The Billings Clinic, Billings, Montana, is participating in a three-year CMS demonstration project, trying to reduce
costs to Medicare. The project seeks to determine whether spending
more money on preventive care and disease management saves money
overall by preventing hospitalizations. The Billings Clinic project is focused on CHF (chronic heart failure) patients. For patients over 65, CHF is the most expensive diagnosis for Medicare.

The telehealth system being used by Billings Clinic is pretty simple:

Allen Martin begins every day with a telephone call and six questions. [...] Martin's answers to those six daily questions, which he records by
pressing buttons on his home telephone, pop up on [Jo] Rowland's computer
screen. If Rowland [the lead nurse for Billings Clinic's heart failure disease management program] notices something out of the ordinary, she calls him.

on what else Martin tells her, Rowland might adjust his medication or
schedule an appointment for him with his physician, Dr. Lynn Otto.

This story resonates with a number of topics that were raised at this week's Healthcare Unbound conference. A critical innovation factor that I mentioned in my presentation at HU, is the availability of proofs to validate marketing claims like improved outcomes or lowered costs. What caught my attention was the low tech way this telehealth application was implemented - basically a phone and IVR application. Payors look at both the general application (here chronic disease management of CHF) and the technology used to provide the telehealth application. So in developing proofs for your solution, be sure to validate both the application and the value of the technology being used. The other thing that jumped out is the high-touch human interaction that the system provides.

For Martin, who struggles daily with the emotional stress related to his failing heart, the program is a security blanket.

"It gives you a sense of knowing somebody cares, knowing somebody's watching out for you," he said.

Even on Independence Day, a holiday for most people, a nurse called to check up on him.

"It just makes you feel good," Martin said.

Since joining the project in January, Martin has not been admitted once to the hospital - not bad form someone who's near the top of the nation's heart transplant list for those same seven months.

Pictured right is patient Allen Martin.