Maine Home Health Program Uses Telehealth, RPM to Combat Loneliness

May 17, 2021 - A Maine healthcare provider has found that remote patient monitoring can produce meaningful results that go far beyond clinical outcomes.

Androscoggin Home Healthcare & Hospice, based in Lewiston, has been using telehealth and mHealth tools for roughly two decades, helping its care teams keep track of a wide range of patients at home. Using a 10-inch tablet and some wireless devices, they’re able to track vital signs and adjust care management when any changes are noticed.

But with the coronavirus pandemic forcing many of these patients to practically quarantine in their homes, cutting them off from family and friends and other social interactions, that RPM platform took on a more important role.

“Many patients in home care programs are isolated and vulnerable to begin with, especially in a rural state like Maine,” says Kathy Baillargeon, manager of volunteer resources. The COVID-19 crisis “made that so much worse. And when you’re affected by that, it can take years off your life.”

To address that isolation, Androscoggin Home Healthcare & Hospice launched AndroPeerConnects, a program that enables volunteers to check in with patients via telehealth. Volunteers are screened by the organization and matched with a couple of patients who have similar interests, then are asked to check in every now and then, or whenever needed.

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“The behavior of our patients has changes since COVID-19 has taken over,” says Shane Levasseur, Androscoggin’s telehealth coordinator. “You can see the effect it’s had on them” and how that, in turn, has an effect on their health.

As healthcare providers – particularly those in the home health space – adjust to using RPM and other connected health platforms to improve access to care, programs like AndroPeerConnects are popping up all over the country. They aim to address an alarming increase in mental and behavioral health concerns, ranging from depression and anxiety to substance abuse, in populations who avoided in-person care during the pandemic and aren’t ready to go back to the doctor’s office.

The development of these program is a natural expansion of the RPM concept, and one that’s been tested in the senior care space for years. As telehealth tools become more sophisticated (and, to a degree, less expensive), providers are using them not only to capture clinical data but details about the home environment and daily routines that may affect health outcomes. They’re checking out the social determinants of health, seeing what’s in the refrigerator and what a typical afternoon is like, and learning that conversation can be just as important as a prescription.

“A lot of times when we think of telehealth, it’s got to be medical or clinical,” says Melinda Lovering, Androscoggin’s manager of virtual health, who sees this sort of program expanding to serve other populations, such as those in hospice or perinatal care. “But there’s a lot more you can do with that (platform).”

Prior to the pandemic, Levasseur says, RPM was a concept slow to develop because much of the technology was still wired, connected to bulky health hubs, other devices or the patient. And it was all dependent on a good internet connection.

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“COVID-19 raised the profile of what telehealth could do,” he says, and pushed the industry to develop wireless devices and passive monitoring systems that could sit in the background and capture data without being noticed or interfering in the daily routine. Yes, broadband is still an issue, but the pandemic has also pointed that out, and federal and state governments are looking to address it as an important part of telehealth expansion.

The pandemic has also highlighted the potential for RPM programs to be used as a social tool, to be used as a means of keeping isolated patients mentally as well as physically healthy.

Levasseur says his program began noticing that need when care providers started talking about patients who wanted to keep on talking to their nurses after all the other data had been gathered. They seemed to cling to that virtual visit, he says, and relished the small talk.

With that in mind, Levasseur, Baillargeon and Lovering developed a list of patients in the home health program who were showing signs of loneliness and isolation, and they sent out a call for volunteers who might want to check in on them every few days. There was no shortage of applicants.

“A lot of our volunteers are retired, and this gives them a sense of purpose,” says Levasseur, who sought to match volunteers with patients who had the same interests. One volunteer, a veteran, asked to help with any patients who were also veterans.

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The program is slowly gathering momentum. Androscoggin has some tablets and recently secured a grant to acquire more, but resources are thin. Reimbursement is very limited, as it has been for all RPM platforms.

“There’s interest” from some private payers, as well as the state Medicaid program, says Lovering of Androscoggin’s full RPM platform, which ramped up in early 2020 when the group partnered with Health Recovery Solutions. That partnership has given Androscoggin some solid footing upon which to grow and expand its offerings, and to take a chance on new ideas.

She expects that RPM programs will prove their value over time, as more and more providers use the platform to address the needs of specific populations of patients, be they COVID-19 patients, those with chronic diseases, or those in home health and hospice care. They’ll be looking to show how care at home is better than care in the hospital, and that these programs improve clinical outcomes, reduce hospitalizations and help patients to better manage their health at home.

For AndroPeerConnects, the proof will lie in patient engagement and satisfaction, as measured in surveys at the beginning, three months in and when the patient is done with the program, whenever that may be. But it may be hard to quantify conversation, or small talk, or that feeling of connection someone stuck at home might get in chatting about a favorite sports team or TV show.

Then again, these days, that might be just as important as a vital sign.

“Telehealth is the glue that holds it all together,” says Lovering. “This is how we’ll be doing things from now on. It’s how we’re making connections and keeping them.”