How Remote Therapeutic Monitoring Works
The patented RTM device latches onto the tube coming out of the IV antibiotic bag/pump/IV push and detects the flow of medication through the tube using proprietary technology. It records the start and end times of infusion and transmits the data through cellular communication to the company's AI system called IVE Mind. This system compares the observed infusions with the expected infusions based on the patient's treatment plan prescribed by their physician and generates an adherence rate and a weekly adherence report. Accountability/monitoring occurs at two levels - the company provides a team of infusion case managers to monitor daily adherence data and communicate with the patient if there is any lapse in adherence. The weekly adherence reports are also scanned into the patient's medical record.The software is capable of interfacing with the Epic EHR, ensuring seamless integration into the healthcare system. Upon consenting, the patient is given a monitoring device and receives structured follow-up support. The first phone call occurs the day after discharge to confirm enrollment and address any immediate questions. Weekly check-in calls are scheduled to monitor progress and encourage adherence. Additional calls are made if any adherence issues arise.
Results of the Clinical Trial
The University of Oklahoma College of Medicine conducted an interim analysis with 64 patients enrolled on RTM and 95 contemporaneous controls. The two groups were similar in terms of baseline demographic characteristics, type of infection, insurance coverage, comorbid conditions, prior healthcare utilization, duration of outpatient therapy, and number of antibiotic doses per day. The results showed a sharp decrease in infection-related readmissions in the RTM group. At 30 days, there was a 74% reduction (4.7% versus 17.9%), at 60 days a 72% reduction (7.8% versus 28.4%), and at 90 days a 56% reduction (14.1% versus 31.6%). When a multivariable logistic regression model was built, controlling for various factors, the odds of infection-related readmissions were decreased in the RTM group by 76% at 30 days, 80% at 60 days, and 68% at 90 days.The sustained response is significant, showing that RTM can break the vicious circle of never-ending infections and hospital readmissions. The median overall adherence rate in the RTM group was 94%, but the range was 18% to 100%, indicating that some patients need more support. More than half of the patients in the RTM group needed an extra intervention from the study team, and two-thirds of these interventions happened within the first week after hospital discharge. This early identification of issues allowed for better patient care and set them up for success.
Advice for Others
Remote therapeutic monitoring is a major technological breakthrough that has the potential to transform healthcare. It can change clinical outcomes in a tangible and beneficial way, as demonstrated by the University of Oklahoma College of Medicine's clinical trial. Healthcare organizations and physician practices should evaluate how RTM can be incorporated into their clinical practice and value-based care models. It has a wide range of applications in healthcare delivery, not only within OPAT but also in other home infusion models and pharmaceutical research.The data generated by RTM has driven the University of Oklahoma College of Medicine to simplify some antibiotic regimens for some patients, increasing their adherence to 100%. Patients enrolled in the trial also reported feeling supported during their transition of care and throughout their antibiotic course, which contributed to their success.
Revolutionizing Healthcare at Home
Why the Need for Home Healthcare is Growing
The world's population is aging, and this demographic shift is driving the demand for home healthcare. According to the World Health Organization, between 2015 and 2050, the proportion of the population over 60 years will increase from 12% to 22%. Additionally, people aged 80 years or older are expected to triple during the same period. A John A. Hartford survey from 2021 indicated that 71% of older adults prefer not to live in a nursing home. Coupled with a shortage of healthcare workers and emerging technologies, home healthcare is set to become a new wave in healthcare. In Kentucky, for example, the Cabinet for Health and Family Services lists roughly 80 entities with Medicaid provider identification numbers for home health, ranging from large healthcare providers to local health departments.A MedicalTechnologySchools.com report projects that nearly 8,000 home health and personal care aide jobs will be added in Kentucky between 2020 and 2030, representing a growth of more than 35%. In a Stacker.com list of most in-demand nursing jobs in the state, home health nurse tops the list, even surpassing registered nurses and nurse practitioners.Services Offered by Home Health
To qualify for home health assistance, per Medicare guidelines, patients must have difficulty leaving the home, such as needing a walker, or be recommended by a doctor not to leave due to a medical condition. Telehealth has gained significant popularity since the COVID pandemic. What was once a trip to the doctor's office for a follow-up check can now be a virtual video chat, keeping patients at home and easing the strain on understaffed doctors' offices.Another development is home-monitoring technology. For instance, if a patient needs ongoing observation for a heart condition, it can be assessed from their own couch instead of through a hospital stay or repeated doctor visits. They may have an in-home unit or wear a biometrics device that monitors vital signs and transmits data in real time.Home health agencies are now capable of handling a wide range of services, from surgical recovery to end-of-life care. A patient can have hip replacement surgery at a hospital and go home the same day to receive follow-up care and rehab at home. The same applies to rehabbing an injury or various physical ailments. Home healthcare services can range from 24-hour-a-day in-home care to simple scheduled medication and meal drop-off.The Benefits of Home Healthcare
The main benefit of home healthcare is better patient outcomes. The industry is still determining when home healthcare is a better option than clinical care. The ongoing shortage of healthcare workers has led to patients being discharged from hospitals too quickly, resulting in readmissions that stress both staff and facilities. Additionally, hospital reimbursements for readmitted patients are lower, further driving the move towards home healthcare. In general, people prefer to be treated or rehabilitated at home whenever possible.Finding the ideal balance between clinical care and home healthcare while building the workforce is a current challenge for the entire industry. It not only eases stress on healthcare systems but also ensures that patients receive the care they need.Training More Healthcare Workers
Healthcare staffing shortages have been a long-standing problem, and in some states like Kentucky, it is critical. Rural areas face challenges with the closure of medical facilities and the purchase of doctors' offices by large corporations. Home health can make a significant difference in these areas by providing better outcomes for patients.A recent initiative by the University of Kentucky, the Advancing Kentucky Together Network, aims to build Kentucky's healthcare workforce and train new healthcare workers. The initiative will invest millions of dollars in resources to support partners in tracking, measuring, and documenting patient outcomes, enhance educational opportunities, and expand community outreach. Keeping people close to their homes and finding the best way to provide care effectively are key goals."Patients want to receive care at home; they do well at home," said Stephanie Henry. "There is a greater need for home care. Value-based care and optimizing care delivery is the trend - the right level of care at the right time. If possible, patients would rather be at home for these services."Charges in Horry County
Rusty Shockley's actions in Horry County were significant. The false pretenses and crimes against a federally chartered institution have brought him under the scrutiny of the law. The transfer of funds from the Little River Medical Center and the subsequent failure to deliver the promised mobile medical recreational vehicle highlight the seriousness of his alleged misconduct. It shows a blatant disregard for the trust placed in him and the financial implications for the healthcare organization.
The discovery that he didn't have a dealer's license and provided false information further compounds the situation. This lack of proper authorization and the deception involved raise questions about his business practices and integrity. Such behavior not only affects the specific organizations involved but also has a broader impact on the trust in the local business community.
Repeated Offenses in Allendale County
The occurrence of similar incidents in Allendale County is a cause for concern. Shockley's failure to deliver mobile medical recreational vehicles on two separate occasions indicates a pattern of behavior. It suggests that he may have been engaging in these illegal activities intentionally, targeting multiple organizations. This raises doubts about his ability to operate a legitimate business and fulfill his obligations.
The fact that he was able to get away with these actions in different counties shows the need for stronger regulatory measures and enforcement. It also emphasizes the importance of thorough investigations and due diligence to prevent such fraud from occurring. The consequences of his actions extend beyond the financial losses suffered by the healthcare organizations and have implications for the overall integrity of the business environment.
Impact on Nonprofit Healthcare Organizations
The nonprofits that were defrauded by Shockley suffered significant financial losses. These organizations rely on donations and proper financial management to provide essential services. The theft of funds intended for the purchase of mobile medical recreational vehicles disrupts their operations and undermines their ability to fulfill their mission.
Moreover, such incidents erode the trust that the public has in nonprofit organizations. When these entities are targeted by fraudsters, it gives the impression that they are not being managed effectively or that their funds are not secure. Rebuilding this trust takes time and effort and requires strict measures to prevent future occurrences.
Legal Proceedings and Prosecution
The case will be prosecuted by the 14th Circuit Solicitor's Office and the 15th Circuit Solicitor's Office. This shows the seriousness with which the authorities are taking the matter. The joint effort between these two offices indicates a commitment to ensuring that justice is served and that those who engage in financial crimes are held accountable.
The legal proceedings will involve a thorough examination of the evidence and a detailed analysis of Shockley's actions. This will help determine the extent of his guilt and the appropriate penalties. It also serves as a deterrent to others who may be tempted to engage in similar illegal activities, knowing that they will face severe consequences.