There are four pillars that contribute to readmissions: ensuring patients are equipped to self-manage and properly take their medications; follow-up (usually by PCPs); managing transitions of care and care coordination, which might be known as interoperability; plus avoiding medical errors. Dr. Kim Noel and I discuss each of these pillars and how telehealth and other digital tools can close gaps and help patients do what they need to do to stay out of the hospital.
Dr. Noel is a clinical researcher, physician, and telehealth specialist. She is an appointee to the New York State Department of Health Regulatory Modernization Initiative Telehealth Advisory Committee and serves as the director of Stony Brook Medicine Telehealth and the deputy chief medical information officer there as well.
Dr. Noel will be speaking at the Digital Medicine Conference sponsored by NODE.Health in New York City coming up in early December, so if you are intrigued by what you hear here, then definitely consider coming. By the way, NODE stands for Network of Digital Evidence; and I will also be at the Digital Medicine Conference in early December. So if you will be attending, too, please definitely let me know!
You can learn more by connecting with Dr. Noel on Twitter at @DrKimNoel.
Kimberly Noel, MD, MPH, is a board-certified, preventive medicine physician. She serves as the telehealth director and deputy chief medical information officer of Stony Brook Medicine, where she provides leadership to all telehealth activities of the health system. Dr. Noel is also the chief quality officer of the patient-centered medical home (PCMH) for the family medicine department, working on quality improvement and population health management for National Committee for Quality Assurance (NCQA) designation. She practices occupational medicine clinically and provides digital solutions for employee wellness programs. She is an appointee the New York State Department of Health Regulatory Modernization Initiative Telehealth Advisory Committee and has won many service and innovation awards for health care. In academia, her research areas are in machine learning, risk models, and remote patient monitoring. Dr. Noel has developed several educational curriculums, including a 40-hour telehealth curriculum for the School of Medicine, as well as interprofessional educational curriculums with the School of Health Technology and Management, Nursing, Dentistry, and Social Work. Dr. Noel is a graduate of Duke, George Washington, and Johns Hopkins Universities. She is a proud graduate of the Stony Brook Preventive Medicine program, whereby she is now working collaboratively with the residency program leadership on development of a telehealth preventive medicine service.
02:14 Medical errors and other health barriers that lead to readmissions.
04:24 How to better understand the problem and start synergizing health care.
05:35 “These patients are also ready to adopt technologies.”
05:58 Looking at the digital solutions themselves.
06:16 “It’s really a call for collaboration for several stakeholders.”
06:38 “Some of the problems that we have in health care are not unique to health care.”
08:54 “These shouldn’t be secrets that we only give to certain patients when they’re hospitalized.”
11:19 Overcoming myths in health care.
12:02 “Age alone doesn’t define.”
13:46 Helping patients navigate their disease and optimizing the technology for their treatment needs.
16:38 Looking at risk stratification as essential and central.
20:10 Optimizing patient self-management.
21:46 What other organizations can learn from what Dr. Noel has done.
23:20 The need for participation from the medical community.
23:38 “How do we best engage and optimize that self-efficacy?”
26:37 Dr. Noel’s advice to vendors with digital solutions.
28:11 Understanding who makes the decision.
30:03 You can see Dr. Noel speak at the NODE.Health conference in December.
