Carolinas HealthCare monitors Fitbit data to intervene with CHF patients

By Brian Dolan
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 With 11 million patient visits each year, Carolinas HealthCare System has been looking for ways to better manage their patient load.
 
“The volume is really starting to crush us, especially in those primary care practices where we see these doctors are busy, busy, busy,” Pamela Landis, vice president of information services at Carolinas HealthCare System said during a presentation at the Patient Engagement Symposium at HIMSS16 this week.
 
That was one of the reasons Carolinas rolled out video visits with American Well in late 2014. Landis described it as an attempt to “virtualize” as much of the care they provided as they could.
 
“About a year and a half ago Carolinas launched on demand virtual visits for low acuity, routine visits,” she said. “People are going online and downloading the app. So you see patients like it, patients like it a lot. They are starting to access it. You know, they aren’t accessing it in the greatest numbers we’d like to see but they are accessing it.  The satisfaction that they get out of it is actually a really big benefit for us.”
 
Landis also mentioned that Carolinas has cameras set up all of its neonatal ICU beds so that parents and grandparents can easily check in on their babies remotely when they can’t be there in-person with them.
 
“It’s not hard to do either,” Landis said. “A lot of the stuff we talk about, we all have this angst about how hard everything is. But not everything is hard and difficult.”
 
Last September Carolinas added OpenNotes for the 550,000 people who are registered users of their patient portal. The healthcare system currently shares 800 document types through its portal as part of its OpenNotes rollout. Landis said 66 percent of patients who log into the patient portal are reading some of the documents shared with them.
 
“We haven’t done any marketing about it,” Landis said. “We haven’t sent out a letter about it. People are just finding this.”
 
One of the newest initiatives at Carolinas is the rollout of its MyCarolinas Tracker app, which Landis said started onboarding care management program patients on February 8th.
 
The app collects data from about 70 consumer health and fitness devices then puts it into clinical context with data visualizations that show whether they are on goal or not. It also connects to the patient portal.
 
“So now all of your clinical data that we collect on you at Carolinas healthcare system, all of your lab values, and test results, are in one place. We let you ship in all your patient generated data,” Landis said. “So now you start to get a picture of your full health.”
 
About 2,000 patients are now using the MyCarolinas Tracker app and collectively they have tracked more than 300,000 measurements. Some of the app’s users are participating in Carolinas’ care management program for chronic heart failure. Landis shared two examples of how the patient generated data had led to interventions in just the past week.
 
“One man, and we noticed this from his Fitbit data, was not getting any steps,” Landis said. “We contacted him and found out his wife had been admitted to the hospital. So he had been sitting at her bedside and wasn’t really able to take care of himself. We got social work down there… got him walking around the hospital while he was with his wife. We also made sure he was getting nutritious food while he was there.”
 
Another patient’s Fitbit data showed she wasn’t sleeping very well at night, Landis said. She went in for a sleep study, was diagnosed with sleep apnea and fitted with a CPAP machine.
 
“Those are the sorts of touchstones we can get now between patient visits.”