How COVID-19 revealed the strong need for remote patient monitoring

At the start of 2020, widespread use and adoption of remote patient monitoring (RPM) was still struggling to get off the ground, despite the technology being available for years.

A majority of the hesitancy on RPM implementation was due to limited reimbursement opportunities as well as lack of incentives for providers offering such services.

Then COVID-19 hit. This pandemic has exposed the need for the rapid adoption of increasingly innovative digital health technologies. And while telehealth, a key component of this, has received much of the focus and spend over the last few years, it’s time for a more comprehensive approach to remote patient care to gain consideration. This view seems to be rapidly gaining traction, as the RPM market is expected to double in the next five years.

The Benefits of RPM Technology During the COVID-19 Pandemic
The typical early use cases for RPM have involved the need to provide continuous, virtual models of care to improve the provider and patient engagement. This has been especially true for underserved, uninsured or Medicaid populations, where there are already disproportionately high rates of chronic disease and other barriers to care, such as limited transportation options and inflexible work schedules.

But today, there are other equally compelling use cases evolving as well, such as monitoring high-risk cohorts with postpartum hypertension or post-surgical monitoring. Furthermore, as the coronavirus rapidly spread across our nation, the use of RPM technology was critically relied on by healthcare providers for a myriad of reasons. Specifically, RPM:
- Enables ongoing monitoring of patients outside of the traditional clinical setting, which means providers will not become disconnected from high-risk populations.
- Eliminates the need for non-essential in-person visits, thus decreasing the chances of patient and provider exposure to COVID-19.
- Reduces overall healthcare costs for patients and physicians, with an overwhelming amount of evidence detailing improved disease management through RPM.
- Helps healthcare organizations scale their valuable clinical staff, which is especially essential during public health crises when providers’ resources are stretched thin.
- Serves as a critical early warning system for COVID-19 detection in individuals, especially for asymptomatic or pre-symptomatic individuals.

Today, very few healthcare organizations are viewing the adoption of digital health as a short-term response. And while this current public health crisis has served as an impetus to move more aggressively toward RPM program implementations, the move was going to happen anyway. When dealing with out of control healthcare costs juxtaposed with the growth in the population with multiple chronic conditions, something simply needed to give.

Not all RPM Technology is The Same
For healthcare providers looking to implement and adopt RPM technology in a post-COVID world, there are a few things to keep in mind. Seek solutions that:
- Support multiple disease states and use-cases
- Integrate with your established EMR to further ensure a holistic, interoperable solution
- Embed actionable insights and clinical decision support
- Have little or no patient intervention needed to transmit the data to the platform, as RPM technology should be largely invisible to the patient

Take Boston Medical Center, for example. During COVID-19, the center began using RPM to remotely monitor blood pressure for new moms who had gestational hypertension or preeclampsia, thus were considered to be high-risk for stroke after pregnancy. Providing the center with the capability to remotely monitor these patients -- combining EHR data with patient-generated blood pressure data from a cellular-connected blood press cuff -- was crucial, as the medical staff was tasked with not only managing better outcomes for the patients, but also ensuring their risk to COVID-19 exposure in the healthcare setting was limited.

Calling for Permanent RPM Reimbursement Reform
The use cases and benefits of RPM are clear. But for RPM to live up to its potential, our industry needs reimbursement reform. Recently, the Centers for Medicare and Medicaid Services (CMS) released its proposed 2021 Medicare Physician Fee Schedule (PFS) addressing questions about the status of temporary policy changes surrounding telehealth including RPM. Here’s what we know:
- During the Public Health Emergency (PHE), the Office of the Inspector General said that they would not penalize doctors for not collecting patient copays for telehealth services-, including RPM. Beyond the PHE, it’s unclear whether this flexibility will remain.
- CMS granted that RPM could be furnished to new patients as well as established patients during the PHE. Following the PHE, CMS will again require RPM to only be furnished to established patients.
- CMS also granted that consent could be obtained at the time RPM services are furnished, allowing for virtual care rather than in-person consent. CMS is proposing keeping this flexibility.
- Finally, CMS clarified that practitioners could furnish RPM services for acute and chronic conditions, and confirmed this was not a temporary measure tied to the PHE.

While our industry is aware that proactive, continuous, virtual models of care like RPM are crucial for patients with chronic conditions -- especially the most vulnerable populations – we need influence and action to further underscore the need for permanent RPM reform and drive change. Together, let’s advocate for policies that promote these models.

About the Author
Joshua Claman is the CEO of Rimidi, a cloud-based software platform that enables personalized management of health conditions across the population. He has over 25 years leading technology businesses in Asia, Europe and the Americas. His industry experiences span his time in Dell in several senior executive positions, including the founding and development of Dell’s European Healthcare business, to his role as president of ReachLocal, one of the largest advertising technology companies in the U.S., and serving as the chief business officer of Stratasys, a leader in 3D printing in the medical field. Josh is a strong advocate for the promise of technology.

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