How home- and community-based remote patient monitoring can boost value-based care

Remote care tools and programs have been around for years, but the benefits they offer to providers in today's value-based care (VBC) environment are only now becoming apparent.

During a November webinar hosted by Becker's Hospital Review and sponsored by TytoCare, Joe Brennan, senior director of provider solutions at TytoCare, moderated a discussion about the importance of remote access in VBC. Panelists were Jeff Bennett, chief executive officer of Higi, and Aneesh Chopra, president of CareJourney.

Four key takeaways were:

  1. Remote access is a key component of VBC offerings. At any one time, up to 95 percent of a physician's panel of patients are not scheduled to come in for an appointment. Yet, a subset of those patients should be seen because they may have an underlying disease such as congestive heart failure or diabetes that, if left untreated, may result in an ER visit or a hospital admission. That in turn may lead to interventions that are costly in terms of human health and financially — outcomes that value-based care arrangements aim to avoid.

Remote care devices that examine and track users' biometrics or other relevant data at home or in the community can identify patients who may merit an intervention before disaster strikes. "The hope is that as technology makes it easier to democratize sensors and gathering of information, the better it will be on the front end for prioritization," Mr. Chopra said. "Remote care programs are building a closed feedback loop that helps doctors get a feel for what's going on with a patient [outside their office]," Mr. Bennett said.

  1. Community-based access points are an optimal way for remote care programs to reach some patients. Before providers can offer care to patients with undetected health conditions, they have to identify, screen and risk-stratify them. Grocery stores, pharmacies, community centers, schools, rural clinics, senior living facilities and public housing units are good locations for placing remote diagnostic tools, especially in communities of lower socioeconomic status, because they are familiar environments that evoke trust in people who may otherwise be skeptical of the health system.
  1. Partnering with remote care vendors can give VBC organizations a leg up. Because remote care vendors enable a component of care delivery by providing individual or mass health screenings, partnering with them may be a competitive advantage for VBC providers. "Pay special attention to policy innovation where consumers can voluntarily align to a practice that raises its hand and says, 'Whether you come to us through the community, through the clinic or connect with us through your home, we will be here for you,'" Mr. Chopra said.
  1. Success with remote care programs requires a set of carefully thought-out implementation steps. To maximize their odds for success, VBC providers are encouraged to incorporate a home- or community-based rmote care component that can follow high-level rules and implementation steps. 

The design of remote care tools should be such that they:

  • Serve as an extension of primary care providers (PCPs), without adding any extra burden to PCPs' workflow or changing any part of that workflow.
  • Enable risk adjustment that reduces or avoids costs.
  • Provide a service that is easily distinguishable from the care a patient receives in a PCP's office, so that there is no brand confusion.
  • Avoid "noise" (e.g., false positives) by using smart triaging logic that escalates potential issues appropriately, with actionable information for PCPs.

As far as implementing these programs, organizations must secure physician buy-in before initiating the process, as well as ensure that implementation is seamless from an IT perspective. "It's important to give physicians tools to prescribe RPM to their patients without feeling as if they are selling something," Mr. Bennett said.

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