Will Remote Patient Monitoring Finally Flourish in 2020?

Joshua Claman, CEO, Rimidi
MARCH 09, 2020
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Each year dozens of innovations are brought to market to advance the industry. But the truth is, the majority of these solutions won't fully meet their potential due to internal disconnect on provider-patient needs, shrinking operating margins and a lack of system processes that encourage innovation. 

One such solution, remote patient monitoring (RPM), is an example of an advancement in healthcare struggling to get off the ground, despite the healthcare industry championing it for years. 

In fact, it’s still happening. We continue to see articles and conversations dedicated to topics encouraging RPM use, including how to make the solution useful, the economic benefits, its role in diabetes care and reimbursements with digital health tools. 

The industry isn’t wrong to continue its promotion of RPM adoption. By gathering data outside traditional healthcare settings through information technology such as smart insulin pens, wearables and connected scales, RPM promises to provide greater patient access, improve outcomes and reduce healthcare costs.

Instead, a longer examination should be given to the current obstacles within healthcare systems that are preventing the progression and successful adoption of this much needed digital innovation. 
 

Why Is Adoption of RPM Still Slow?  

As connected devices get more common and sophisticated, the promise of RPM continues to expand, such as using connected devices to monitor patients with multiple comorbid conditions. For example, scales could be used to manage heart failure and obesity. Blood pressure cuffs can be used for cardiovascular disease and Type 2 diabetes.

At first, hesitancy on RPM implementation focused on the limited reimbursement opportunities for healthcare providers as well as the lack of incentives for offering such services. Additionally, there was confusion on requirements for offering such services. 

However, since the launch of RPM reimbursements two years ago, the Centers for Medicare & Medicaid Services (CMS) as well as the American Medical Association (AMA) have announced additional RPM CPT codes, making it easier for clinical teams to manage patients who require daily monitoring. And yet, despite the acceptance of these reimbursement codes and the eagerness of healthcare systems to adopt RPM models, innovation is still frustratingly slow, with only 7.3% of physicians using RPM.

For the most part, it has nothing to do with the readiness of the device or platform technology. Instead, thin profit margins in primary care create a de-prioritization of investments that focus on these areas. Many healthcare systems have to carefully balance the reassurance of revenue streams from fee-for-service with the demand to remain competitive by transitioning to value-based care. 

As a result, processes to actually evaluate and purchase technology are ill-defined and tend to frustrate internal advocates. And the consequences of conflicting needs and objectives is that many initiatives, including RPM, are piloted in ways that do not scale because they aren’t given the right tools by healthcare executives to start with. 
 

Concrete Steps for RPM to Succeed with Provider Needs

Despite hurdles around innovation, as more and more healthcare systems look for new ways to better patient experience, steps are being taken to avoid “death by pilot:” 
  1. Define necessary features when considering new technology. Providers should be looking to implement RPM solutions that are flexible and can capitalize on data to improve the quality of care delivered. Additionally, consider if the solution can integrate within a hospital’s EHR while also supporting multiple disease states and service lines. 
  2. Establish a technology procurement process. With healthcare executives cynical about ROI analyses, often only the expenditure side of innovative investments, like RPM, is considered. Formal processes, which calculate potential savings, and bonuses tied to quality scores, need to be implemented. Administrators should also empower advocates within organizations with a clear process for how new RPM technology will be procured. 
  3. Clearly define the success criteria before the implementation phase. Administrators must ensure that project ownership is clear, that there’s no room for doubt and that measurable objectives are specifically identified and agreed upon before the implementation of a new digital solution. For example, start RPM with a cohort of 100 high-risk patients with Type 2 diabetes who have Hemoglobin A1Cs over nine with the goal being to bring A1C down to X by X number of days/months of remote monitoring. 
  4. Enable a seamless patient onboarding experience. Providers should look for a device or solution that allows for easy, out-of-the-box user experience. Cellular connectivity is a good option and the way of the future and is great for older populations. Despite pushback, cellular technology is arguably more user-friendly than Bluetooth. It’s also continually improving. The FCC has focused on closing the digital divide and broadband access in rural areas is increasing by using TV White Space. 
The shift to value-based care from fee-for-service has encouraged competition among health systems to take larger steps towards the innovation toolbox. But unless steps are taken to help scale the innovation, such as RPM, it’s not enough to reach the potential we will see from the HIMSS show floor in Orlando, Florida.

Technology-led innovation, like RPM, is no longer an option, but rather a necessity if providers are to continue to treat patients and truly be the change that is sought after in today’s healthcare. 

About the Author: Joshua Claman is the CEO of Rimidi, a cloud-based software platform that enables personalized management of chronic cardiometabolic conditions across populations. He has over 25 years leading technology businesses in Asia, Europe and the Americas.

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