Winter Bootcamp: Understanding the economics of remote patient monitoring

For the video of this Bootcamp session, click here.

INTRODUCTION

Americans have adopted technology and adapted to it in so many aspects of life, including when they go to the doctor’s office. And once they leave, the latest internet connections and devices in remote patient monitoring (RPM) allow their physicians to follow them home — at least digitally.

The U.S. Department of Health and Human Services noted that RPM helps physicians manage acute and chronic conditions, such as high blood pressure, diabetes, weight, heart conditions, chronic obstructive pulmonary disease and more. RPM can also decrease patient travel costs and infection risks. And the American Medical Association recognized the benefits of RPM beyond health: “Successful implementation of digital health technology will be imperative for improving patient outcomes and ensuring financial stability for health care practices.”

The technology has a cost to patients and to physicians’ practices because expertise is required to assist patients and monitor results. This session was held to introduce the latest concepts for integrating RPM into medical offices.

LEARNING OBJECTIVES

• Why RPM and why now?
• Clinical and financial benefits of RPM.
• RPM staffing models.
• Getting started with RPM.
  

MEET THE PANELISTS

Crystal Kaiser
Senior RPM Solutions Director
Optimize Health

Sunny Bjerk
Senior Director, Product Marketing
Optimize Health

How to get started with RPM

RPM is built on a relatively easy concept: Physicians have an RPM platform or software in their offices to check on health readings of patients at home. If something is amiss, doctors and support staff will notice it and contact patients to provide continuous, proactive care, says Sunny Bjerk, senior director of product marketing for Seattle-based Optimize Health.

RPM is a natural, elegant evolution of three trends in the recent history of medicine, according to Bjerk. The transition from paper to electronic health records began in the 1980s. Technology has gotten smaller, so monolithic machines used in hospitals became portable. And the internet enabled video conferencing that led to virtual visits.

And it appears RPM is poised for growth. The average office visit lasts about 18 minutes, and 75% of that time goes toward routine maintenance for chronic conditions such as hypertension, diabetes or weight control. In addition, about 80 million Americans are dealing with two or more chronic conditions, and that number is expected to increase.

As good as physicians are, Bjerk says there’s no way they will solve or support those conditions with office visits every four, six, eight or 12 weeks.

“RPM does a couple of things here,” she says. “So when you have real-time data from your patients, you can start tracking them every day.” By doing this, physicians and support staff may quickly catch changes in patient conditions due to health or human error. And these insights increase over time, with real results.

“When you think about accessing patients every day, in real time, you’re going to do things like reduce (emergency department) visits, (reduce) rehospitalizations or readmissions, and understand their understanding of their medication and treatment plans,” Bjerk says.

Patients like knowing their doctor is paying attention too. “Patients are more engaged than they were just going to see the doctor every episodic visit of four, six, eight (or) 12 weeks,” Bjerk says. “That’s really the power of taking the script from once-in-a-while office visits to real-time care with RPM.”

For clinical outcomes, Crystal Kaiser, senior RPM solutions director at Optimize Health, offered examples of RPM patients lowering their blood pressure and hemoglobin A1C readings in three to 4 1/2 months. And because RPM is not tied to a specific chronic condition, physicians can order RPM for patients when there is a medical necessity.

Exact reimbursement may vary based on specific Current Procedural Terminology codes from the Centers for Medicare & Medicaid Services (CMS). Physicians have billed $100 to $120 per patient per month for RPM care, and CMS and health insurance payers benefit through decreased emergency costs — so revenue tied to RPM is “significant,” Kaiser notes.

Health insurance companies are a key player in starting RPM, and every plan handles it differently. “So that does take some time to be able to pull that patient information, call and verify insurance benefits,” Kaiser says.

Patients are another key player, so onboarding them is crucial for success. Not every patient will qualify; those who do must know copays in advance. Patient education may take as little as 15 minutes, but time must be allocated for patient education.

“This is where you have staff that are going to educate the patient around the program, making sure that they, No. 1, understand the benefits of the program, how to use the device that you’re assigning them, (know) to take their readings every day (and understand) their copay,” Kaiser says.

That can be done in clinic or at home. “If it’s done at home, it’s highly recommended you don’t just ship a device to the patient to leave it for them to figure out,” Kaiser says.

Solutions & takeaways

Kaiser and Bjerk offered the following five elements for developing a successful RPM program:

Get organizational buy-in for RPM. That means everybody in the practice. Patients will call the front desk with questions about RPM, so anyone who answers the phone or encounters a patient at least must be familiar with the program to answer questions or be able to quickly guide patients to someone who can.

Create RPM goals. Physicians should set clinical goals for patients and financial goals for the practice. Staff should be aware of the goals. Monthly or quarterly business reviews with the entire staff are crucial to a successful program.

Find the right RPM partner. The right partner will help discern whether a practice can internally manage an RPM program or needs a consultant to manage the program for the practice.

Select the best RPM model. This is related to finding the right partner. Will the RPM program be self-managed or partner managed? If self-managed, consider whether you will need to hire staff and whether they will work exclusively with RPM or have other job functions.

Invest in marketing, management and growth.Patients want RPM, so tell them you offer it. Let them know in your waiting room, exam rooms and social media channels.