Background: The Ontario Telemedicine Network's Telehomecare initiative brings together specially trained clinicians and technology to coach patients with COPD and/or heart failure to monitor vital signs and manage their health at home.

Objectives: To evaluate pre- and post-enrollment and post discharge data captured by Telehomecare host William Osler Health System (WOHS).

Outcomes: Results demonstrate a 46% reduction in emergency department use and a 53% reduction in hospitalizations post-enrollment compared to pre-enrollment. Average length of stay (LOS) dropped by 25% of a day compared to pre-enrollment. In addition, six months after Telehomecare discharge, inpatient admissions and emergency department visits continued to decline, by 65% and 57% respectively, compared to pre-enrollment. While average LOS increased between pre-enrollment and post-discharge, the reduction in acute inpatient episodes created a net reduction in accumulated inpatient days of 563.16 days (63% reduction).

Conclusions: The WOHS Telehomecare results strongly support the positive influence of the program on health system utilization and the development of effective long-term self-management skills. Next steps could include reviewing, more closely, the reasons for hospital utilization and undertaking a cost-benefit analysis to support further expansion of the program to address other chronic illness and care needs.