5 questions with Alignment Healthcare CEO John Kao on remote patient monitoring

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While the decision to deploy telehealth services often becomes mired in concerns over reimbursement, quality and care continuity, one facet of remote care continues to gain traction — remote patient monitoring.

The number of remotely monitored patients hit 7.1 million in 2016, according to a February report out of "internet of things" market research firm Berg Insight. And in December 2016, a report commissioned by HHS' Agency for Healthcare Research and Quality found research consistently indicates remote monitoring for patients with chronic conditions is one of the greatest benefits of telehealth.

Alignment Healthcare, an Orange, Calif.-based healthcare services startup, is one organization integrating these capabilities into its repertoire. The startup, which launched in 2013, coordinates personalized healthcare delivery by operating an HMO plan for seniors in California and partnering with other payers to provide healthcare services for seniors in North Carolina and Florida.

"[We're] shifting the focus from payments to people," explains John Kao, CEO of Alignment Healthcare. "We are committed to caring for seniors in Medicare Advantage with an innovative care model that coordinates hospitals, health plans and physicians so that each patient and member receives the highest quality healthcare at the lowest possible cost."

Mr. Kao spoke with Becker's Hospital Review about how Alignment Healthcare serves patients as both a value-based payer and provider and how remote patient monitoring services fit into its mission to improve healthcare for seniors.

Editor's note: This interview has been edited for length and clarity.

Question: What does Alignment Healthcare's mission mean to you?

John Kao: Personally, an unfortunate healthcare experience involving my mother validated what we are trying to accomplish at Alignment Healthcare. She survived a heart attack, but upon her discharge from the hospital, she was prescribed prescriptions that conflicted with her other medications. There was no one looking at her entire healthcare picture to realize she could have severe side effects if she took all the medication prescribed to her by various physicians. I saw an opportunity to improve this in the healthcare system and for this reason, Alignment Healthcare provides coordination between a patient's doctors — no matter the location — so there are fewer lapses in providing the correct care.

Q: How does Alignment Healthcare fit into the broader healthcare landscape?

JK: In recent years, the U.S. has made moves toward value-based care, but full-scale adoption is slow and difficult to realize. Siloed interests within the healthcare system lead to inefficiencies, misaligned incentives, financial waste and poor clinical outcomes, especially for the people who need care the most — frail and chronically ill seniors. Alignment Healthcare's high-touch clinical model, combined with proprietary data analytics technology and case management, gives us minute-by-minute updates on patient and member health status and allows us to coordinate everyone involved to ensure the best care at the lowest cost. We are able to align health providers and payers into one team to improve the health and wellbeing of Medicare beneficiaries. We've assimilated ourselves into the landscape and are causing a disruption from within.

Q: How does Alignment Healthcare use remote patient monitoring to improve health outcomes?

JK: Alignment Healthcare's remote monitoring program gives medical professionals a real-time, 360-degree view of a patient's health after they've left the hospital and in between visits. On an individual level, reliable personalized data allows us to understand each individual's normal baseline and how serious fluctuations from that baseline may be. While the immediate goal of our remote monitoring program is to care for elderly patients and those with chronic conditions, it can also inform how other populations are treated on a broader scale. In aggregate, we are able to monitor the health of the population we are responsible for at any given moment and see trend lines that inform the algorithms we develop to trigger care interventions. Do heart failure patients have a rough week a few days after hospital discharge? If so, why is this and what can be done to avoid it?

Q: What are the challenges of delivering remote patient monitoring solutions?

JK: The challenges we've seen in Alignment Healthcare's remote monitoring program stem from two issues. One: an ability to identify the sickest patients that need remote monitoring. Two: making sure the patient and/or their caregiver understands how the technology can help and that they are using it correctly. Patients with heart failure often qualify for Alignment Healthcare's remote monitoring program because they have the highest readmission rates — 24 percent to 26 percent — of any type of patient. Once that patient is identified, we need to dedicate training time for the remote monitoring program, so the patient and/or their caregiver understands the necessary steps to submit vital sign updates to Alignment Healthcare to ensure successful monitoring of their health on a day-to-day basis.

Q: What advice do you have for healthcare organizations working with seniors?

JK: An especially important piece of advice when working with the elderly population is to meet the patient where they are. Another is to be compassionate. Seniors may not always have the tools to care for themselves, whether that's because they don't have the family support, struggle to understand and implement physician recommendations or don't have a grasp on today's health technology. The key to success in implementing today's healthcare advancements is understanding that extra time and education is necessary for working with the senior population.

Leaving the elderly patient to figure out a care process for themselves can have serious consequences, while engaging the provider, patient and caregivers can make a big difference. With Alignment Healthcare's remote monitoring program, for example, we offer some high-tech tools, but take the time to fully orient the senior and/or their caregiver to the materials and the daily vital update process. If you put the patient first, good things will come. If you care for a patient or member as if they were your mom or dad, that's all that matters. It's about changing healthcare one person at a time.

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