1. Increased program enrollment
   
2. Improved patient compliance with prescribed medical regime
   
3. Improved patient compliance with CCHT program monitoring
   
4. Improved patient outcomes as evidenced through decreased inpatient admissions, decreased bed days of care, decreased ER visits, and decreased outpatient clinic visits.
   

 Evidence Based Framework
Evidence based research supports the theory that an open therapeutic relationship between the provider of care and patient results in improved positive patient outcomes.  The development of a therapeutic relationship in the clinical encounter has been proposed as the key factor in human healing (Biker, 2005), and research by Jackson (2005) indicated 95% of patients reported better symptom outcomes following treatment that utilized " patient-centered patterns of communication".  Better communication has correlated with higher rates of compliance and improved glucose control for diabetic patients (Jackson, 2005).  In patients with chronic disease states, negative perceptions of the patient-provider relationship resulted in non-compliance with medical advice, avoidance of routine preventive care, and deterioration of health status (Blanchard, 2004).

 Methodology
The CCHT program uses a systematic method, based on established criteria, to identify potential program participants.  The veteran and their family’s willingness and ability to participate in a remote monitoring program are assessed.  A written statement of the program Mission and Scope of Services is shared with each enrollee upon admission.  The veteran, family and caregiver are actively engaged in the provision of services based on clinical practice guidelines.  Daily contact via telephone and/or electronic monitoring devices is utilized to maintain the positive patient-provider relationship.

 Results
The CCHT program monitors performance measures (outcomes) that are evidence-based and relevant to the targeted patient population or disease management process. Enrollment targets have been exceeded with a current active enrollment of 260 veterans.  Implementation of identified processes by registered nurses to be attuned to patients has proven effective as shown by the following positive outcome results:

 Conclusion
The ultimate goal of CCHT is to improve clinical outcomes and quality of life for our veterans.  The establishment of positive patient-provider communication has resulted in improved outcomes related to utilization of healthcare services and cost avoidance.  Our program has provided improved continuity of care with better informed patients and family and the realization of cost avoidance by utilizing the efficiencies of technology to proactively monitor patients with chronic disease states.