#ATA2021: How Remote Patient Monitoring Can Provide Insightful Patient Care

Remote Patient Monitoring Empowers Patients with Data

Physicians and patients often talk past each other, said Schiller, co-founder and CEO of Validic, a digital health platform that connects healthcare systems with remote patient data. For example, physicians may tell patients they need to exercise or follow a healthier diet, while patients say they’re trying but it’s not helping. RPM data can provide clarity and guide conversations with patients.

Validic partnered with Sutter Health in 2016 to capture patient data using RPM. One patient in the program with Type 2 diabetes had an A1C level consistently above 9 despite trying to manage his diet and walk regularly. Consistent tracking using the patient’s glucose meter, blood pressure monitor and weight scale showed clinicians that the patient’s glucose level spiked at the same time every night. The patient revealed that he usually ate popcorn at that time but didn’t record it because he thought it was healthy.

READ MORE: 5 key considerations for effective remote patient monitoring.

“In the first 30 days, his A1C dropped by a point. It was the first time he had noticed that a behavior chance could change health, and this systematically changed his health, with his A1C level eventually dropping below 6,” said Schiller. “The patient isn’t a different person, and the healthcare system isn’t a different healthcare system. Data helped provide insight into the patient’s life and led to a conversation about what was happening, not what should be happening. Data works well for people, and it’s the way people want to receive healthcare.”

Nixon, co-founder and managing partner of healthcare innovation firm Nixon Gwilt Law, pointed out that in one program, asthma patients use a peak flow meter to measure how well air was moving in and out of their lungs before and after taking their medication.

“The readings are much better when taking their medication. Before, the patients didn’t have a good sense of what the medication was doing for them. This knowledge is a key part of adherence,” she said.

The data gleaned from RPM empowers patients, and can lead to improved medication adherence, said Carrie Nixon of Nixon Gwilt Law.

RPM integration is another way to provide more holistic patient care. Kolodner, vice president and chief medical officer for telehealth software company ViTel Net, described GPS-enabled inhalers that can tag areas that set off asthma attacks, providing an immediate benefit to the patient’s health.

Emerging technologies such as artificial intelligence and machine learning can also play a role in RPM, Schiller explained. Algorithms that process the data can generate health alerts and can use social determinants up front to ascertain the best mode of RPM implementation and how to engage the patient.

“Physicians can use the data to engage patients in different ways. If they expected to see the data trending in a certain way and it’s not, they’ll know it’s time for a conversation with the patient to determine if something has changed,” Schiller said.

A Value-Based Care Model Better Supports RPM

RPM devices are used to manage chronic care, manage costs and improve patients’ health while keeping them out of the hospital. However, RPM programs function better when financial incentives are aligned using a value-based care model rather than fee-for-service model, Kolodner said.

With a workforce shortage worsened by the COVID-19 pandemic, and 10,000 people — some with chronic conditions — aging into Medicare every day, there is a need for continuous healthcare but a lack of clinicians to provide it, said Schiller. A top-down approach is not sustainable in the long term, he explained; current policy has created barriers to RPM success.

LEARN MORE: Find out the possibilities and pitfalls of wearable technology.

One barrier is the fee-for-service payment model, which provides reimbursements only to those with chronic disease — patients whom Kolodner called “high flyers.” The current reimbursement framework does not reimburse for preventive monitoring.

RPM billing structure also can make the devices used for monitoring more expensive for patients, said Schiller. Changing this to allow RPM access to more patients is a good way to help people live longer and healthier, he said, rather than just longer and sicker.

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