VidyoHealth and Global Telehealth Services recently presented a webinar, Harnessing the Power of Remote Patient Monitoring in the Post-Pandemic Era. We’ve had great feedback and put together this summary for those who couldn’t watch the entire webinar. We hope you find it insightful.
What is Remote Patient Monitoring?
Remote patient monitoring (RPM) is the collection of health data generated by a patient or caregiver, typically outside of a traditional clinical setting. That data is digitally stored and transmitted to a physician or clinical staff for review or intervention if needed. Data is captured via a remote device such as blood pressure cuff, pulse oximeter, glucose monitor or many others. The data is either relayed by the patient or automatically generated and transmitted automatically via the remote device.
How has the use of RPM evolved in the pre-COVID and COVID eras?
COVID has been a large catalyst for the adoption of telehealth and relocation monitoring, although both were already gaining momentum prior to the pandemic. When COVID hit, it immediately put a spotlight on telehealth as it became the only way to continue to care for patients while keeping everyone safe. What we expect to see in the post-COVID era is the continued use of telehealth and the acceleration of RPM.
Just as many providers and patients experienced a learning curve when implementing telehealth at the beginning of the pandemic, there will certainly be a learning curve when starting an RPM program. However, we expect that those kinks will be worked out quickly once providers, payers and patients begin seeing the benefit.
Now that telehealth processes are in place and patients have embraced it, the time seems right for the broad implementation of RPM.
What are some of the influences that have driven the growth of RPM?
The biggest impetus for the growth of RPM is the skyrocketing incidence of chronic disease. According to the CDC, 51.8% of adults in the U.S. now have at least one chronic condition and 27.2% have two or more. We have seen firsthand how effective RPM is in managing chronic conditions and reducing readmissions. We have had pilots where we have seen a reduction in hospital visit more than 80%.
Another considerable influence in driving growth is the creation of new CPT codes that reimburse RPM care as well as chronic care management (CCM). In many cases, that care can be provided by a clinician other than the provider, which allows providers to see more patients, making an RPM program even more attractive.
Another influence is the evolution of technology, especially remote devices. In the past, you had thermometers, blood pressure cuffs and pulse oximeters—simple devices that most patients could use at home unassisted. Then other devices came along that could use Bluetooth, but many only captured a single data point. Today’s wearables, which continue to evolve, can do so much more. Their ability to continuously monitor multiple vitals and transmit that information automatically to the provider allows for faster interventions. These wearables are key to a successful RPM program and to the success of chronic disease management.
How will RPM evolve as we move into the post-pandemic era?
We expect that the adoption rates of RPM will mirror the adoption rates of telehealth. The hospitals we have spoken with over the past six to nine months have told us that 2021 is the year they are going to begin reviewing RPM solutions and get the selection process started.
We also see a shift in profit dynamics and the revenue implications of implementing RPM. Payers are going to begin doing market analysis to determine where dollars are best spent. The implementation of the new CPT codes is an example of how this trend is already under way.
What are the top use cases for RPM now and which will lead us into the future?
With COVID, one of the first use cases—and one we had not anticipated—was in the hospital itself. We realized that we could keep both patients and staff safer using RPM technology. We could capture vitals and interact with patients from outside the room. It allowed us to continue caring for critically ill patients while keeping our doctors and nurses safe.
The most promising area and one we touched on previously is chronic care management. We can create specific use cases for the most complex and critical diseases like diabetes, hypertension, and heart disease. These conditions are top killers of Americans and top drivers of costs. Heart disease, stroke and diabetes cost the US more than $650 billion (about $2,000 per person in the US) each year. RPM will be key to more effective management of these conditions.
Another use case, and one that is gaining a lot of attention, is in the post-discharge recovery at home. 20% of patients experience some type of adverse event in just the first three weeks after discharge, with the majority being preventable. The top three issues found in the study were adverse drug events, hospital-acquired infections, or procedural complications. RPM allows physicians and other care providers to continue evaluating patients at home to ensure they remain in stable condition or to proactively intervene if necessary. In turn, this can reduce readmission penalties, which can save hospitals tens of millions each year.
What are the best practices to increase patient adherence for RPM?
At some point, there will be a retail model for RPM, but in the near term, adherence is going to be driven by the health system and providers. This will continue to evolve and change. As patients begin to interact more with RPM technology, they will become more informed about their health. This, we believe, will encourage them to become more engaged in their own health. Once they experience improvements in their health, they will want to ensure it continues.
We also see RPM adherence growing as patients see it to engage with their provider more proactively in a way that was not possible in the past. Previously, a patient’s vitals were only taken at their annual checkup or during an office visit. With RPM, patients know their providers are always paying attention to their vitals. They know that if a vital is falling out of line, their provider will reach out to see what is going on and intervene to prevent complications or a costly hospital visit. In other words, RPM changes the dynamic of the patient-provider relationship to one that is more of a partnership.
What are the top challenges for RPM adoption and what should health systems consider when choosing a solution?
One of the biggest challenges is the number of data capture companies in the market. Some are device companies, some are software companies, and others are a combination. It can be difficult to understand all the options and determine the right choice to align with the health system’s financial model and priorities.
In many cases, data capturing platforms are created by device manufacturers and are closed systems. In other words, their platforms only work with their devices. Health systems must ask whether they want to be limited in their choice of devices or do they want a device-agnostic option. Either one could be the right answer; it just depends on the health system’s particular priorities. They also need to determine adaptability of the company’s solutions with provider workflows, as well as integration within an EMR.
The first thing a health system needs to do is clearly define their priorities and determine what level of flexibility and customization they need. We advise choosing a solution that is customizable all the way down to the patient level and one that is device-agnostic. This gives the health system the most options for scaling and evolving as their RPM program grows. Health systems also need to choose a solution provider that can show a positive return on investment. In these challenging times, health systems cannot afford to invest in technology that does not add value. With the right RPM and telehealth technology, health systems can improve outcomes, reduce costs, and enhance the patient experience.