Chronic Obstructive Pulmonary Disease (COPD) poses significant challenges for both patients and healthcare providers. Frequent hospital readmissions due to exacerbations strain resources and impact patient well-being. However, there are advancements in technology that are enhancing treatment strategies. With O2 Concepts’ DNA Technology®, we aim to equip clinicians and healthcare professionals with actionable knowledge to improve patient outcomes and ultimately reduce the burden of readmissions.

This article explores the transformative potential of DNA technology in helping reduce hospital readmissions and improving outcomes within the realm of long-term oxygen therapy delivered through home medical equipment (HME) provision. By leveraging the advanced support capabilities of DNA Technology, both HME providers and patients can benefit from enhanced care coordination, proactive monitoring, and targeted interventions, leading to reduced healthcare utilization and improved well-being.

The Burden of Low Blood Oxygen (Hypoxemia)

One of the common reasons patients with COPD are readmitted to the hospital is due to low blood oxygen levels, also known as hypoxemia. Defined as a decreased PaO2 (partial pressure of oxygen in arterial blood) of < 60 mmHg or oxygen saturation (SaO2) of < 90% in subjects breathing room air. Hypoxemia can have severe consequences if left untreated. According to recent estimates, more than 1.5 million adults in the United States rely on supplemental oxygen therapy to manage their respiratory disorders and improve their quality of life. (1)

Treatment and Consequences of Severe Hypoxemia

Oxygen therapy is the administration of oxygen at concentrations greater than that in ambient air. In cases of severe hypoxemia, unplanned medical encounters, including hospitalization, are often necessary. Chronic severe hypoxemia can result in unplanned medical encounters, including hospital readmissions. The average hospital readmission rate is 14.56%, with rates ranging from 11.2% to 22.3% in the United States. (2)

The Cost of Hospital Readmissions

The economic burden of hospital readmissions is substantial. With approximately 35 million hospital discharges annually in the United States, the cost of unplanned readmissions is estimated to be between 15 to 20 billion dollars each year. (3)

The Role of Post-Acute Care and Home Oxygen Therapy in Reducing Readmissions

Home Oxygen Therapy (HOT)

Post-acute care, including home oxygen therapy (HOT), plays a critical role in reducing hospital readmissions. (4) HOT is typically delivered through tanks and/or oxygen concentrators, including stationary and portable oxygen concentrators (POCs).

Here’s how it helps:

Improved Oxygen Levels: Home oxygen therapy ensures that patients receive adequate oxygen supply when they need it most. It helps maintain oxygen saturation levels, preventing complications and reducing the risk of exacerbations which could result in readmission.
Reduced Hospitalization Risk: Studies have shown that combining home oxygen therapy with noninvasive ventilation (NIV) significantly lowers the risk of hospital readmission or death after an acute COPD exacerbation. The 12-month risk of readmission or death was 63.4% in the home oxygen plus home NIV group compared to 80.4% in the home oxygen alone group, resulting in an absolute risk reduction of 17.0%. (5)
Longer Admission-Free Survival: Patients using home oxygen therapy with NIV had a median admission-free survival time of 4.3 months, compared to 1.4 months for those using home oxygen therapy alone. This three-fold difference highlights the benefit of combined therapy. (6)

Maintaining a Patient’s Lifestyle with a Portable Oxygen Concentrator

Post-acute care, combined with the use of portable oxygen concentrators, significantly enhances patients’ mobility, autonomy, and overall quality of life. (7) Portable oxygen concentrators provide a continuous supply of oxygen, which is crucial for patients with respiratory conditions including COPD. Unlike traditional oxygen tanks, these devices are lightweight with ease of mobility, allowing patients to move freely and engage in daily activities without being tethered to a stationary unit.

This increased mobility enables patients to participate in social, recreational, and physical activities, including physical therapy, which can lead to improved mental and emotional well-being. Additionally, the autonomy gained from using portable oxygen concentrators empowers patients to manage their own care more effectively, reducing the need for constant supervision and support.

Introducing DNA Technology: A Game-Changer In HME Provision

Enhancing Patient Outcomes Through Personalized Support and Interventions

DNA Technology, a cutting-edge innovation from O2 Concepts in the field of HME provision, offers a transformative solution to help reduce patient readmissions and improve outcomes. By providing initial and ongoing patient monitoring, DNA Technology enables HME providers to deliver personalized support and interventions, thereby mitigating risk factors for hospital readmissions and fostering better patient outcomes.

Key Features of DNA Technology

DNA Technology offers a range of advanced features that empower HME providers to deliver high-quality care, including:

24/7 Remote Monitoring:

DNA Technology is a device-initiated telemetry solution that enables the device to communicate independently from reliance on the patient to connect to their personal phone or tablet.
DNA Technology enables daily monitoring of medical devices used by COPD and other chronic pulmonary disease patients. This continuous surveillance allows healthcare providers to track device performance and utilization remotely.
By identifying issues promptly, clinicians can intervene before they escalate, reducing the need for field calls and preventing complications that might lead to readmissions.

Intuitive Customer Support Resources:

HME (Home Medical Equipment) providers benefit from easy access to customer support resources related to DNA technology.
When providers encounter challenges or have questions, efficient support channels help them address issues.
Improved support ultimately enhances patient care and satisfaction, minimizing the likelihood of readmissions.

Streamlined Asset Management and Inventory Control:

DNA technology incorporates geofence features and GPS-enabled inventory management.
Hospitals and HME providers can precisely track the location of POCs within their inventory.
This reduces losses due to misplaced or stolen equipment, ensuring that patients receive the necessary devices promptly.
Efficient inventory management also prevents delays in care, which can impact readmission rates, in addition to supporting device availability for initiation of care at patient discharge from hospital or clinic.

Proactive Monitoring and Clinical Support:

Clinicians receive daily alerts and insights through DNA technology.
By monitoring patient data—such as settings being used, hours of use per day, indications of mobility, combined with additional information including oxygen saturation levels, respiratory rates, and medication adherence—healthcare professionals can intervene proactively.
This enhanced monitoring capability allows for interaction opportunities to encourage early-stage therapy adherence, timely adjustments to treatment plans, personalized guidance, and early clinical support help prevent exacerbations and readmissions.

DNA technology empowers healthcare providers to deliver high-quality care by combining remote monitoring, streamlined asset management, and proactive clinical interventions. These efforts collectively contribute to reducing COPD readmissions and the burden on healthcare systems.

Conclusion

The integration of DNA Technology into HME provision has the potential to revolutionize the way we approach patient care, reducing hospital readmissions and improving patient outcomes. By leveraging the advanced features of DNA Technology, HME providers can deliver personalized support and interventions, ultimately leading to better patient outcomes and reduced healthcare utilization across all resources – personnel, operating, clinical and financial. As healthcare plans and routes of treatment evolve, it is essential for HME providers to stay at the forefront of innovation, embracing cutting-edge technologies like DNA Technology to drive positive change and improve patient lives.

Sources:

(1) Jacobs, S. S., Lederer, D. J., Garvey, C. M., Hernandez, C., Lindell, K. O., McLaughlin, S., Schneidman, A. M., Casaburi, R., Chang, V., Cosgrove, G. P., Devitt, L., Erickson, K. L., Ewart, G. W., Giordano, S. P., Harbaugh, M., Kallstrom, T. J., Kroner, K., Krishnan, J. A., Lamberti, J. P., & Porte, P. (2018). Optimizing Home Oxygen Therapy. An Official American Thoracic Society Workshop Report. Annals of the American Thoracic Society, 15(12), 1369–1381. https://doi.org/10.1513/annalsats.201809-627ws

(2) Definitive Healthcare. (2024, May 10). Average hospital readmission rate by state. https://www.definitivehc.com/resources/healthcare-insights/average-hospital-readmission-state

(3) Kong, C. W., & Wilkinson, T. M. A. (2020). Predicting and preventing hospital readmission for exacerbations of COPD. ERJ Open Research, 6(2), 00325–02019. https://doi.org/10.1183/23120541.00325-2019

(4) Sami, R., Savari, M. A., Mansourian, M., Ghazavi, R., & Meamar, R. (2023). Effect of Long-Term Oxygen Therapy on Reducing Rehospitalization of Patients with Chronic Obstructive Pulmonary Disease: A Systematic Review and Meta-Analysis. Pulmonary Therapy, 9(2), 255–270. https://doi.org/10.1007/s41030-023-00221-3

(5) Murphy, P. B., Rehal, S., Arbane, G., Bourke, S., Calverley, P. M., Crook, A. M., Dowson, L., Duffy, N., Gibson, G. J., Hughes, P. D., Hurst, J. R., Lewis, K. E., Mukherjee, R., Nickol, A., Oscroft, N., Patout, M., Pepperell, J., Smith, I., Stradling, J. R., … Hart, N. (2017). Effect of Home Noninvasive Ventilation With Oxygen Therapy vs Oxygen Therapy Alone on Hospital Readmission or Death After an Acute COPD Exacerbation. JAMA, 317(21), 2177–2186. https://doi.org/10.1001/jama.2017.4451

(6) Vestbo, J., Hurd, S. S., Agustí, A. G., Jones, P. W., Vogelmeier, C., Anzueto, A., Barnes, P. J., Fabbri, L. M., Martinez, F. J., Nishimura, M., Stockley, R. A., Sin, D. D., & Rodriguez-Roisin, R. (2013). Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: GOLD executive summary. American Journal of Respiratory and Critical Care Medicine, 187(4), 347–365. https://doi.org/10.1164/rccm.201204-0596pp

(7) AlMutairi, H. J., Mussa, C. C., Lambert, C. T., Vines, D. L., & Strickland, S. L. (2018). Perspectives From COPD Subjects on Portable Long-Term Oxygen Therapy Devices. Respiratory Care, 63(11), 1321–1330. https://doi.org/10.4187/respcare.05916

The Transformative Potential of DNA Technology® in Reducing Patient Readmissions