The following is a guest article by Lucienne Ide, MD, PhD, Founder and CEO at Rimidi
Remote patient monitoring (RPM) is a key capability in healthcare, particularly as we have seen multiple factors align in recent years: advances in medical device technology, decreased cost of cellular connectivity, new reimbursement models, and consumer demand that accelerated during the pandemic. RPM offers the ability to follow the patient from the clinic to the home and to provide a more complete picture of their health by collecting daily metrics such as blood pressure, blood glucose, weight, pulse oximetry, etc. But the healthcare industry needs to look at RPM as a tool in the toolkit for managing health conditions. The goal is management. Remote monitoring is one strategic capability for how we get there.
As a clinician, I’ve had a front row seat to the evolution of RPM. Early efforts to deploy remote monitoring tools and technologies faced multiple challenges. Prior to the introduction of RPM reimbursement codes in the Physician Fee Schedule in 2019, financial hurdles made it difficult for medical practices to perform remote monitoring activities as there was not a mechanism for reimbursement to cover the cost of the devices and the practice’s time unless the practice was part of a value-based contracting model and assumed the cost as part of their model of care delivery. In addition to the financial barriers, lack of broadband infrastructure and the slow digital transformation in healthcare, hampered widespread adoption of RPM in the early years.
Within the last five years, however, we’ve seen dramatic changes that have pushed RPM to the forefront in patient care. Consider the impact of consumer wearable technology, like the Fitbit and Apple watch, which is used to keep track of key fitness metrics. We have seen this kind of innovation come to the medical device space, first with Bluetooth-enabled devices and then with cellular-enabled devices such as blood pressure cuffs. This innovation in connectivity was an important step in making it more efficient and scalable to track biometrics from patients outside of the clinic. Together with the innovation in reimbursement models for remote patient monitoring, a path to adoption of RPM as a core component of medical management of health conditions emerged.
Perhaps the biggest driver in recent RPM adoption was the COVID-19 pandemic. When physicians were unable to see patients in person, telehealth and RPM became a necessary capability not a nice-to-have. RPM enabled providers to continue to support patient care from afar. This new paradigm in care was particularly useful for patients with chronic diseases like diabetes, heart failure and hypertension, some of whom have a high potential for complications if not receiving regular care. In recent years, usage spiked. Currently 54% of U.S. internet households have at least one connected health device, with about one-quarter possessing three or more.
More practices are adopting RPM programs because of the increasing patient acceptance of virtual care models, widespread reimbursement from CMS as well as private payers and Medicaid plans, and decreased cost of connected devices. Today, only about half of practices use RPM, but surveys show that there will be dramatic growth – reaching about 76% of practices within the next year. And, by 2025, more than 70 million U.S. patients – 26.2% of the population – will benefit from some kind of RPM.
Putting Patient Data in Context
While it’s great to see more practices adopt RPM, I always like to look at the bigger picture of why CMS introduced reimbursement for RPM in the first place: It is a more proactive approach to care delivery that facilitates better patient outcomes. Consider Remote Patient Monitoring for chronic disease management. A person lives with diabetes 365 days a year, not just once every three months when they visit their doctor. How can looking at a paper logbook or a consumer app for the five minutes clinicians have with their patient adequately tell them enough about how the patient has done in between visits? In contrast, when a clinician can see the patient’s blood glucose data in between visits, not only can they observe the effect of medication or lifestyle changes without waiting to see the individual back in clinic, but they can visualize trends in the data over time making the brief in-person visit more efficient and meaningful. In other words, CMS created these reimbursement pathways as a bridge to practicing proactive, value-based care.
As more and more practices begin to implement RPM, it’s important to remember that the goal shouldn’t be to simply collect and monitor the data. The goal should be to improve health outcomes for patients, and in order to do that the RPM data needs to be shown in the context of what else is going on with the patient, it needs to be integrated into existing workflows, and it needs to be actionable.
The evolution of remote patient monitoring to remote patient management requires patients and providers to have the necessary tools. Putting the right pieces together will enable providers to understand the story of each patient’s health by looking at trends and insights in their condition on a day-to-day basis in combination with all other aspects of their care. What’s needed is:
- Data connectivity and interoperability between various systems, such as electronic medical records (EMRs), clinical management platforms and telehealth solutions
- Transparent access to data by a patient’s entire care team, from primary care doctors to specialists and more.
- Clinical decision support tools that empower providers to interpret data within their workflow and make personalized treatment decisions based on the latest clinical guidelines.
The combination of these tools can deliver real benefits. In one study, a remote patient management program for high-risk diabetes patients at Leon Medical Centers in Miami helped lower A1c levels below 9% for 84% of patients – a key indicator of better diabetes control. More broadly, a KLAS Research report noted that more than one-third of healthcare organizations saw fewer readmissions when using RPM for chronic care management, and 17% said they achieved cost reductions.
These kinds of results will only be possible going forward if we redefine the “M” in RPM – management – moving from basic monitoring of health metrics to management of a patient’s overall health. But we need more certainty going forward. Reimbursement levels must encourage and support RPM deployment and broad usage in hospitals and health systems. Physicians need the tools to help them derive actionable insights from the data they collect. With these in place, we can see even more benefits – from reduced admissions and fewer complications to lower healthcare costs and better results – that will serve as the foundation for the future of value-based care.
About Lucienne Ide
Lucienne Ide, MD, PhD, is the Founder and Chief Executive Officer at Rimidi, a leading clinical management platform designed to optimize clinical workflows, enhance patient experiences and achieve quality objectives. She brings her diverse experiences in medicine, science, venture capital, and technology to bear in leading Rimidi’s strategy and vision. Motivated by the belief that we can do so much better as individuals, in industry and society, Lucie left clinical medicine to join the ranks of healthcare entrepreneurs who are trying to revolutionize an industry.
