Healthcare has recently had a lot of conversations about Remote Patient Monitoring (RPM). The rapid adoption of telehealth during COVID, improved data analytics, and RPM’s proven healthcare benefits have all contributed to the increase in the discussion. Furthermore, revamping RPM CPT codes in 2019 has undoubtedly helped further the interest in Remote Patient Monitoring as well.
When designing and implementing an RPM program, getting from point A to B requires many steps. Inventory acquisition and management, consents, software platforms, additional staff time, data analysis, and data reporting are just a few reasons many physician offices choose to partner with a vendor rather than try implementing the program themselves. Partnering with a vendor can help create a more streamlined approach to offering this valuable service to patients.
Because of the complexity of Remote Patient Monitoring, I will break it down into phases over a series of blogs. This first blog will help identify patients who would benefit from Remote Patient Monitoring and succeed in participating in the program.
The main criterion for a patient to be able to participate in RPM is the presence of a chronic condition. This condition can be anything from hypertension, diabetes, congestive heart failure, obesity, etc. There is no black-and-white table of what conditions would qualify for RPM and which won’t. The patient with whatever chronic diagnosis needs to benefit from the monitoring in order to qualify. Read more at this link.
Once a patient with a chronic condition has been identified, it is essential to confirm three factors. These are what we will focus on today.
1) Does the patient WANT to participate?
RPM is a commitment. There is a process involved with implementation and utilization that the patient has to achieve to be successful. They must receive the equipment, learn to use it, then measure their biometrics most days of the month. For some patients, this will be easy, and they will be excited to play an active role in the participation of their healthcare journey. For others, this will be a challenge both technically and physically. Patients have to want to participate to be successful participants. Following is an example of a patient who does not want to participate.
Kitty is a pleasant and outgoing female in her 80s who would benefit from Remote Patient Monitoring. She is fully capable of measuring her weight and blood pressure each day which will help monitor her chronic conditions of hypertension and obesity. Kitty’s granddaughter is in healthcare and told Kitty that participating in the program would help her, so Kitty signed up. She trusts her granddaughter. After two months and four in-person visits, Kitty still struggles with the equipment and has yet to take independent readings. She is busy with her activities and feels the devices could be more convenient and time-consuming. When Kitty receives calls from the RPM team offering coaching and guidance, she becomes flustered and hurries off the phone. Kitty wants to please her granddaughter so she does not quit the program, even when the RPM team offers her that option.
Carrie is an example of a patient that wants to participate. Carrie has recently gained weight and developed hypertension and diabetes. She recognizes that participating in a Remote Patient Monitoring Program will help hold her accountable as she tries to lose weight. She eagerly measures her vital signs daily and looks forward to documenting her progress.
In summary, find patients who want to participate and who will readily embrace the process and monitoring. There will be more success and more satisfaction for the patients and the healthcare teams.
2) Is the patient CAPABLE of participating?
There is baseline technical knowledge required to be a successful user of Remote Patient Monitoring. While the RPM team can assist with some troubleshooting, they cannot be present for all the troubleshooting. The patient or a present, engaged caregiver needs to be able to handle some basic technology to achieve success. The most basic of which is changing batteries in devices. While changing the batteries might sound highly simplistic, it can be a real issue. Many aging or disabled patients are uncomfortable with or can no longer change device batteries. Some patients cannot afford new batteries. These are two very separate but equally impactful issues that may prevent the success of RPM.
Other knowledge needed might involve:
- Setting a date and time
- Pairing the devices
- Logging in to devices or applications
Another hot topic is access to the internet. Until recently, blue tooth-enabled devices have been the standard in traditional RPM Programs. These devices connect to software downloaded on cell phones or tablets. Utilizing blue tooth-enabled devices is only possible for patients with wifi, internet, cell phones, or tablets. Fortunately, cellular devices are now more readily available. If a patient does not have internet access or a smartphone or tablet, a patient can be issued a cellular device to use instead. These devices conveniently send the data through cellular networks, but an additional cellular fee is associated. The patient or the vendor will need to pay this fee, which is not reimbursable by insurance. This fee typically makes this the less attractive option when selecting between cellular and Bluetooth-enabled devices.
3) Can the patient PAY for the service?
With the rapid adoption of telemedicine during COVID, we have also seen advancements in insurance coverage for associated services such as Remote Patient Monitoring. Medicare and many other payers will cover the cost of RPM for patients, although standard copays and deductibles do apply. It is essential to be transparent with patients and help them understand whether their insurance will cover the service or out-of-pocket rates will apply. The patient must also consent to participate in a Remote Patient Monitoring program, preferably in writing.
In conclusion, identifying the ideal patient for Remote Patient Monitoring is achievable with the following key points in mind:
- Determine if the patient has a chronic qualifying condition.
- Ascertain the patient’s desire to participate in a Remote Patient Monitoring Program.
- Understand if the patient is technologically able to participate.
- Finally, determine is the patient can pay for the service with insurance or privately.
Once a patient meets these critical criteria, then congratulations! You have a patient whose health can be positively affected by remote patient monitoring.