MDLife – January 2021
By Frank Astor, MD, MBA, FACS, Chief Medical Officer for WITHmyDOC.
It has become a familiar sight, especially during the very worst days of the COVID-19 pandemic: news reports on surging numbers of positive cases and hospitalizations resulting in lack of hospital beds and resource capacity. Hospital staff and providers sharing stories of overwhelm and fatigue. A combination that points to a sure-fire formula for a new level of crisis response.
In the midst of it all, remote patient monitoring (RPM) has emerged as a scalable, intelligent solution providing comprehensive care at home, improved quality of life, relief for hospital bed capacity and reduced provider burnout.
The Centers for Medicare & Medicaid Services (CMS) recently agreed. On November 25, CMS launched its Acute Hospital Care at Home program, providing eligible hospitals with allowances
to treat patients in their homes. Hospitals using RPM to monitor patients at home report they are able to deliver hospital-level care in patients’ homes with lower readmission rates, more physical mobility, and a positive patient experience. They tout the CMS program as a timely move that enables hospitals across the country to use effective tools to safely care for patients during the pandemic and beyond. By allowing physician extenders to handle monitoring of the vitals, physician time is freed up for other duties. This also increases the potential number of patients that can be treated on a daily basis.
Less Severe COVID patients can be monitored at home
The pandemic showed us the need for more telehealth options, and now RPM and remote provider-patient interaction are here to stay. With RPM, patients are given the technology and devices to take their vital signs at home. Clinicians can monitor temperature and pulmonary function, blood pressure and other appropriate physiology for changes 24/7 and communicate any necessary modifications in medicine and other self-care back to the patient.
One of the monitoring goals is to detect any significant changes in the patients’ vitals as early as possible. In the case of COVID-19, early detection of a drop in oxygen saturation levels has been a key indicator. It can be a precursor to shortness of breath and warrant the physician’s decision to admit the patient. Some of the RPM programs available, like WITHmyDOC’s RPM@Home, trigger critical alerts to the provider if a patient’s vital signs fall out of their normal range.
RPM can handle increasing numbers of COVID-19 positive patients at home. By remaining at home, these less severe patients help reduce the transmission of disease and increase bed availability and capacity for others needing inpatient care.
COVID-19 Clinic Solution
WITHmyDOC’s RPM@Home was developed prior to the pandemic to provide better care to patients at home. For COVID, RPM@Home provides a solution to lessen the impact on emergency rooms and hospital beds. Using RPM@Home for less severe COVID patients is a risk mitigation tool that proactively protects patients, reduces the spread of infection and helps alleviate hospital capacity issues.
Less severe patients can be sent home with a tablet and a pulse oximeter so they can be monitored daily from home, optimizing hospital bed utilization for patients who need them. RPM@Home records and submits oxygen levels via a Bluetooth device to the platform. The platform captures prescribed oxygen use, providing patient status with or without oxygen. A feature unique only to RPM@Home is the availability for the patient card to show how much oxygen the patient is taking along with the oxygen level. Alerts are then sent if patient levels fall outside of parameters set by the physician. RPM@Home is also device- and EHR-agnostic.
RPM brings quality, manageability and cost-effectiveness into a difficult public health situation. It has increasingly been recognized as an essential clinical tool to follow COVID-19 positive patients at home during the pandemic and to care for chronic conditions. As more hospitals move beyond their walls to care for patients at home, RPM will continue to bring improved efficiency and capacity to the healthcare system.