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Data is powerful and the key to patient participation. Remote patient monitoring equipment is a tool that clinicians can use to authorize patients to manage their own health. RPM can not only track and manage chronic diseases, but also detect health problems early.
However, panelists at the 2021 virtual meeting of the American Telemedicine Association stated on Tuesday that the pay-for-service payment model limits the benefits of RPM to patients and healthcare organizations.
In the conference titled “Looking to the Future: The Evolution of Insightful Patient Care by Remote Monitoring,” hosts Drew Schiller, Robert Kolodner, and Carrie Nixon discussed how RPM can improve patient care and how the healthcare system can better support RPM plan.
Schiller, co-founder and CEO of Validic, said that doctors and patients often talk to each other. Validic is a digital health platform that connects the healthcare system with remote patient data. For example, a doctor may tell a patient that they need to exercise or follow a healthier diet, while the patient says they are trying but it does not help. RPM data can provide clarity and guide conversations with patients.
Validic partnered with Sutter Health in 2016 to use RPM to capture patient data. A type 2 diabetic patient in the program tried to control his diet and walk regularly, but his A1C level was always higher than 9. Using the patient’s blood glucose meter, blood pressure monitor, and weight scale for continuous tracking, the clinician found that the patient’s blood glucose level spiked at the same time every night. The patient revealed that he usually ate popcorn at the time, but there was no record because he thought it was healthy.
“In the first 30 days, his A1C dropped by one point. This is the first time he noticed that behavioral opportunities can change his health. This systematically changed his health, and his A1C level eventually fell below 6.” Schiller said. “The patient is not a different person, and the healthcare system is not a different healthcare system. Data helps to gain insight into the lives of patients and guide people to discuss what is happening, not what should happen. Data is very important to people. It’s useful, it’s the way people want to get health care.”
Nixon, co-founder and managing partner of Nixon Gwilt Law, a medical innovation company, pointed out that in one project, asthma patients used a peak flow meter to measure the air in and out of the lungs before and after taking medication.
“When taking medication, the readings are much better. Previously, patients did not have a good understanding of the effects of medication on them. This knowledge is a key part of persistence,” she said.
Carrie Nixon of Nixon Gwilt Law says that data collected from RPM empowers patients and can improve medication compliance.
RPM integration is another way to provide more comprehensive patient care. Kolodner, vice president and chief medical officer of ViTel Net, a telemedicine software company, described GPS-enabled inhalers that can mark areas that trigger asthma attacks and provide direct benefits to the health of patients.
Schiller explained that emerging technologies such as artificial intelligence and machine learning can also play a role in RPM. Algorithms that process the data can generate health alerts and can use social determinants in advance to determine the best mode of RPM implementation and how to attract patients.
“Doctors can use this data to attract patients in different ways. If they want to see trends in the data in a certain way, but they are not, they will know that it is time to have a conversation with the patient to determine whether something has changed. “Schiller said.
RPM equipment is used to manage chronic disease care, manage costs, and improve the health of patients while keeping them away from the hospital. However, Kolodner said that RPM programs play a better role when adjusting financial incentives using a value-based care model rather than a fee-for-service model.
Schiller said that because the COVID-19 pandemic has exacerbated labor shortages, 10,000 people (some of whom have chronic diseases) are enrolled in health insurance every day, and therefore require continuous medical care, but lack clinicians to provide it. He explained that in the long run, the top-down approach is not sustainable. The current policy has created obstacles to the success of RPM.
One obstacle is the fee-for-service payment model, which only provides reimbursement to those who suffer from chronic diseases—patients that Kolodner calls “masters.” The current reimbursement framework does not reimburse preventive monitoring.
Schiller said that the RPM billing structure can also be used for monitoring equipment that is more expensive for patients. He said that changing this to allow RPM to reach more patients is a good way to help people live longer and healthier, not just live longer and get sicker.
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Post time: Jun-21-2021