management through 24/7 symptom and medication monitoring, and educational resources on advanced directives and condition management. 

"I've always had a passion for helping my patients in the best, most supportive way possible. I'm so excited to add Remote Patient Monitoring/Telehealth to my tool belt, and truly believe this program will elevate our ability to care for, protect and encourage our patients. In particular, it brings an amazing degree of care continuity, keeping doctors, family and caregivers continuously connected," added Janine Hickman, Dedicated RPM LVN at American Homecare Health Services. 

Explore Telehealth for Home Health