By Monica Bolbjerg, MD, co-founder and CEO of Qure4u
Healthcare has been flirting with Remote Patient Monitoring (RPM) for a decade, and in theory RPM makes so much sense. So, why aren’t we seeing RPM being rolled out at scale?
Having worked with RPM since it first appeared on the healthcare map, I believe we’re on the verge of a breakthrough as the devices become more reliable and data-flow more precise and stable.
This playbook is meant to help you put together an RPM plan so you can scale quickly and enjoy early success.
Step 1: Define your goal
Your RPM program can look pretty different depending on your goal, and you might even put together several programs to achieve different goals.
Is your goal to …
- Increase revenue by capitalizing on new billing codes? Then you should go simple and at scale, (example: enroll low-risk hypertension patients).
- Manage a specific group of patients differently – either to reduce cost or to improve outcomes, or both? You could manage CHF patients more efficiently with RPM and at a lower cost.
- Expand your market reach and enroll patients that live too far away to come in often? If you have an excellent reputation, patients will seek you from far away if they don’t need to come in too often.
- Increase patient/provider count by making it possible for your providers to take care of more patients? What if a doctor could treat 5,000 patients instead of 1,500 per year?
- Improve outcomes for patients under risk-based or value-based contracts? Then you need a program tailored specifically for that patient population.
Once your goal is defined, you need to build your program.
Step 2: Build a successful RPM program
- Define use cases
Pick an initial use case/condition that is:
- Broad enough to have volume: Avoid the rare conditions.
- Easy to identify patients: Make sure you have the data to identify readily available.
- RPM devices are available: You need to be able to easily monitor vitals.
Don’t start with rare conditions. You want enough patients to get early momentum as you learn the best way to talk to your patients about the program.
- Choose a device
Don’t go cheap! You want a cellular-enabled device that allows data to flow directly to your RPM platform. These devices are not the cheapest, but you’ll benefit from not having to pay staff to onboard patients or troubleshoot connection problems. Another bonus: Your patients will stay longer in the program thanks to minimal (or no) technology challenges for them.
- Choose a technology platform
You will need an RPM management platform integrated to your EHR because EHRs are not built for the volume of data you will receive once you go live with home-monitoring devices for your patients.
The RPM platform should:
- Be integrated, pull patients and demographics, and push vitals back into the patient’s chart.
- Have single sign-on for providers and staff.
- Show detailed graph and table views of vitals to make it easy to review metrics.
- Calculate averages and out-of-range data.
- Allow you to set individual goals for the patient.
- Import vitals field-to-field, bit also allow for posting a PDF with graph view and nurse observations.
Maybe most importantly, make sure the RPM platform you choose can show the care coordinator lists of patients who have vitals out-of-range or are non-compliant. You don’t want your staff reviewing data for every patient every day.
- Make sure you have easy device ordering – don’t pre-buy
Preferably, the RPM platform you choose includes device ordering and management. Today, you can order devices directly from the platform with a click of a button, and the device is shipped directly to the patient’s home.
This means you no longer need to pre-buy devices in bulk. This saves you cash and:
- Gives providers flexibility to define what individual patients need – some patients only need a blood pressure monitor, while others might also need a scale.
- You don’t need storage. Pre-buying thousands of devices in bulk creates storage and logistical challenges.
- You need to have your staff spend time on handing out devices and give patients instructions.
- You never end up with old devices that can’t be used.
- Prepare patient info and “pitch”
Not all patients “get it” right away, so to effectively onboard patients, you need to “sell it” to them. What’s in it for the patients? How much work is it?
Try these ideas:
- By enrolling in this RPM program we can keep your blood pressure under control, which means that long-term you will need less medication and have lower risk for side effects.
- You will come in for fewer in-person control visits.
- You no longer need to write down your home-monitoring results because they’re automatically captured and populated in the doctor’s system.
- You will get an assigned care coordinator who you can communicate with via messaging or telehealth calls.
- Set your team, onboard your providers
Now you’re almost ready to get started. You probably have some providers who are more eager than others … so begin with them. But take note: When possible, choose more than a handful of providers for the launch of this project, because if they run into barriers, get distracted, or give up, it might look as if the entire thing is a failure, when it’s not. Challenges are inevitable, so embrace the early setbacks because this gives you the opportunity to figure things out before you do it at scale.
As you create a pitch for your patients, you’ll also need to “sell it” to your providers and nurses. I recommend creating an internal FAQ and good training of internal workflows.
- Go after the “easiest” patients first
One of the biggest mistakes organizations make, in my opinion, is to begin their RPM program with the sickest patients.
I get it. It would be amazing if providing an RPM device could help that population, but the sickest patients typically have 2-3 conditions, are on multiple medications, and need much more than home-monitoring to get better. They’re also often not tech-savvy because many of them are elderly, and you don’t want to spend more resources supporting them with RPM devices than if you simply keep them on your current treatment program.
Successful programs typically start with patients who have only one condition and are motivated to get better. That might be 30-50% of the patients in your targeted demographic, and because this population often requires less staff attention, your staff is free to onboard the more “complex” patients next.
Another benefit of starting with the “easy” or “simple” patients is that you’ll probably get great success stories that can be shared with other patients to help them get started.
- And finally, start simple!
Choose one condition with one or two vitals to measure, define one initial goal that is achievable within three months, evaluate, adjust, and set a new three-months goal.
Good luck and please share back your experiences and feedback.
Together, we’re reinventing what’s possible in healthcare.