Virtual Cardiac Rehabilitation

We partnered with a large healthcare delivery network beginning in 2017.  The team had completed a small pilot with 37 patients that delivered remote rehabilitation overseen by physicians and nurses.  The results were quite encouraging and they desired to scale the pilot to a large geographic region with 13 sites.  We were grateful to play a pivotal role in the effort.

Business Case – At scale, the program would cost multiple millions of dollars and reimbursement in this area is marginal at best.  We worked with the finance and management team to develop a model that balanced the appropriate reduction in third party utilization and readmissions.  We are quite proud that after over two years of implementation, the actual results have beaten the business case.  Not many efforts can claim that title.

Program Development – Where was the team to start?  We had a pilot program that was modeled after traditional cardiac rehab but with no comprehensive guidelines.  The Island Creek team worked with nurses, physicians, physical therapy and pharmacy to ensure a satisfactory treatment guide was in place.  This included Inclusion Criteria, Screening and Intake on the front end of the process.  We were dealing with a new concept and ensuring patient safety was at the core of our goals.  The management of patients within the program needed to be strongly considered and balanced between nutrition, exercise, medicine adherence and sleep.  Finally, we put together a graduation criteria and Individual Treatment Plan for post program support.

We developed the organizational model balancing cost and clinical need.  The team includes clinicians of various levels to balance the cost and needs of the program.  The design also included the optimization of workflow and coverage models.  This highly distributed and federal model was unique to this program and highly effective.

We are proud that in the two years following launch, there were zero adverse patient events in the program.  Our readmission rate was a fraction of the national average for this patient cohort and 87% of our enrollees graduated from the program.

Enrollment Equity - We believe that every patient regardless of race, gender or income deserves cardiac rehabilitation where clinically indicated.  By reducing barriers to adoption that included the elimination of copayment, ethnic diversity in the program skyrocketed.  While enrollment in all minority groups increased, the Black Community was most greatly represented with a 28% increase in the virtual program when compared to traditional in-person rehab.

Launch Cadence – A standardized site launch model was created and repeated successfully through 13 main locations.  This included program promotion, nurse training and support, ongoing analytic measures of success, communication plans and more.  The repeatable template led to 13 "go live" events in seven months.  This efficiency is unheard of in large healthcare delivery.

Results – We are humbled by the stories of lives that have been changed by this program.  Speaking directly to patients that are living longer, healthier lives is profoundly rewarding.  But, we all understand that healthcare runs on numbers as well.  Here's our story from the first two years:

• Over 12,000 Patient Referrals
• 13 Sites implemented
• 270+ Ordering Cardiologists
• ZERO reported adverse events
• Low single digit rehospitalization rate
• 8,300 Patient Graduations at a 87% Rate
• Over an 80% conversion rate of referrals to intakes (compared with 40-50% in traditional programs)
• 225 Lives Saved (based on NNT of 37)