Debunking Common Remote Patient Monitoring Myths

October 25, 2021 - While telehealth and digital health saw moderate growth over the past few years, the pandemic accelerated adoption even more as healthcare organizations sought to push more care out of the hospital and doctor’s office and into the home. That growth is expected to continue as the industry moves to embrace virtual care as a standard and integral part of healthcare.

One of the more popular strategies to come out of this period is remote patient monitoring (RPM), an innovative approach in which care providers monitor their patients at home through a variety of digital health and telehealth tools, sometimes integrated with home healthcare services. While RPM has gained attention in helping to monitor COVID-19 patients at home, its value over the long run will only grow as health systems adopt the technology for other patient populations, including those newly discharged from the hospital and those with chronic care management needs.

Much of that growth will be tied to payer coverage, particularly Medicare reimbursement, which only emerged in 2019 when the Centers for Medicare and Medicaid Services released its first CPT codes for remote physiological monitoring services. Medicare coverage has since evolved, this year adding proposed coverage for remote therapeutic monitoring. Therefore, the growth of RPM and its adoption by care providers in the future will depend on how CMS improves coverage and defines the platform.

In the meantime, healthcare providers have been experimenting with various tools, platforms, and techniques to define their own RPM uses. In doing so, they have been tackling some prominent myths around adoption. 

RPM Is Too Expensive

Remote patient monitoring programs do not have to be complex or costly to impact clinical outcomes or improve care management. In fact, many organizations have launched small RPM programs that address one specific health concern, using one or two devices and just a few data points to get a feel for the platform and to help both patients and staff become comfortable with monitoring.

The key to developing an early-stage RPM service is to identify a population that accounts for significant healthcare costs and to design a program that reduces those costs through improved monitoring, such as helping patients control their high blood pressure or guiding those living with diabetes to reduce their A1c levels and insulin intake. 

These programs do not have to be expensive. Creating a platform with one or two devices and a few measurable data points can give care providers information they have not had before with annual, monthly, or even weekly office visits. This data will allow them to identify trends at home, recognize when and why patients are doing things that affect their health, and adjust a care plan accordingly to reverse those trends, improve outcomes, and reduce costs.

Organizations might believe they are reducing costs by having patients use their own devices and report data back to care providers, but this can cause problems and negate the program’s effectiveness. The devices may not work properly or be reliable; patients may report their data inaccurately or not at all. To accurately address care management and position a program for scalability and reimbursement, supplying devices for patients and establishing an onboarding routine takes much of the work out of patients’ hands while ensuring that providers get information they can trust and use. All of this combined shows how RPM can actually save organizations money.

RPM Is Too Difficult to Implement

The question of implementation is two-fold: Is it easy to onboard patients to new devices, and can care providers easily navigate data and notifications emanating from the technology? RPM addresses both of these issues with platforms that are both simple to launch and easy to manage.

From a patient onboarding standpoint, today’s RPM programs often use devices that come out of the box fully functional and ready to use. Providers have often screened patients for digital literacy and given them any needed instructions well ahead of time. These devices are also configured beforehand to connect via cellular or Wi-Fi, depending on what’s available, so that the patient need only turn on the device. 

Regarding ease-of-use for providers, companies spend millions of dollars a year to ensure the user experience is as smooth as possible. Dashboards that easily convey patient vitals and relevant notifications for when patients need attention are key focal points in RPM development. The system can be so easy to use that some providers outsource communication with patients to call centers. In addition, many RPM programs have coordinators that help hospitals with the set-up and installation process. 

Finally, effective RPMs already integrate with electronic health records (EHRs). A care provider’s ability to integrate RPM data with treatment programs and diagnoses in the medical record assures effective care management and coordination, eliminating gaps in care that lead to costly treatments and adverse health outcomes.

RPM Only Works With Broadband Access

Many programs run on Wi-Fi networks that require broadband connectivity, sometimes an issue in remote or rural locations or expensive for those on limited incomes. While both federal and state governments are moving to expand broadband to underserved areas, healthcare organizations will sometimes set up their own Wi-Fi services or partner with local providers, community health organizations, or charitable groups to arrange connectivity for those who need it. 

To avoid broadband issues, some RPM programs use technologies beyond Wi-Fi to ensure connectivity in remote areas. For example, many of today’s smart devices are Bluetooth-enabled, allowing providers to run programs through mHealth apps that connect to a smartphone, tablet, or home computer and transmit gathered data to a care provider. Beyond Bluetooth, cellular networks run through hubs or gateways, giving providers the freedom to use devices in homes that lack Wi-Fi or smartphones. Those networks pull data in through the hub and create a portal through which care providers use APIs to access the information. 

The key to ensuring connectivity is proper planning. Healthcare organizations should survey the communities and populations they expect to serve through RPM, then select the technology that affords the best connection.

RPM Is Limited in Length and Focused on Reducing Hospitalizations

While many RPM programs begin with the premise that they exist to reduce hospitalizations and only last a short while, the landscape is shifting quickly to embrace programs that target care management and long-term health and wellness for months, even years. 

As healthcare providers use RPM to address chronic care management, post-discharge rehabilitation, and other services, they are connecting patients to care teams for as long as necessary, which benefits patients with lifelong care needs. These services may evolve so that patients and providers connect at less frequent intervals or as needed. Still, their purpose will evolve into long-term health and wellness with measurables that include reduced healthcare costs.

Many programs have established limits or goals that trigger the end of the service — and for good reason, as this is how RPM can be measured for success in treating episodic concerns, such as a surgical procedure or illness. But these programs can be open-ended when needed. They look beyond hospitalizations to monitor and manage long-term health and wellness goals, especially for patients who need continuous care management. Their goals include continued medication adherence, reduced incidences of avoidable medical emergencies, reduced in-person care expenses, and better long-term health and wellness.

That is where RPM fits into the concept of value-based care. Its value lies in allowing healthcare organizations to monitor and care for patients not only when they show up to the hospital, clinic, or doctor’s office, but in-between those visits, when patients are living their daily lives and engaging in activities and habits that affect their health. 

All of the above myths stem from valid concerns, but solutions and applications have been developed to address worries around RPM. The expanded use of RPM promises to create more accurate data, better patient experiences with clinics, and reduced costs for all parties involved.

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Withings brought the first consumer smart scale to market in 2008 and has since expanded its portfolio to include hybrid watches, connected blood pressure monitors, sleep trackers, and smart thermometers. This growth has led to Withings Health Solutions, a division for health care professionals to leverage patient-generated data using remote monitoring and Withings range of award-winning medical devices.