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Telemedicine to Reduce Readmissions Post Liver Transplant: Compliance and Feasibility Results.

T. Kaiser,1 P. Kimmel,2 S. Osborn,2 S. Diersing,2 B. Boswell,2 J. Huff,2 J. Garrett,1 N. Anwar,1 S. Shah.1

1Medicine, University of Cincinnati, Cincinnati, OH
2Transplant, University of Cincinnati Medical Center, Cincinnati, OH.

Meeting: 2016 American Transplant Congress

Abstract number: C210

Keywords: Adverse effects, Liver transplantation, Outcome, Outpatients

Session Information

Date: Monday, June 13, 2016

Session Name: Poster Session C: Liver Transplantation Complications and Other Considerations

Session Time: 6:00pm-7:00pm

 Presentation Time: 6:00pm-7:00pm

Location: Halls C&D

Related Abstracts
  • Hospital Readmissions in the First Year Post Transplant Over a 12-Year Span at a Single Center.
  • Hospital Readmissions Following Discharge After Liver Transplantation (LT).

Telemedicine (TM) was added to our care model as a mechanism to reduce readmissions post liver transplant (LTx). Establishing a TM home allows for remote monitoring between visits which may trigger a clinical intervention and subsequently prevent readmissions. We sought to evaluate our TM pilot study to assess health session (HS) compliance rates and TM feasibility in our post LTx population.

Retrospective review of subjects enrolled in TM study was performed. Upon discharge, subjects received an electronic tablet to conduct daily HS which included: measurements (i.e. vital signs, blood glucose), assessments (i.e. activity, wound) and questionnaires (i.e. PHQ-9, stress) at variable frequencies over 90 days. Compliance was calculated by adding up days a HS was initiated and subjects were categorized accordingly: excellent (> 80%), good (50-79%) and poor (0-49%). Data was grouped into 3 study intervals according to study days: 1-30, 31-60 and 61-90. Questionnaire completion rates were tabulated. TM feasibility was defined as > 50% of subjects initiating HS's more than 50% of the time. Study supported by Intel-GE Care Innovations LLC.

20 subjects were enrolled (9/14 – 2/15). Male (80%), age 56 (range 42-70) years, 32 (range 6-75) days post LTx. LTx indication: HCV (50%), NASH (20%), alcohol (20%), alpha 1 (5%) and cryptogenic (5%). Compliance with HS of > 50% (categories excellent and good) was achieved in 85-95% (day 1-30), 80% (day 31-60) and 70-80% (day 61-90). Data is summarized in Table 1. Questionnaire response rates: PHQ-9 (66%), stress (65%), and program satisfaction (68%). TM feasibility was achieved; at least 50% initiated HS's more than 50% of the time.

Our findings demonstrate that LTx recipients are compliant and that the use of TM technology is feasible within this population. Establishing a TM home has promise to reduce hospital readmissions by providing a mechanism for care in between visits that is efficient, patient-centered and low in cost.

Rate of Initiating HS (Measurements and Assessments) per Compliance Level and Study Interval    
     Rates by Compliance Level (%)
 HS by Study Interval (days) Excellent Good Poor
 Measurements 
      1-30  60  35  5
      31-60  50  30  20
      61-30  60  10  30
 Assessments  
      1-30  45  40  15
      31-60  60  20  20
      61-90  50  30  20

CITATION INFORMATION: Kaiser T, Kimmel P, Osborn S, Diersing S, Boswell B, Huff J, Garrett J, Anwar N, Shah S. Telemedicine to Reduce Readmissions Post Liver Transplant: Compliance and Feasibility Results. Am J Transplant. 2016;16 (suppl 3).

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To cite this abstract in AMA style:

Kaiser T, Kimmel P, Osborn S, Diersing S, Boswell B, Huff J, Garrett J, Anwar N, Shah S. Telemedicine to Reduce Readmissions Post Liver Transplant: Compliance and Feasibility Results. [abstract]. Am J Transplant. 2016; 16 (suppl 3). https://atcmeetingabstracts.com/abstract/telemedicine-to-reduce-readmissions-post-liver-transplant-compliance-and-feasibility-results/. Accessed March 3, 2021.

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