5 Top Reasons Why Remote Patient Monitoring Is Destined to Take Off

As the nation moves from uncoordinated fee-for-service delivery of health services to a coordinated, accountable and patient-centric fee-for-value model, the ability of hospitals and physician practices to survive and thrive will depend on whether they can achieve the triple aim of higher-quality care that leads to better outcomes at lower costs. To realize these goals, providers must close the continuum of care loop by integrating the patient's home into the health system. Remote patient monitoring can provide appropriate support for patient self-management since most care coordination does not occur in the hospital or in physician offices, but in the home. Here are five reasons why remote patient monitoring is poised for explosive growth.
1. It reduces 30-day readmissions and prevents unnecessary hospitalizations and ED visits. To improve care transitions between the hospital and home and reduce an estimated $25 billion to $45 billion in avoidable costs, CMS now penalizes hospitals for 30-day readmissions for heart attacks, heart failure and pneumonia. Reimbursement penalties for excessive 30-day readmissions are set to increase from 1 to 2 percent in October 2013 and to 3 percent in 2014, increasing the financial pressure on hospitals. In FY 2015, CMS will also add hip and knee replacements and chronic obstructive pulmonary disease to the list of conditions subject to 30-day readmission penalties. Remote patient monitoring enables hospitals and health systems to improve care transitions, ensure compliance with discharge plans, identify potential health problems and intervene before they become emergencies, thereby reducing readmissions and emergency department visits and preventing avoidable hospitalizations.

2. It addresses the coming demographic storm that will accelerate over the next few years. A confluence of trends is creating a demographic "perfect storm" that will push the expansion of remote patient monitoring to improve access to care, reduce costs and do more with less. These include a rapidly aging population with fewer available family caregivers, increased incidence of chronic illness, the stress 30 million newly insured people will place on an already strained healthcare system, a shortage of primary care physicians that is estimated to grow from 16,000 in 2013 to 50,000 by 2025 and a projected shortage of 260,000 nurses by 2025. Remote patient monitoring is an effective alternative to clinic visits, increasing provider caseloads without increasing their workloads. In addition, family members who don't live close to their aging relatives will embrace technology that allows them to participate in their care and provides peace of mind because they know their loved ones are receiving the care they need.

3. It's more efficient. Remote patient monitoring can be deployed and scaled quickly, improving the transition to home for the 35 million patients who are discharged annually from the nation's hospitals and the 133 million Americans — nearly 1 in 2 adults — who have at least one chronic disease. Remote patient monitoring that  continually captures and analyzes real-time data and incorporates "alert" algorithms can identify patients who are at risk of developing significant, but often preventable, problems that lead to emergency department visits and and/or hospitalizations, as well as a decline in patients' quality of life. Remote patient monitoring that incorporates dynamic exception management by identifying and prioritizing high-risk patients based on readings that are significantly outside the normal range and/or troubling trends allows a small number of clinicians to keep a watchful eye on a large cohort of patients and to intervene to prevent or mitigate problems in a timely manner.

4. It delivers proven benefits. Until recently, a lack of proof that telehealth yielded clear positive results has been a major obstacle to adoption. However, solid evidence has emerged over the past two years that remote monitoring enhances quality of care and saves money. Examples include:

  • A study in Medical Care found that a post-discharge interactive voice response remote patient monitoring solution paired with case management helped the Geisinger Health Plan lower 30-day all-cause readmissions among Medicare beneficiaries by 19.5 percent.
  • A study of a New York City Health and Hospitals Corporation diabetes remote patient monitoring program in the Journal of Managed Care Medicine showed a 1.8 percent reduction in the hemoglobin A1c levels of Medicaid patients with diabetes. The decrease is significant because a 1 percent drop in HbA1c cuts the risk of stroke by 12 percent, heart attacks by 14 percent, heart failure by 16 percent, diabetes-related complications and mortality by 21 percent, and peripheral vascular disease — including amputations — by 43 percent.
  • A study by HealthPartners Institute for Education and Research published in the Journal of the American Medical Association found that pharmacists guided by telemonitoring results helped patients achieve better blood pressure control (71.2 percent) than those who received traditional office-based care from their physicians (52.8 percent) over a prolonged period of time.

5. The technology has improved significantly. Remote patient monitoring equipment is more reliable and easier to use today than it was even a few years ago. The technology is not intrusive, and patients no longer need to self-report their data, problems that have derailed telehealth programs in the past. Bluetooth monitors and cellular modems wirelessly upload temperature, weight, blood pressure, heart rate, blood glucose, oxygen saturation and other measures to a secure website, and patients report symptoms and receive health education and reminders with IVR, text messages or live calls or video consults with clinicians. Remote visits with two-way video over high-speed connections enable clinicians to talk with patients and observe affect, gait, speech, cognition, posture, breathing and other important health-related indicators. Nurses review the information in real time to identify urgent issues and developing trends, and provide interventions that range from telephone education to a home or physician visit to a 911 call.
Early adopters have used remote patient monitoring to improve quality, care coordination, cost effectiveness and efficiency of care for years, but misaligned incentives and lack of outcomes data hampered widespread adoption. Today, reliable and user-friendly remote patient monitoring systems offer a solution to the crises of cost and access facing the U.S. healthcare system, and the technology is poised to soar as hospitals and physicians scramble for ways to navigate, adapt and succeed in the emerging value-based healthcare model.

Nesim Bildirici is President and CEO of AMC Health, a leading provider of end-to-end telehealth solutions.

More Articles on Remote Patient Monitoring:

Essentia Health's Remote Monitoring System Cut HF Readmissions to 2%
Report: 2.8M Patients Worldwide Use Home Monitoring Device

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