MD LIFE – August 2020
The COVID-19 pandemic certainly has brought telehealth to popularity. The surge in telehealth use during the pandemic was expedited by the Centers for Medicare & Medicaid (CMS) easing the prior restrictions for use by rural patients only. Educational crash courses in telehealth sped up the implementation for physicians. Likewise, consumer adoption of telehealth increased, from 11 percent in 2019 to 46 percent as of April of this year in order to replace cancelled healthcare visits, according to a McKinsey & Company study. Further, 76 percent of consumers say they are highly or moderately likely to use telehealth in the future.
But telehealth can’t do it all. While providers can “see” patients in a telehealth visit, they can’t monitor vital signs. The increased use of telehealth during the pandemic exposed some of the limitations of the technology. Vital sign readings such as blood pressure, temperature and oxygen saturation were missing.
Enter Remote Patient Monitoring (RPM). The use of RPM accelerated rapidly when COVID-19 hit as patients were monitored at home rather than make trips to the doctor’s office or healthcare facility, thus avoiding potential coronavirus exposure. Although RPM has accelerated the value of telehealth during the pandemic, its real purpose is for chronic care monitoring. RPM can connect patients to their care teams, providing the real-time data needed to control symptom and disease progression.
RPM provides a better care path. The physician sets the target parameters for each patient’s vital signs and patients take their vital signs every day. An ideal RPM program triggers a critical alert if a patient’s vital signs fall out of their normal range. These critical alerts serve as proactive intervention to address any health issues that arise, in an effort to keep patients out of the emergency room and prevent readmissions.
Patients Ideal for RPM
While RPM can be utilized for any patient, “well” patients are not a high risk for readmission and are less likely to monitor their vital signs on a daily basis. These patients would benefit from a telehealth visit on an as-needed basis.
During COVID-19, RPM can be utilized to monitor patients at home, keeping them out of the hospital or the physician’s office, reducing contact with the medical staff and essentially decreasing the need for PPE use.
However, RPM’s ongoing use is for chronic care management. It is very beneficial for patients with chronic illnesses like congestive heart failure, diabetes and COPD. RPM also is useful for patients who are considered to be “moderate to severe” in their disease state or who have comorbidities, such as hypertension, obesity or coronary artery disease. RPM can detect high blood pressure, low oxygen levels, increase/decrease in weight possibly due to medications, arrhythmias, high temperature and elevated blood glucose levels.
Physician reimbursement for RPM is encouraging. Medicare and many commercial payers cover RPM and, according to the Center for Connected Health Policy, 23 state Medicaid programs currently reimburse for RPM. It started when CMS expanded chronic care management to include RPM. There are CPT Codes for the work typically performed around RPM programs, including training patients on equipment, supplying devices, receiving and collecting electronic transmissions, monitoring clinical data and interactively communicating with patients.
And just recently, CMS expanded its guidelines to begin allowing clinical staff to perform these services under the supervision of physicians. Under this guideline, physicians are no longer required to be on site when the associated services are performed, so physicians can devote their time to more complex treatments and procedures while clinical staff perform those services.
Despite the questions that exist around telehealth post-COVID-19, RPM is here to stay and its utilization will increase significantly.
The RPM Solution from Florida-based WITHmyDOC
What began nearly two years ago as an idea for a new digital health platform has quickly accelerated into web-based intelligence that will transform healthcare, with Ft. Lauderdale-based healthcare technology startup WITHmyDOC at the epicenter of the innovation.
“With the healthcare industry changing so rapidly, we felt like the future would see a need for more real-time patient data for physicians to monitor care. We started developing the WITHmyDOC platform because we saw the lack of real-time data in current telemedicine solutions as a hindrance for the patient to get quality care and for the physician to get the best possible information to treat the patient.” WITHmyDOC President Richard Rodriguez explains. “We began working on the technology and last October formed WITHmyDOC. Little did we know there would be a COVID-19 pandemic drawing more attention to telehealth and telemedicine options. We’re excited about announcing our product offering this summer and entering the telemedicine market,” he adds.
WITHmyDOC’s HIPAA-compliant digital software is programmed with ease of use in mind for both doctor and patient. The platform can be viewed on a desktop, laptop or phone, and even data from health devices like fitness bracelets, smart scales and more can be used in conjunction. The software application acts like a monitoring station, capturing each patient’s vital signs and keeping a historical record that can be uploaded or integrated into the EHR, if necessary.
WITHmyDOC Introduces RPM@Home
WITHmyDoc recently announced the launch of RPM@Home, its remote patient monitoring kit poised to transform healthcare. Using a web-based intelligence platform to monitor patients and transmit real-time biometric data to healthcare providers, RPM@Home supports chronic care management and telehealth visits by providing real-time data to facilitate proactive intervention.
WITHmyDOC’s RPM platform allows healthcare providers to review patients’ biometric data as frequently as needed – even daily – between office visits, making it easier to detect, diagnose and treat symptoms. Medical devices in the base kit are Bluetooth-enabled and include a pulse oximeter, a weight scale, and a blood pressure monitor. Additional devices available are a glucometer, a 24-hour continuous monitoring temperature sensor and an ECG/respiratory rate sensor. The RPM@Home kit also includes a 10-inch tablet that transmits vital data to the physicians’ office in real time and communicates critical alerts programmed for the individual patient.
Designed for chronic care management, WITHmyDOC’s RPM platform delivers predictive analytics through advanced artificial intelligence and utilizes a bilateral notification system. It is a patient-centric platform that is both device- and EHR-agnostic.
When their patients use the RPM@Home kit their vital sign data is transmitted in real-time directly to the healthcare provider’s dashboard. The physician can set parameters for each patient’s vital signs which will trigger a critical alert if the patient’s vital signs fall out of their normal range. This allows for timely intervention, making a real difference in outcomes as well as avoiding a costly care episode. In addition, incorporating RPM in chronic disease management can significantly improve patients’ quality of life by preventing complications, allowing them to maintain independence and minimizing personal costs.
RPM@Home can significantly reduce the spread of the COVID-19 virus by minimizing healthcare professionals’ exposure to infected patients. Monitoring can be done while the patient is in an isolation unit, at the hospital or even at home.
“This is a new world for healthcare. As telemedicine takes on a more significant role in healthcare delivery in the future, remote patient monitoring and the RPM@Home patient kit will be key drivers,” Rodriguez concludes.