MDLife – March 2021
By Frank Astor, MD, MBA, FACS, Chief Medical Officer for WITHmyDOC.
Changes in healthcare delivery have come about in the past year that likely would not have happened as quickly if it weren’t for COVID-19. During the pandemic, physicians and patients turned to telehealth and virtual care in lieu of routine, in-person doctor’s office visits and for chronic disease follow-up visits. Healthcare systems provided care at home for some COVID-19 patients in lieu of admitting them as inpatients in order to free up hospital beds for more critical cases.
This was made possible by remote patient monitoring (RPM). More attention centered on RPM programs because of their ability to successfully monitor patients outside of the hospital and the doctor’s office. RPM allowed the care to be provided at home.
Home care is on the rise. In fact, care management, including RPM, was recently named as one of the top home care trends for 2021. One of the reasons is home care’s role in new delivery systems designed to treat higher-acuity patients such as those with an increased risk for hospitalization and those with chronic disease – either newly diagnosed or recently discharged – and both have a higher probability for rehospitalization.
Another reason for increased popularity is reimbursement. Late last year, CMS announced its new Acute Hospital Care at Home program giving health systems the opportunity to reduce inpatient volume by treating certain acute care patients at home through a telemedicine platform that allows for daily check-ins and monitoring, it was a major step forward for value-based care.
Medicare also recognizes that RPM can help home health agencies improve the care planning process. In October 2018, CMS released a final rule allowing home health agencies to bill for remote patient monitoring. To incentivize the adoption of RPM, the costs of necessary equipment, set-up, and related services can now be included as allowable administrative costs on the home health agency’s cost report. However, home health agencies are only responsible for the collection of data, not the 20 minutes of data interpretation and intervention the same way a physician would be.
Home health care providers aim to provide a continuous care experience by using programs like RPM. While home health’s in-person provider visit may only be for a limited amount of time, RPM is with the patient 24/7. RPM is not a substitute for home health visits. Rather, RPM upgrades home health services, improving the quality of care for patients leading to better patient outcomes. Clinicians and clinical staff can communicate modifications in medication and other self-care to the patient in real-time without any delays in the communication process. If symptoms and the disease progress to the point that hospital services are needed, providers will be able to arrange for care and transport that will ensure safety of the patient and health personnel.
Using RPM allows home health agencies to collect more data to better understand the patient’s condition on a daily basis. It also helps to quickly identify fluctuations in vital signs and get the
physician to intervene right away and adjust the treatment plan. RPM not only has proved to reduce hospital admissions and lower healthcare costs, but also to yield better healthcare outcomes.
In many ways, home has already become an extension of the hospital, albeit with the addition of the convenience and comfort we have grown accustomed to in our daily lives.