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Remote Patient Monitoring Workflow: How To Build Effective Programs

The remote patient monitoring workflow of clinicians across the country’s health systems has dramatically increased patient engagement during the COVID-19 pandemic. When going to a public space became a risk, many Americans put off seeing their healthcare providers, until they discovered the benefits of telehealth and remote patient monitoring (RPM) — technology that allows clinicians to remotely track patients’ real-time health data, then integrate it into their care plans.

Clinicians who once resisted going digital have also discovered the benefits and efficiencies of remote patient monitoring workflows. Chronic conditions like hypertension, congestive heart failure, and COPD require real-time virtual care delivery via telemedicine — and now that they’ve had a chance to try it, healthcare providers (and their patients) are much more comfortable leveraging technology to improve health outcomes.

The effects of COVID-19 on remote patient monitoring

Many of the changes COVID-19 has caused in our clinical workflows across healthcare systems have already led to more efficient real-time patient care via telehealth. This is enabled by remote patient monitoring . According to the CDC, telehealth use increased by 50% in the first quarter of 2020 — 154% just in the last week of March.

The coronavirus pandemic has been a game-changer for telehealth and remote patient monitoring. As clinicians limited their inpatient appointments to mitigate the spread of the virus, remote patient monitoring became the country’s real-time care delivery solution. Many diagnosed patients were required to self-isolate for 2 weeks, and some of them were at risk for complications. Remote patient monitoring for blood glucose levels, blood pressure, or hypertension status, for example, requires uninterrupted clinical support from healthcare providers at home, which RPM supports.

Effective digital healthcare extends beyond the capabilities of an EHR to provide a patient monitoring workflow for long-term chronic conditions. Real-time patient care with patient data follow-ups requires integrating EMRs and EHRs with next-generation technologies that make the lives of your clinical staff easier and more rewarding.

Implementing a successful remote patient monitoring program

The successful implementation of an RPM program can improve your patients’ health outcomes and offer a new revenue stream by providing financial stability in uncertain times. Try following these steps to do so with less stress and more team buy-in.

1. Gather consensus on the needs and goals for RPM

Telehealth is a broad term for the entire industry, methodology and technologies that enable digitally enabled healthcare. RPM is a type of telehealth delivery system that uses the latest advances in information technology to gather patient data outside of traditional healthcare settings and facilitate patient-provider interaction.

According to Health IT News, 36% of U.S. consumers are now using telehealth to replace healthcare office visits. But there are still many healthcare providers who aren’t encouraging the use of telehealth — they question the accuracy of patient data collected from medical devices and wearables in real-time from locations where patients may not use them properly. These clinicians may also fear that EHR integration is too complicated.

You’re likely to get much less resistance from clinicians and administrators alike if you include them in the conversation about your practice’s need for a new remote patient monitoring workflow. Does everybody agree that reducing readmissions of patients with chronic conditions is a priority? Are all team members concerned with addressing social determinants of health? What about streamlining workflows so they have more time to dedicate to patients?

Show them case studies from research firms like Data Bridge on how RPM accomplished that for other practices and health systems. If your patient load is not as large as you’d like it, demonstrate through statistics and surveys how RPM can provide a potential new revenue source. Once everyone agrees on needs and goals, your Care team will be more motivated to embrace the imminent learning curve coming to their workflows and care plans.

2. Map out your remote patient monitoring workflows

Implementing virtual care with a remote patient monitoring program requires mapping out distinct workflows for clinical staff in all specialties. A dermatologist, for example, may need only a high-resolution, high-quality camera to begin delivering virtual care via telehealth. A cardiologist, on the other hand, requires medical devices that monitor BP, weight, heart rate, and EKGs in real time. If you map out each clinician’s remote functions, budget, and ROI, then provide a peer’s successful case study, your Care team will be more likely to embrace and even enjoy telemedicine as much as your patients do.

Telehealth and remote patient monitoring workflow optimization requires careful consideration of all your clinicians and their care delivery processes. A study conducted by the University of Texas Health Science Center found that the most important factors that affect the quality and efficiency of clinicians’ work include workflow interruption, platform effectiveness, and collaboration with bedside caregivers. Make sure your team’s concerns about these issues are addressed by the remote patient monitoring and Care Management technologies you choose.

3. Train and educate clinicians on remote patient monitoring use and trends

A new platform for collecting and analyzing patient health data is bound to impact the clinician’s experience as much as the patient’s. Make sure to request demos from each vendor you’re considering and ensure each team member’s learning curve is not too disruptive. Review each vendor’s onboarding training and follow-up programs — it will be critical for adoption.

Educate your clinicians on how the RPM program will improve your practice’s unique workflows and demonstrate how much it’s already doing so across the healthcare industry. A VivaLNK survey found that nearly half of healthcare providers believe RPM adoption will be on par with in-patient monitoring in 5 years, and 35% believe that it will surpass in-patient monitoring by then. Meanwhile, 20% are already enjoying remote patient monitoring programs, and another 23% plan to adopt one in the next year.

The vast majority of clinicians surveyed said they preferred continuous, 24-hour data to episodic data — choose technology that offers that capability. Also, make sure your team keeps up on fee schedules as well as state and federal RPM regulations. The Centers for Medicare & Medicaid Services (CMS) released its 2021 remote patient monitoring (RPM) reimbursements and rules, so check to make sure your programs comply.

4. Source optimal RPM hardware

A remote patient monitoring system can be considered an internet of things (IoT) system. To make it efficient and user-friendly for both clinicians and patients, invest in personal medical devices with Bluetooth modules, RPM wearables, dedicated mobile apps, and a cloud repository where you’ll back up all medical data patients will be sending you.

These non-invasive tools that remotely track or measure common biometrics in hospitals have now been authorized for remote use by the FDA:

    • Audiometers
    • Blood pressure monitors
    • Breathing frequency monitors
    • Electronic stethoscopes
    • Electronic thermometers
    • Electrocardiographs (ECGs)
    • Electroencephalographs (EEGs)
    • Cardiac monitors
    • Apnea monitors
    • Spirometers
    • Pulse oximeters

Whatever RPM devices you choose to implement, make sure you understand how they fit into your EHR system.

5. Integrate RPM hardware with a team-first platform

Your patient’s workflow may contain elements outside your EHR — which would require that you implement EHR integration. This step will be critical when developing your remote patient monitoring workflow, either within your EHR or within a dedicated Care Management platform. Many health organizations are choosing to integrate their new RPM workflows into their EHRs, which are essential to managing a patient’s healthcare journey.

Your EHR stores patient data and contains information about all clinicians involved in a patient’s care; this can be shared with other healthcare providers. However, it lacks the ability to build and update a program, so it’s not an optimal tool for enabling patient-centered care.

A Care Management platform, on the other hand, is designed to streamline workflows and integrate with your remote patient monitoring tools to build and update your care plans. It also:

    • Automates collection of patient data and relevant assessments
    • Supports care coordination with built-in automation and escalation paths
    • Enables patient-centered care with tracked and accessible communication
    • Supports patient engagement throughout the entire care journey
    • Provides a 360-degree view of the patient for the entire Care team

According to HIT Consultant, to make significant advancements in RPM innovation, platform developers must build a digital framework with data storage, security, middleware, machine learning, artificial intelligence, and automated workflows to enhance the user interface and user experience. These functions require high-level expertise in design, software engineering, and data science, as well as knowledge of artificial intelligence and machine learning algorithms.

Once you’ve assessed the operational aspects of all your hardware and platform options — user experience, device efficacy, support, and integration — decide on the tools that streamline your workflow while simplifying remote follow-up care and patient education.

6. Segment eligible patients

The best way to identify eligible patients for your remote patient monitoring program is to break your patient population down into segments by:

Medicare Part B enrollment

Medicare Part B covers 80% of RPM costs. Many Medicare Advantage and Medicare Replacements also cover 80%, and more primary insurance providers now cover RPM as well, while secondary providers cover the 20% difference. Because coverage varies from state to state, check with insurance companies to verify coverage. Since the majority of a Medicare patient’s copay is likely to be covered, these patients will be more likely to enroll in your remote patient monitoring program.

Short-term and long-term care

Short-term care includes post-acute Care Management — this can be transitory, where patients recover and adjust in their homes after receiving critical care, or it can be post-surgical. From eye infection viewing, to wound consultation, to a behavioral health episode resolution, virtual care via telehealth services can help both patients and healthcare providers save lots of time and frustration. Without scheduling office visits, new patients can also get to know and understand how clinicians practice and what they specialize in via a telehealth visit, then decide whether to follow up in person later.

Potential uses of RPM for short-term acute care are numerous. They include patient data gathering, patient education, self-monitoring, pre- and post-acute chronic condition management, post-acute patient stabilization, long-distance routine check-ups, virtual assessments and diagnoses (like teleradiology), and specific teleconsults for treatments or prescriptions (telepharmacy).

Condition

According to The National Health Council, more than 75% of all healthcare costs in the U.S. are attributed to chronic conditions — so they’re likely to make up a large portion of your patient base. Segment the patients who could benefit from biometrics tracking by their conditions:

    • Asthma
    • Allergies
    • Diabetes
    • High blood pressure
    • Hypertension
    • Obesity
    • COPD
    • Cancer
    • Dementia
    • Alzheimer’s Disease
    • Certain mental health conditions

These can all be tracked with a remote patient monitoring platform that sends patient data from your patients’ medical devices to your Care Management platform for clinicians to analyze. These can include measures like heart rate, blood pressure, glucose levels, temperature, headaches, sleeping patterns, food reactions, disorientation, dizziness, mood, and daily function.

Chronic Care Management with remote patient monitoring helps patients track the ebb and flow of their symptoms and integrate their medical information into their healthcare providers’ workflow. When they send this patient data to their clinicians in real-time via medical device or wearable, patients can identify concerning trends before chronic conditions reach debilitating levels that require scheduling inpatient office visits or laboratory follow-ups.

Tech-savvy

A patient who has trouble learning new technologies may desperately need remote patient monitoring but give up on it if their device or platform is not user-friendly. Make sure to segment your training programs to cater to various learning curves in each of the groups listed above. Some will be able to navigate apps immediately, others will prefer to watch an instructional video, and a percentage will insist on a brochure or workbook. Do whatever works to ensure patients embrace remote patient monitoring and comply with their remote care plan.

7. Manage your patient data

After patients receive and set up their medical device, they should use it for at least 16 days every month so data can be frequently added to your remote patient monitoring platform. Your clinicians should decide the following:

    • Who will monitor patient data?
    • What will you do if the patient is not using their device?
    • Who will inform the physician if a patient’s condition escalates?
    • How will your patients’ health data be integrated into your electronic health record (EHR)?
    • Who will train your clinical staff to do remote patient monitoring?
    • Which actions will your Care team document and where?

It’s critical to develop a security framework that keeps data confidential for unauthorized users. At the same time, patients must be allowed to establish clear boundaries of ownership over the data, whether that access is given to family members or primary care providers. In the case of an emergency where the patient is incapacitated and unresponsive, the authorized user must be able to quickly access the data to treat the patient.

8. Recruit and engage eligible patients

To get your patients excited about your new program, notify them during clinic visits (or telemedicine visits in times of quarantine), make calls, or send out mailers. Your RPM vendor should have enough experience to advise on what works best in your target patient demographic. They may provide clinical marketing materials or, with your cooperation, market directly to your eligible patients.

Once you’ve inspired patients to agree to RPM, you’ll need to train them to use it effectively. When they’ve been on board for a while, use surveys to gauge patient satisfaction and increase engagement. Surveys can help:

    • Determine the patient’s mental or emotional state
    • Measure things that are not “machine measurable”
    • Gauge the patient’s engagement with their care
    • Document their health status at different phases

The Patient Activation Measurement (PAM) survey developed by Insignia Health asks questions that measure how “ready, willing and able” the patient (or caregiver) is to take charge of their health. Your Care team should pair it with PAM Activation Coaching for optimal results. Periodic surveying shows whether the patient’s self-activation is improving.

Your team can survey patients to ask about their general health, biometrics, symptoms, and emotional state. The format can consist of yes/no questions, ratings, or branching logic questions. You can decide whether your patients would appreciate daily, weekly, or monthly communications depending on their condition and demographic. Implementing a Rothman Index-like survey combined with biometric readings can enhance your care plan and your remote patient monitoring workflow.

9. Reach new patients with inbound and outbound marketing campaigns

The typical patient does extensive research before choosing a provider. According to Google, patients who book appointments with healthcare providers run 3 times more searches than those who don’t. Also, 60% of patients search online before calling a healthcare provider’s office. It goes without saying that the more content you create, the more prospects you’ll connect with and potentially convert into patients.

Empathetic, targeted messaging lies at the core of both inbound and outbound marketing efforts and crafting a strategy that integrates both is likely to bring you the most success. Whatever it’s a digital platform (website, Google ad, ebook) or printed medium (pamphlet, mailer, billboard) they find you on, your future patients should feel how much you care. Competence and compassion should emanate from all content you produce, which should also include a call to action.

According to Hubspot, video has become the most commonly used format in content marketing, overtaking blogs and infographics. Promotional videos and brand storytelling are the most common video types created by marketers. 87% of video marketers say video has increased traffic to their website. 80% of video marketers claim video has directly increased sales.
Inbound and outbound efforts should complement one another. For example, an ebook download from your website can inspire a mailer to be sent or a call to be made. A highway billboard, on the other hand, can direct prospects to your website to download a content offer about their condition. Blend these 2 approaches to craft a content marketing strategy that meets your patients where they are, offers them the education they need, and gives them the inspiration they deserve.

Streamline your remote patient monitoring workflows

Remote patient monitoring is here to stay, and along with it patient engagement, satisfaction, and outcomes are improving every day. Keep up with the healthcare industry’s hottest trend — read our guide to remote patient monitoring.

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