Experts believe remote patient monitoring (RPM) and telehealth technologies are here to stay and that a new model of hybrid care is emerging that will enhance the experience for both patients and providers.
During a September webinar hosted by Becker's Hospital Review and sponsored by Biofourmis, five key opinion leaders in remote care discussed scenarios where episodic & continuous monitoring can support improve outcomes with remote care-at-home programs and improve patient outcomes:
- Iris Berman, VP telehealth services, New Hyde, Northwell Health
- Bill Chasanov, DO Chief Population Health Officer, Beebe Healthcare
- Vincent Turner, Jr., AVP continuum of care, St. Bernards Healthcare
- Kristopher Brenner, DO, Division Chief Virtual Care, Spectrum Health
- Sandeep Pulim, MD, Medical Director, Biofourmis
Key takeaways:
1. To fully realize the value of virtual-enabled care, payers and providers must consider new care-delivery models. Convenience is a top priority for consumers. Spectrum Health, for example, has created an integrated e-triage solution for virtual visits that enhances the organization's digital front door. Telehealth has also improved access to behavioral health services, especially for rural residents. "We've seen an uptick in virtual behavioral health services and we continue to expand those offerings in provider shortage areas," Dr. Brenner said.
To improve outcomes for chronic conditions where patients need post-acute care, Spectrum has integrated apps and digital tools into the home to promote health and wellness. "We are also experimenting with virtual-first health plans where primary care is 100 percent virtual," Dr. Brenner said.
2. Continuous monitoring is valuable, but organizations must avoid data overload. One solution is using AI to identify trends and flag when something is moving in the wrong direction. "We need to identify people who might be heading toward an urgency where we can intervene before it becomes an emergency," Dr. Chasanov said. "I think that's what continuous monitoring will evolve to." Northwell Health has already used predictive analytics and AI in support of tele-ICU services. "That has allowed nurses to work at the top of their license in a different way," Ms. Berman explained.
3. Both continuous and episodic patient monitoring are beneficial for hospital-at-home programs. Continuous data, for example, can identify which patients need to be seen first when nurses do rounding for acute-care-in-the-home initiatives. Episodic data still has a role, however. "It informs the overall clinical picture of patients. If you layer continuous data with episodic data, you can expand patient selection criteria to reduce length of stay and increase transition of care programs," Dr. Pulim said.
4. Demonstrating the ROI of remote care programs requires two paths. It's important to focus on both potential reimbursement opportunities and the potential to reduce costs through better outcomes. In terms of reimbursement, CMS has opened up different avenues for billing certain CPT codes. "You have to map out what you're doing with remote patient monitoring and telehealth and get very specific," Mr. Turner said. "If you have a chronic care management RPM program, how many hospital readmissions is it preventing and what is the dollar value of that? You must be intentional and map the entire patient journey."
5. When selecting a remote patient monitoring vendor, consider your overall strategy. Telehealth, telemedicine and hospital-at-home programs are converging. It's important to consider what data is critical to remote care and how best to integrate these platforms with an organization’s EHR. "The infrastructure needs to be right to facilitate data flow. If manual data extraction is needed, you increase the workload and the risk that documentation will be missed," Ms. Berman said.
In the months and years ahead, innovation around clinical care will continue and continuous monitoring will play a key role. "Technology will always drive change, but from a clinical perspective, we all want to move in a direction that will benefit patients," Dr. Chasanov said.
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