MD LIFE – October 2020
Remote patient monitoring is the ability to monitor patients’ vital signs on a daily basis and can be done either manually or electronically, especially for patients with COPD. Just imagine for instance that your patients are able to take their vital signs every morning and transmit them to your office in real time. Predetermined alerts are set to advise you if any one of your patients’ vitals falls out of the normal range. If they do, your medical assistant can reach out to your patient and see if he or she is okay. Based on the severity of the alert, your medical assistant can then triage the patient to either a telehealth visit or a live office visit. If your patient is a Medicare patient, CMS will reimburse you for all of these services. In many cases, private payers are also reimbursing for these services, although you should check each plan before initiating remote patient monitoring. It seems like every article I read these days starts with “the Covid-19 pandemic has changed our lives forever.” For physicians and patients, the changes have been significant. Physicians had to resort to a crash course in telehealth in order to “see” their patients and keep their practices alive. Patients were also required to “adapt and adopt” to the new technology despite many of them being challenged by the process. In the wake of the first wave of Covid-19, some of the limitations of telehealth were exposed, i.e. poor connectivity, lack of patient vital signs and not being able to see your own physician. Is remote patient monitoring a better
solution?
What patient types should be considered candidates for RPM? CMS lists more than 70 disease states for RPM with the largest patient volumes being Congestive Heart Failure (CHF), Diabetes Mellitus (DM) and Chronic Obstructive Pulmonary Disease (COPD). Managing patients with these diseases is challenging and keeping them out of the emergency room is a priority, especially if the patient is on a capitated plan. An at-risk or capitated patient visiting the ER can cost $3K-$5K of an allotted $10K annual budget. By having these patients on remote patient monitoring, one can proactively intervene in a potentially negative event if you can see the signs in advance.
One example of a congestive heart failure patient comes to mind, whereby the patient had their diuretic adjusted at the physician’s office and several days later was showing up on the remote patient monitoring system as having gained 5 lbs. Upon further review and notification to the physician’s office, the diuretic was re-adjusted and the patient’s weight stabilized. Were it not for a proactive alert notification system, this patient may have ended up in the emergency room, or worse. Many of these examples exist across a variety of different patient types. Once you have chosen which patients to include in remote patient monitoring, you will need to determine which devices to incorporate. Most systems will have a weight scale, a blood pressure monitor and a pulse oximeter as the main devices. Other devices that can be added include a thermometer or temperature sensor, a glucometer, and even an ECG sensor. Ideally, all these devices will be Bluetooth enabled and connected to a tablet or smartphone which transfers the data to the physician’s office through secure and compliant cloud technologies. By simplifying the data capture process at the patient level, you will increase compliance and adherence over time. In a small patient survey conducted last year, patients liked their devices, but more importantly they liked that someone was watching out for them and would contact them if something was wrong with their health.
So, let’s circle back to the Covid-19 pandemic changing our lives forever and the question of remote patient monitoring…why now? If this virus rears it ugly head again in November as some have predicted, and the patients discussed above, who for the most part are at higher risk for Covid-19 are on an RPM system, then your ability to monitor these patients will not only provide peace of mind to the patient, but also keep the pandemic from impeding your business in the case of another shut down.
