Sizing up the impact of remote patient monitoring
RPM programs in tandem with a broader array of telehealth services can build new outpatient revenue streams and reduce hospital utilization.
The growth of remote patient monitoring technology and telehealth over the past two years is transforming the way hospitals, health systems and clinics deliver healthcare. Remote patient monitoring technology in particular is set to explode. But with so much change happening so fast, even the terms themselves are the subject of some confusion.
So, what is remote patient monitoring, exactly, and how does it differ from telehealth? Because the market for these technologies is expected to explode in the next five years, it’s important to define our terms.
Telehealth is an umbrella term
Simply put, telehealth is an umbrella term describing the use of technology to deliver healthcare remotely.
Several organizations have published their own definitions of telehealth, although healthcare providers are usually most concerned with definitions released by the Centers for Medicaid and Medicare Services. In a resource on telemedicine published for healthcare providers, CMS defines telehealth as “the use of telecommunications and information technology to provide access to health assessment, diagnosis, intervention, consultation, supervision and information across distance.”
Thus, telehealth refers to a suite of services for delivering remote care, both in and out of traditional care settings. One subset of those services is remote patient monitoring.
Defining of remote patient monitoring
Remote patient monitoring is the use of technology, often wearable devices, to monitor patients outside of clinical settings. These devices are internet-enabled and can thus send information on patient health directly to the offices of care providers.
Combined with technology platforms that can aggregate and analyze the data as well as integrate it into clinical workflows for care delivery, remote patient monitoring has the potential to transform patient care for the better – and reduce its cost.
A Government Accountability Office report defines remote patient monitoring as “a coordinated system that uses one or more home-based or mobile monitoring devices that transmit vital sign data or information on activities of daily living that are subsequently reviewed by a healthcare professional.” The report notes, however, that Medicare fee-for-service does not have an explicit definition of remote patient monitoring. Rather, Medicare pays separately for some services that are used to remotely monitor patients, as well as for other remote monitoring bundled with other services.
It’s important to understand the full breadth of what remote patient monitoring includes.
Applications for remote patient monitoring
Understanding the full breadth of applications for remote patient monitoring technology will help your organization realize the full potential for expanding and improving care delivery.
Essentially, any device that can monitor patient vital signs or physiological data and transmit that data to care providers can be used to manage patient conditions outside of traditional care settings. Following are some examples:
At the Mayo Clinic Cancer Center, cancer patients can be enrolled in a remote patient monitoring program that a recent study showed has helped them avoid unnecessary hospitalizations.
The program gives patients Bluetooth-enabled blood pressure cuffs, pulse oximeters and thermometers and a tablet that prompts them to take vital sign measurements, which are then delivered to an interdisciplinary care team.
Remote patient monitoring is a potent tool for measuring blood oxygen levels, which are a critical indicator of whether COVID-19 patients require hospitalization.
Hospitals can enroll patients in a remote monitoring program after inpatient discharge, use remote monitoring to manage “long-COVID” and reduce the load on critical care resources by keeping patients who do not require hospitalization safely at home.
The FDA has issued an Emergency Use Authorization for certain remote or wearable patient monitoring devices during the pandemic.
Remote patient monitoring can help monitor patients who have several chronic conditions, including Chronic Obstructive Pulmonary Disorder.
The remote monitoring may be used to predict exacerbations, which can lead to hospitalization, thus providing care teams a more proactive strategy for management.
Dementia and falls
Patients with dementia are at risk for falls and wandering.
Just as connected wearable technology can help users monitor the number of steps they take and whether they are walking, running or in the car, the sensors on connected wearables can detect falls and alert caregivers when dementia patients may be hurt or need help.
Managing diabetes remotely requires ongoing control over blood pressure, weight and blood glucose.
A remote patient monitoring program can help track these and deliver results and proactive alerts to healthcare providers. A randomized control study found that diabetes management via RPM is as effective as regular clinic visits, leading to a significant reduction in cost.
Congestive heart failure
Cardiac implantable electronic devices (such as pacemakers) can deliver useful physiological data to help remote care teams identify and manage heart failure.
A systematic review of 42 studies on remote patient monitoring programs for CHF found the programs improve quality of life, reduce mortality rates and help reduce length of stay when patients are hospitalized.
The bottom line for hospitals and healthcare organizations is that RPM programs used in coordination with a broader array of telehealth services can help build new outpatient revenue streams and reduce expensive in-hospital utilization. “RPM is more than just fancy activity trackers,” writes Katie Nunn, practice management consultant for the Medical Group Management Association. “It is a way to reduce hospital admissions, lower healthcare costs and provide better care and outcomes for patients.”
Bryan Schnepf is vice president of marketing at Caregility.