Remote patient monitoring and virtual care – a paradigm shift

Reimbursement will make a big difference, "because it not only pays providers for performing these services but it's yet another recognition of the value" of remote patient monitoring, says the VP of nursing and care delivery at Brook Health.

The connected care leader at Philips explains how remote patient monitoring tech can combat hospitals' and health systems' problems with patient retention and overall capacity.

Remote patient monitoring has begun to collect vital signs and other patient data more strategically and efficiently: Instead of waiting until a patient experiences distress, AI can help clinicians intervene earlier.

As one telemedicine CEO looks to the year ahead, he predicts RPM will improve outcomes for congestive heart failure patients and help manage those on the wildly popular GLP-1 diabetes and weight loss medications.

The University of Oklahoma College of Medicine did a controlled test and showed the odds of infection-related readmissions were decreased in the RTM group by 76% at 30 days, 80% at 60 days and 68% at 90 days.

The combination of 5G and IoT could redefine remote healthcare, getting closer to a future where patients can receive hospital-grade care from anywhere. And more user-friendly and patient-centered devices should drive broader adoption.

The strategy has had a big impact on patient access, bed capacity, and heart failure and all-cause readmissions – not to mention appreciation of patients and family thankful to receive care safely at home instead of having to be admitted to the hospital.

A nurse remote patient monitoring expert explains why she's seeing more providers looking for new tools to help manage CHF – and how advancements in virtual care are allowing more patients to be cared for at home.

MD Home Health CEO explains why the organization embraced the four-pronged, technology-infused style of home health and how the approach should streamline delivery and improve patient outcomes.

An expert discusses the combination of RPM and artificial intelligence, with examples of how tools are being developed and used today to improve patient access and expand virtual care.

Artificial intelligence is helping improve remote patient monitoring technology, with especially promising applications focused on diabetes. One CEO discusses the quality and cost-efficiency promise of "the next generation of remote care."

Erie County Medical Center Corporation's RPM initiative has been successful in "improving health outcomes and reducing the risks associated with hypertension," says its VP of population health.

The sophisticated program employing patient monitoring, patient tracking and reporting technologies also has enhanced patient follow-up and engagement and yielded a big win on overall healthcare delivery.

The panel likely needs more data and a decision on what constitutes a good form of engagement in order to make an informed decision on the proposed changes to the CPT code language for RPM reimbursement, one expert says.

A risk management expert offers perspective on shoring up data security, preventing misdiagnosis and avoiding overreliance on RPM.

Only 0.6% of remote encounters managed by the health system's remote patient monitoring vendor's caregivers escalate to Providence clinicians. Hypertension RPM patients saw a 12.55% reduction in systolic blood pressure by week 12.

If the CPT Editorial Panel approves new changes and Medicare and private payers follow suit, providers that expand their remote patient monitoring programs to fit the new codes will gain the most benefits for their patients and clinics.

Karin Schifter-Maor discusses how remote patient monitoring can bring the Acute Hospital Care at Home program to more people, make the program affordable and use centralized patient data to improve health outcomes.

Clinical outcomes have shown 82% of patients experienced lowered blood pressure via remote patient monitoring at the health system, with severely hypertensive patients seeing a significant decrease after 90 days on the program.

Cindy Gaines, RN, chief clinical transformation officer at Lumeon, explains why making the home another part of the care continuum is so crucial – and discusses the technologies that can make it happen.

The health system's medical director will offer more perspective on how remote patient monitoring is helping, including enabling an adherence rate of 80% to daily vitals, at HIMSS24.

The FDA-cleared tool can help at-risk provider organizations reduce costs while improving patient outcomes through earlier lifestyle and treatment interventions, its inventors say.

Done right, more widespread adoption of remote patient monitoring will offer breakthrough innovations where healthcare delivery can be improved, clinician workloads can be right-sized and better patient outcomes can be achieved, an expert says.

The health system and health plan has seen a 4-times ROI from its durable medical equipment technology work with its healthcare at home program. What's more, Geisinger has reduced overall turnaround time by 83%.

The FQHC has seen significant improvements in blood pressure and A1c numbers across the patient population enrolled in its remote patient monitoring program.

New monitoring devices and AI algorithms could help reduce staggering costs and improve quality of life for patients with chronic diseases such as COPD, asthma and chronic cough.

Dr. John Busigin, Covenant Health's Advanced Care at Home medical director, said that 20-30% of patients who traditionally received high acuity care at hospitals could receive virtual care through the program.

Signs point to yes – and mature remote patient monitoring and telemedicine tools will be key to helping providers capitalize on the shift, one technology leader says.

In one example, RPM helped detect impending potentially fatal adverse events 18 hours in advance of readmission. A wearable sensors expert discusses the benefits of RPM in cancer care.

With remote therapeutic monitoring, care teams are alerted and can intervene quickly when a patient is concerned or isn’t progressing as expected. Early action potentially can prevent complications and avoid unnecessary ED visits.

Remote patient monitoring has helped the health system boost patient engagement, improve patient care quality through evidence-based therapies and reduce clinicians' workloads.

The San Diego-based provider sees around 30 readings per patient per month, showing a high level of compliance – and is better able to identify white coat hypertension in doctors' offices.

For example, the Mayo Clinic has shown that 72.5% of remote patient monitoring patients comply with care plan tasks, including taking meds and monitoring vitals. Further, only 9.4% were readmitted within 30 days versus 20% of patients not using RPM. 

Working with Telemetrix and Remote Care Partners, the Atlanta health system is enabling cloud-based data exchange between home patient monitoring devices and its electronic health records.

The future of remote patient monitoring will be defined by broader adoption, novel devices, application to more conditions and consolidation of vendors, one expert says.

Not too long ago, about 17% of remotely monitored patients needed a higher level of care. Today it's in the 3% to 5% range, keeping more people in their homes and coordinating their care.

Through a new partnership with Cadence, the health system plans to launch a responsive virtual care and remote patient monitoring program at 30 hospitals and 200 care sites in six states over the next year.

Half the population has at least one chronic disease. Care for these sick patients is costly. RPM has the potential to help.

RPM can greatly aid providers treating chronic conditions and ease overburdened hospitals. The future of wearables is also looking bright.

The New York health system launched telehealth in 2019 and widely diversified its offerings to, among other things, decrease inpatient length of stay and readmission rates.

The National Institute of Standards and Technology's National Cybersecurity Center of Excellence published its final guidance this week on securing telehealth and remote patient monitoring ecosystems.   The guide is intended, according to NCCoE, to help identify risks associated with RPM architecture and ensure healthcare organizations are partnering with appropriate telehealth platform providers.   "While [healthcare delivery organizations] do not have the ability to manage and deploy privacy and cybersecurity controls unilaterally, they retain the responsibility to ensure that appropriate controls and risk mitigation are applied," wrote researchers.   WHY IT MATTERS   In order to develop the guidance and demonstrate how organizations can enhance resiliency, NCCoE collaborated with industry partners to build a laboratory environment – specifically, one where a patient is being monitored by an in-home device capturing biometric data. Those partners included Accuhealth, Cisco, Inova, LogRhythm, MedCrypt, MedSec, Onclave Networks, Tenable. University of Mississippi Medical Center and Vivify Health.   "While the NCCoE used a suite of commercial products to address this challenge, this guide does not endorse these particular products, nor does it guarantee compliance with any regulatory initiatives," noted the experts.   "Your organization’s information security experts should identify the products that will best integrate with your existing tools and Information Technology system infrastructure," they continued. The practice guide operated under the assumption that the delivery organization is using a separate telehealth platform provider that manages a distinct infrastructure, applications and a set of services.    Using the NIST Risk Management Framework, the NIST Cybersecurity Framework, the NIST Privacy Framework and other relevant standards, the NCCoE analyzed risk factors in an RPM ecosystem and identified measures to safeguard it.   It outlined several potential vulnerabilities, including fraudulent uses of health-related information, interruption or inaccuracy of patient diagnoses, disrupted processes and system disruption.   "As organizations consider measures to disrupt threats and adverse actions made against the ecosystem, an opportunity exists where organizations examine threats to identify controls that mitigate adverse actions identified by threat modeling," read the report.   The guidance authors noted that, although they used cellular data-based biometric devices and addressed those using broadband communications, a future build may also implement an electronic health record system that would receive automated data from the telehealth platform provider.     "The future build may include direct messaging from the RPM systems to the EHR," they wrote.   THE LARGER TREND   NIST has been offering tips around cybersecurity and telehealth deployments for years. NIST IT Security Specialist Nakia Grayson, who co-authored the guidance, told Healthcare IT News Executive Editor Mike Miliard in April 2021 that the agency began the work in response to  an uptick in patient and provider interest in virtual care, particularly amidst the COVID-19 pandemic.   "Without adequate privacy and cybersecurity measures, unauthorized users may expose a patient's sensitive data or disrupt the patient monitoring system," Grayson said in a HIMSSTV interview.     ON THE RECORD   "Technology solutions alone may not be sufficient to maintain privacy and security controls on external environments," wrote NCCoE experts.   "This practice guide notes the application of people, process and technology as necessary to implement a holistic risk mitigation strategy," they continued.   Kat Jercich is senior editor of Healthcare IT News. Twitter: @kjercich Email: kjercich@himss.org Healthcare IT News is a HIMSS Media publication.

The result? Greatly improved patient outcomes and big cost savings.

WebCareHealth CEO Dr. Teresa Sieck unpacks the results of the report about remote patient monitoring's abilities to find gaps in care, improve patient engagement, enhance the provider experience and boost revenue.

Now more than ever, healthcare IT leaders can use a comprehensive listing of companies that make technologies that help keep tabs on patients from afar.