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UPMC venture aims to reduce unnecessary hospitalization of nursing home patients

| Wednesday, Sept. 21, 2016, 9:54 p.m.

A business funded by UPMC Enterprises uses telemedicine to try to reduce trips from nursing homes to hospitals, a service the venture's founder said could improve care and save money as new federal penalties kick in for the homes.

Curavi, which UPMC announced Thursday, uses mobile carts equipped with sensitive cameras to connect nurses with Pitt geriatricians during off-hours. The geriatricians guide the nurses through treatment or, if necessary, recommend hospitalization.

Dr. Steven Handler, a geriatrician and one of the company's founders, said the idea came from a successful Medicare experiment at UPMC that reduced unnecessary hospitalizations in a group of Western Pennsylvania nursing homes. He helped turn it into a business with help from UPMC Enterprises, a for-profit arm of UPMC, a nonprofit. UPMC would not disclose how much money it contributed toward Curavi.

“This has been a great opportunity for me and colleagues to serve a particular type of patient that often doesn't have a voice in their own care,” Handler said.

Hospital admission is often disruptive for nursing home residents, especially those with mental conditions such as Alzheimer's, he said. Patients and their families, who have become accustomed to their nurses and resident doctors, often have little say in whether they are transported to the hospital, he said.

Many of the conditions that send seniors to hospitals — things such as pneumonia, dehydration, infections and skin ulcers — could be treated by a guided nurse, and staying where they are could even help the seniors avoid dangers of infection and errors at hospitals, he said.

Medicare will start penalizing skilled nursing facilities with high rates of avoidable hospitalization in Oct. 2018, according to the federal Centers for Medicare & Medicaid Services, and will start posting information on the Nursing Home Compare website earlier. The effort mirrors a program the agency launched in 2012 that reduced hospital readmissions nationwide.

Handler helped launch the telemedicine experiment that led to Curavi in 2012 as part of a CMS innovation initiative. The program reduced potentially avoidable hospitalizations in a group of 17 participating nursing homes by about 26 percent, according to a CMS report, and reduced potentially avoidable emergency department visits by 40 percent. The program saved Medicare $5 million, according to a UPMC press release on the program.

Curavi, incorporated in January, has contracts to use the cart at UPMC's nursing homes, Charles Morris Nursing and Rehabilitation Center in Squirrel Hill and Asbury Heights in the South Hills, Handler said.

He said he is negotiating additional contracts and expects the technology to be applicable across the country. In other states, nursing homes could make arrangements with their local hospital systems for the geriatricians doing the consulting, he said. As the business progresses, he said he plans to add specialties, such as geriatric psychiatrists.

“We can help so many more people than if I and my colleagues were just to go nursing home to nursing home,” Handler said.

Wes Venteicher is a Tribune-Review staff writer. Reach him at 412-380-5676 or wventeicher@tribweb.com.

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