What Is Remote Patient Monitoring?

Posted by: Alok Prasad


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What is Remote Patient Monitoring?

Remote Process Monitoring (RPM) is the use of digital technologies to monitor and capture medical/health data from patients and transmit the same electronically to healthcare professionals for assessment and intervention when necessary. RPM technologies allow patient data to be monitored even after discharge or between follow-up appointments.

Telehealth and remote patient monitoring (RPM) solutions saw an uptick in popularity during the Remote Patient MonitoringCOVID-19 pandemic; in a time when people were encouraged to stay home and social distance, physicians could still be able to monitor their patients through the use of technology. Even before the pandemic, 2020 changes to CPT codes launched RPM into the spotlight as a preferable Medicare management program. When the pandemic hit, the federal government recognized the importance of RPM services and expanded Medicare coverage to include acute conditions, not just the chronic conditions covered before.

The cost of treating chronic health conditions is on the rise, and although prevention is preferred, many Americans are already living their lives with chronic illnesses. The implementation of RPM has expanded the access to care and the ability to receive care quickly and avoid a crisis. There are benefits in RPM that established and new practices can both benefit from.

The use of patient remote monitoring is currently trending in 2022, but the concept was not well-known before 2020, and the CPT code changes. There are still many inconsistencies in the understanding of RPM, so it is best to look at three leading medical organizations and associations that describe RPM – U.S. Government Accountability Office, Medical Group Management Association (MGMA), and the Institute for Health Policy and Leadership.

Where Does RPM Fit in the Telehealth Landscape?

Telehealth, as a whole, is an umbrella term for care provided by a medical provider that occurs without an office visit. Telehealth visits and telehealth remote monitoring often consist of a telephone or video call that results in a provider and the patient discussing their health, symptoms, etc. Although RPM is a useful tool in telehealth, it is not meant to replace the benefits of an in-person visit. RPM complements the routine medical care that healthcare professionals provide for their patients, allowing them to monitor vitals and other health risks between appointments remotely.

Telemedicine, another term used synonymously with telehealth services, focuses on virtually handled services – like the online facilitated office visits or consultation between two clinicians. Telehealth, on the other hand, also includes non-clinical services. In either scenario, there are various modalities of providing these  , including:

  • Live video communications
  • Store-and-Forward (transmitting videos and digital images through secure electronic communication systems)
  • Remote Patient Monitoring (RPM)
  • Mobile Health (mHealth) (smartphone apps that facilitate health and well-being)

For patients living with chronic illnesses, frequent doctor's visits are required. Physicians may implement RPM to be proactive about these patients' healthcare by having the patient's information checked daily to ensure that they are on track with care plans, medications, and treatment. For example – if a patient has high blood pressure that puts them at risk of serious health problems, the physician can monitor their blood pressure through a blood pressure monitor that transmits the data to the office. They can see if the medications are working, and if they aren't, they can adjust them accordingly. They can also use the data to call the patient for an earlier appointment if data warrants it.

Benefits of Remote Patient Monitoring

Although some patients will require in-person testing, diagnostics, and monitoring, there is a large pool that can benefit from RPM. For most patients, using RPM depends on their physical condition, ability to use the internet, and personal preference. There are still many ways that RPM can benefit those with chronic illnesses or other health problems, including:

  • Reducing hospitalization/time spent under supervision in the hospital
  • Fewer emergency room visits due to proactive healthcare practices
  • Better health outcomes for patients living in rural areas
  • Better preventative management for patients with chronic illnesses
  • Reduced risk of COVID-19 exposure and other communicable illnesses for patients and healthcare workers

In many instances, with the proper training on the RPM, home patient monitoring can be successful. For patients who can take their blood pressure, monitor their blood sugar levels and oxygen saturation levels, and other diagnostics, the option of RPM is a valuable solution that keeps them in their homes where they are more comfortable.

Pros and Cons of RPM

While RPM is right for some patients, it may not be right for others and this must be determined before implementing them. That is why patients and their providers must look at each pro and con and determine if using an RPM solution for a patient is in their best interest.

Pros

  • Anticipating a wider range of benefits by adopting RPM tools
  • Patients enjoy quick access to healthcare services, especially those they need the most. RPM also allows care providers to pull up historical data to see how the patient is (or has been) doing.
  • More data is compiled than would be possible in a clinical setting. Through the process of daily monitoring, physicians can be alerted of a potential health problem early.
  • RPM can help with patient compliance rates when providing treatment plans. Patients tend to take their conditions more seriously when they know that the physician is receiving regular updates on their progress.
  • Through the data collected, anomalies in a patient's health can be isolated and addressed before their next appointment. In traditional scenarios (without RPM), a patient may end up in the emergency room or worse if the anomaly is not caught in time.

Cons

  • There are some healthcare professionals that feel implementing RPM is too expensive for set up, let alone the requirement for their patients to sign up for use.
  • There is a common misconception that using RPM and setting them up and deploying them is too difficult; however, this is not the case as most of these tools are ready to go out of the box.

RPM Solutions and Devices

Six of top remote patient monitoring companies – Dexcom, Honeywell Life Sciences, Medtronic, Philips Healthcare, ResMed, and Senseonics – are primarily responsible for the manufacturing and distribution of five popular remote patient monitoring services on the market today. Each of these devices offers patients the freedom to take their vitals at home while transmitting them effortlessly to their healthcare professional.

The Top Five RPM Devices on the Market

Although there are many devices on the market that allow patients to remain home while being monitored by medical professionals, five of the most common remote patient monitoring devices in healthcare commonly seen being implemented in the course of treatment for patients with both acute and chronic illnesses can be found below. These devices provide specific insight into the patient's health using it while collecting data and transmitting it periodically (sometimes daily) to the physician who ordered the RPM.

Blood Pressure Cuff

A blood pressure cuff is used to calculate heart rate and blood flow by measuring the changes in a patient's artery motion. These cuffs are often equipped with Bluetooth capability, allowing the data to be transmitted to the physician for review in real-time. These devices can assist in managing multiple conditions, including but not limited to hypertension, diabetes, CHF, and kidney dysfunction.

Blood Glucose Meter (Glucometer)

A lot can be learned about a patient from a small drop of blood placed on a test strip. In most cases, patients who have diabetes (type 1 and type 2) will check their blood sugar levels daily (sometimes multiple times a day) using a glucometer. The use of a glucometer that regularly transmits patient glucose levels can help healthcare professionals determine possible factors influencing their patient's blood sugar levels.

Pulse Oximeter

A pulse oximeter is a small device placed periodically on the patient's finger and monitors blood oxygen levels – how much oxygen is circulating among the red blood cells. The device also monitors heart rate. The most frequent use of the pulse oximeter is seen for patients with chronic heart or lung problems, like COPD, CHF, or even the monitoring of COVID-19.

Activity Trackers

One of the most popular devices on the market today are activity trackers – we have all seen the FitBit and other trackers made in their likeness; however, technology has changed enough that some of these are as small as a patch worn for a specific amount of time to monitor a patient. Activity trackers are used for monitoring steps, heart rate, fall risk, sleep habits, and more. All of this data is then transmitted and can help develop a more successful treatment plan.

Scale

Bluetooth scales allow patients to monitor their weight while transmitting the information to their healthcare provider, often to ensure that symptoms are not worsening. In the case of CHF patients, fluctuation in weight can be caused by water retention, which is an indicator of worsening symptoms. Patients who are obese may use the same types of scales with a BMI calculator, which can help determine and identify trends in behavior.

How to Select an RPM Solution

When a provider suggests a patient use an RPM solution, the decision is not made lightly. In fact, they probably weighed out a series of pros and cons to determine if their patient is the best candidate for the device. Many times insurance will require physicians to answer the question “why use remote patient monitoring?”

For most providers, they must consider the following:

  • Does the device facilitate the data and frequency required to monitor the patient safely? Some patients require more frequent monitoring than others, so finding the solution that facilitates this is of high
  • Is the information coming from the RPM reliable? Not all of these devices are FDA-approved or regulated (like activity monitors), which means that the data may not be as reliable as a physician hopes.

These are a few of the factors that physicians will look at, in addition to the acute or chronic illness that the patient has. Some illnesses require more monitoring than others, and some patients cannot cope with the change of using such technology. The physician and the patient have to make the decision that is best for the patient's overall health.

RPM Market Trends – Is RPM the Future?

Insider Intelligence estimated that 70.6 patients in the United States (26.2% of the population) will implement RPM tools in their healthcare by 2025. With the threat of readmission penalties, many healthcare providers are implementing RPM solutions after hospital releases to monitor patients after leaving the facility. The University of Pittsburgh Medical Center reduced their risk of re-admissions by 76% and increased patient satisfaction scores to over 90% by providing tablet and RPM equipment to patients being released.

There is a high likelihood that RPM solutions will only increase among the population, alongside the number of telehealth appointments across the country in the coming years. With the ability to take a passive approach to one's healthcare, implementing RPM solutions for acute and chronically ill patients makes monitoring their changes simpler instead of waiting a month before their next appointment. With lower instances of ER visits and readmissions, healthcare providers are saving money across the board by implementing a solution that allows monitoring vitals and symptoms at home.

 

Resources

https://telehealth.hhs.gov/providers/preparing-patients-for-telehealth/telehealth-and-remote-patient-monitoring/

https://www.adsc.com/blog/pros-and-cons-of-remote-patient-monitoring

https://hitconsultant.net/2021/12/21/telehealth-vs-remote-patient-monitoring/

https://www.prevounce.com/a-comprehensive-guide-to-remote-patient-monitoring#ch1

https://www.healthrecoverysolutions.com/blog/7-common-remote-patient-monitoring-devices

https://ccalac.org/wordpress/wp-content/uploads/CTRC-RPM-Toolkit.pdf

https://www.insiderintelligence.com/insights/remote-patient-monitoring-industry-explained/

Topics: Provider/Physician, Consultant

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