DISEASE MANAGEMENT PROJECT UTILIZING TELEMETRIC MONITORING OF BLOOD PRESSURE IN COMMERCIAL PILOTS - PowerPoint PPT Presentation

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DISEASE MANAGEMENT PROJECT UTILIZING TELEMETRIC MONITORING OF BLOOD PRESSURE IN COMMERCIAL PILOTS

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patients at high risk of hypertensive sequelae. are useful and cost-effective tools' ... Indicated current heart disease or family history in HRA. Enrollment ... – PowerPoint PPT presentation

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Title: DISEASE MANAGEMENT PROJECT UTILIZING TELEMETRIC MONITORING OF BLOOD PRESSURE IN COMMERCIAL PILOTS


1
DISEASE MANAGEMENT PROJECT UTILIZING TELEMETRIC
MONITORING OF BLOOD PRESSURE IN COMMERCIAL
PILOTS
  • Thomas Bettes, MD, MPH
  • Sukhwant Khanuja, PhD
  • Brad Bowman, MD
  • Adam Pannell, MBA

2
Morbidity Associated with HTN
  • Prevalence 50 million Americans
  • Prevalence rate 1 out of 5 (18.4)
  • Undiagnosed prevalence gt 15 million (gt 30)
  • Undiagnosed prevalence rate 1 out of 18 (5.5 )
  • Estimate 55 billion
  • (74 direct costs)

National Heart Lung Blood Institute
3
FAA Certification
  • Upper limit 155 / 95 without CVE
  • Untreated stage 1 (possibly stage 2) HTN within
    FAA medical standards

National Heart Lung Blood Institute
4
Heart Dis. 2001 May-Jun3(3)152-6 Disease
management and pharmacoeconomics as tools for
mass prevention of hypertensive complications
  • Disease management programs
  • that incorporate pharmacoeconomic analysis and
    computerized methods of targeting
  • patients at high risk of hypertensive sequelae
  • are useful and cost-effective tools

5
DM Project Highlights
  • Identify
  • BP measure greater than 120/70 (originally
    140/80) and BMI gt30
  • Indicated current heart disease or family history
    in HRA
  • Enrollment
  • Confidential and secure email, toll free number
    to enroll voluntarily
  • Enrolled 23 out of about 200 contacted via e-mail
  • Monitoring
  • Participants received BP and weight monitors for
    daily transmission
  • Pre-set alert parameters (135/90) were set for
    both BP and weight readings
  • Intervention
  • Participants contacted if readings were outside
    alert parameters
  • Participants given access to secure web site to
    view their personal data

6
Carematix Wireless Monitoring Solution
Hosting Center
Hub in the living room
Portal on any PC
Alerts, Charts, Trends
e.g., Weight Scale in the Bathroom
7
Carematix Monitoring Devices
Wireless Hub
Weight Scale
Blood Pressure Monitor
8
Web-Based Monitoring ToolsTables, Charts and
Reports
9
DM Program Metrics
  • Participation Metrics
  • Clinical outcomes
  • Financial outcomes
  • Satisfaction Surveys

10
Participation- Compliance
  • Enrollment 23
  • Compliant in transmitting data 19
  • BP transmissions 5.7 times/wk
  • Weight recordings 3.3 times/wk

Out of N200 contacted
11
Participation- Certification issues
Indicates a significant number of potentially
disqualifying readings
12
Participation- Dropouts
  • 4 Pilots discontinued after enrollment
  • (1) Cited confidentiality concerns
  • (2) Very compliant for 4.5 months and had good
    control of BP
  • (3) Compliant for 2 months and had good control
    of BP
  • (4) Discontinued after 1 reading with no known
    reason

13
Clinical Outcomes
Sample size too small to establish a
statistically significant reduction in BP
14
Case Study -Recertification
Average Blood Pressure
  • Enrolled 1/18/06 after being grounded.
  • Worked closely with Cardiologist to monitor data
  • Cardiologist used data to adjust and modify meds

166
130
89
80
  • Member scheduled FAA physical and got
    recertified

First 23 readings over 14 days in Jan 06
Latest 40 readings over 30 days in May 06
15
Case Study -Recertification
Trended Data for Pilot over 4 months
16
Financial Outcomes- Medical Claims
Control Group
Intervention Group
N 524 Avg. Age52
N 23 Avg. Age52
6656
6288
5199
4842
-6
7
02/06-08/06
02/05-08/05
02/06-08/06
02/05-08/05
Medical claims decreased instead of increasing
17
Financial Outcomes- Pharmacy
Control Group
Intervention Group
N 524 Avg. Age52
N 23 Avg. Age52
550
528
4
41
137
97
02/06-08/06
02/05-08/05
02/06-08/06
02/05-08/05
Number of script filled went up at a higher
percentage
18
Satisfaction Surveys
  • High level of satisfaction and ease of use
    indicated
  • Overcame concerns of confidentiality and
    management access to protected health information
  • Responses indicated high level of awareness,
    control, and responsibility for BP management
  • Indicated willingness to endorse to fellow
    employees

19
Participant Satisfaction- Use
Easy to use
Privacy addressed
Data access was useful
Users found the solutions easy to use
20
Participant Satisfaction- Outcome
Helped Manage BP
Confidence for Physical Exam
Made lifestyle changes
Solution helped users manage their health better
21
Participant Satisfaction- Endorsements
  • The blood pressure monitor was easy to use and
    the online personal tracking is great. I have
    even lost 12 pounds since I started using the
    tracking program
  • The system is a quantum improvement over the
    manual monitoring and log book that I previously
    used. I am more quickly aware of adverse trends
    and can take measures sooner to correct them.
    Thank you American Airlines.
  • Actually tracking the trend of my weight and
    blood pressure has been very enlightening and
    beneficial. I know many more pilots who would
    benefit by utilizing this tool
  • I would like to take this opportunity to express
    my appreciation of the AA Pilot wellness Program

22
Conclusions
  • Issues related to records confidentiality and
    access to data by Management or FAA must be
    overcome in this population
  • Increased BP awareness enhanced via telemetric
    monitoring may lead to improved BP control in
    pilot population
  • Even in a small sample size a decrease in medical
    claims and improved pharmacy utilization was
    observed
  • Additional intervention strategies and longer
    monitoring periods may lead to further
    improvement

23
Contacts
  • Thomas Bettes, MD, MPH
  • American Airlines
  • 817 963 1295
  • Thomas.Bettes_at_aa.com
  • Sukhwant Khanuja, PhD
  • Carematix Inc.
  • 312 627 9300
  • skhanuja_at_carematix.com
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