Remote Patient Monitoring: Decrease Rehospitalization for Spinal Cord Injury Patients

Practice Problem: The lengthy distance required to access specialty care, the overall higher cost of SCI/D care, complications associated with SCI, and the potential negative impact of shortened hospital stays are all compelling reasons to use telehealth technologies to deliver specialty services for medical issues. PICOT: The PICOT question that guided this project was in adult spinal cord injury patients with chronic disease receiving primary care at a spinal cord injury center (P), how does the implementation of a remote patient monitoring home telehealth for SCI patients recently discharged from acute-care setting (I) compared to the usual practice of one post-discharge follow up phone call at 7 days (C), improve early recognition of patient deterioration to prevent acute care rehospitalization (O) within 30 days of discharge (T). Evidence: Spinal Cord injury patients are at risk for developing complications after injury. Paststudies have demonstrated the effectiveness of telehealth to prevent rehospitalization, which suggests the potential of telehealth on post-discharge follow-up care. Intervention: Implement remote patient monitoring home telehealth for SCI patients meeting the criteria for high-risk rehospitalization. Outcome: The pilot project results have a positive correlation with the reduction of 30-day hospital readmission rates for SCI patients participating in the RPM. During the pilot period, no readmissions occurred for the RPM participants, whereas those who declined participation were readmitted at a rate of 22%. Clinical significant findings of improved outcomes and reduced 30-day readmissions are supported through this pilot project. Conclusion: The project utilized the Johns Hopkins evidence-based model’s three-step PET framework and Roger’s diffusion of innovation change theory to support reduced rehospitalization for SCI patients through RPM