Jim Brown, MD, Medical Director-RPM
The benefits of remote patient monitoring (RPM)—using devices in the home to track patient vital signs such as heart rate, blood pressure, and weight—have become clear in the last few years. A growing number of practices now use RPM programs to proactively manage the health of patients with chronic conditions such as diabetes, congestive heart failure, and hypertension.
A recent survey of 100 physicians and practice administrators found that nearly all respondents (92%) believe RPM is important to ensuring high-quality care. And a growing number of medical associations approve of these programs, including the American Heart Association, which supports using RPM to provide a more holistic view of health that can help physicians intervene before a patient gets into medical jeopardy.
Yet one factor has prevented many physician practices from adopting RPM: The concern that adding this service will significantly add to staff and clinicians’ workloads. That may be why the same survey of 100 physicians and administrators found that about half of practices have not yet implemented RPM.
And that’s a shame, because many patients could benefit from RPM, such as those with a hemoglobin A1C level over eight, those with heart failure, and those with blood pressure greater than 140/90 that is not well controlled.
I’ve personally experienced just how challenging it is to monitor such patients without RPM. If a patient comes for an office visit with hand-written records of their vital signs, not only am I unable to take the time to review that data in advance, but it’s also likely too late to take proactive measures.
Common Mistakes: When RPM Becomes a Burden for Staff and Physicians
Some physicians believe that implementing and managing an RPM program independently (without a third-party partner) will generate more revenue for their practice. This is a common misconception.
Many practices underestimate the amount of effort it takes to develop a program in-house, while being overly optimistic about how many patients they can enroll and how much revenue they can generate. Many practices also underestimate how much time and effort is involved in complying with guidelines and regulations regarding in-office visits and reimbursement. Typically practices that implement RPM without engaging an outside partner should plan to add at least one clinician and three administrative staff for every 1,000 patients that will be monitored.
Practices struggle with setting up a robust RPM function in-house because it requires the ability to manage the following tasks:
- Assessing and selecting monitoring devices
- Delivering, setting up, and training patients on devices
- Performing device maintenance, updates, and troubleshooting
- Identifying ideal candidates
- Engaging, onboarding, training, and communicating with patients
- Analyzing and monitoring incoming data
- Processing data to use during appointments
- Monitoring vital signs for early intervention
- Completing billing and reimbursement forms
- Creating monthly reports summarizing patient status
Benefits of Risk Stratification
More efficient and informed decision-making
Rhythm provides devices that are connected via cellular technology that automatically send measurements to its expert team, without the need for special applications, passwords, or internet connection. When vital signs monitored by patients at home indicate significant changes or emergencies, their physician receives a Core Alert to immediately address critical problems. These types of alerts can be useful, but the value of RPM is to see the trend over time.
To capture these trends in a valuable way, Rhythm developed its Risk Stratification month-end reports, which summarize readings for each patient in each risk range: Controlled, Low, Medium, and High. Based on the number of readings in each range, patients are categorized into the appropriate risk category, enabling the practice to:
- Easily identify level of risk using trend data
- Quickly determine which patients need higher-level intervention
- Better manage uncontrolled patients
- Track patient populations over time
Best Practices: How to Make RPM Easy and Seamless For You and Your Staff
A great third-party partner can minimize work associated with RPM, while optimizing revenue.
Practices should look for a partner with extensive experience, a proven track record, and the ability to deliver a combination of high-quality service and technology.
It’s also important to ask about the typical enrollment rates the partner achieves for practices. Many third-party partners will enroll less than half of eligible patients, while Rhythm achieves a registration rate well above industry average.
Other key capabilities to seek out in a partner include:
- Identifying RPM-suitable patients through EHR review
- Conducting patient outreach, onboarding, training, and education
- Selecting, delivering, setting up and maintaining RPM devices
- Offering a secure, centralized data platform
- Automatically flagging and triaging abnormal results
- Identifying trends within incoming data
- Generating monthly risk stratification reports that make it easy to view trends and spot health issues
- Automatically processing clinical data to use during scheduled appointments
- Providing billing compliance support
Before you decide to launch into RPM on your own, do your due diligence. Talk to physicians who have tried this approach and compare their experience with those who work with a partner they trust. And make sure you take the challenges of hiring, training, and managing experienced clinical and administrative staff into account.
