Friday, December 23, 2011

40% readmission for CHF: the challenge and a novel innovation

“Sometimes a simple idea floods the room with light,” wrote Ross Weaver in a note to me recently.  

Ross Weaver, PharmD, MBA joined Adjility Consulting earlier this year.  In this blog, I want to share his innovation inspiration.

Here is the challenge:

Nationally, about 40% of hospitalized congestive heart failure patients were readmitted to a hospital within 120 days.

This was an interesting and medically relevant finding, but it had no negative financial implications to hospitals.  Actually, hospitals profited from readmissions because it meant more beds were filled.

However, the PPACA legislation changes all of that.  Now, the legislation allows CMS to withhold a portion of the total Medicare payments to hospitals with excessive CHF re-admissions within 30 days.

Now, there’s a financial incentive to avoid hospital readmissions!

Lots and lots of programs are being instituted to decrease the 30-day readmission rate.  Complicated approaches.  “We know best” approaches.  Intrusive approaches.  Approaches that seem good on paper, but are doomed to failure – because people are people. 

Here’s a novel idea:

Instead of reengineering the whole cardiology department, how about providing a simple IT-based solution?  How about have patients weigh themselves every day and while on the scale answer a few simple questions?  Here is the neat part.  How about have the scales submit the data daily to the appropriate medical practice, with software that identifies outliers who might need medical intervention? 

Well, that is what the Montefiore hospital is doing.  Kris Becker, RN and clinical care manager, monitors 120 heart failure patients daily.   She works with cardiologists to modify drug therapy when required, gets transportation for a patient to go to a physician’s office, and refers acutely ill patients to the emergency department.

This approach, using ‘telescales’, helps keeps small issues small.

At Adjility, we too focus on keeping small issues small.  Give us a try.

You can find contact information for Ross at

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