There is little debate that healthcare is gradually shifting from a model that is focused on treating the sick to one that is driven by population health management. The payers – led by the Centers for Medicare and Medicaid Services (CMS) – are forcing this transformation by tying outcomes to financial incentives and disincentives for providers. In fact, pay-for-performance initiatives are now in place for hospitals, physicians, and home health agencies; the financial impact to providers who are unable to improve healthcare outcomes could be severe.
CMS has set its sights squarely on reducing hospitalizations. If hospitals don’t reduce the number of readmissions during the first 30 days after discharge, and if home health agencies don’t reduce the number of unplanned hospitalizations during the first 60 days of home health, then they stand to lose a substantial amount of revenue in future years.
The economics of this new paradigm are forcing providers to harness technology in new ways, specifically to be able to better communicate with and manage the care of patients. As such, remote patient monitoring is already being embraced by providers across the country, with recent studies estimating that as many as 50% of hospitals are using telehealth in some capacity, with another 10% considering a telehealth launch in the near future. What’s more, in a survey conducted by iHeartBeat, 89% of healthcare executives said that telemedicine is on the cusp of transforming the U.S. healthcare system.
If further evidence is needed to prove that remote patient monitoring has fast become a strategic imperative for many providers, then consider this: In its “World Market for Telehealth” 2014 study, IHI reported that worldwide revenue for telehealth devices and services is expected to swell from $440.6 million in 2013 to $4.5 billion in 2018.
The explosive growth of the remote patient monitoring industry is with good reason. For instance, consider this:
A care manager who is remotely monitoring a patient can proactively identify emerging issues before they become full-blown problems and provide immediate interventions – leading to improved outcome measures, reduced hospitalizations, and reduced E.D. visits. That’s not all. Remote care managers can also improve HCAHPS (for hospitals) and HHCAHPS (for home health agencies) scores – think about the impact a care manager can have on communication between providers and patients, which is one of the performance measures in both CMS surveys. That’s not all; remote patient monitoring positively effects many of the existing measures that comprise a hospital’s or home health agency’s CMS Total Performance Score.
Where remote patient monitoring is most valuable is for patients with one or more chronic conditions that requires a structured program such as diabetes management, CHF management, COPD management, or the management of metabolic syndrome. In addition to monitoring biometric readings for these patients and intervening when necessary, care managers can:
- Evaluate patients’ medication compliance, including whether a patient has filled a prescription on time or is taking a drug as prescribed.
- Help patients identify the link between the onset of symptoms and a newly prescribed drug.
- Provide education to help patients understand their co-morbidities and how best to manage their conditions.
- Coach patients to better manage their overall health.
- Assist clinicians with monitoring a patient’s treatment plan.
- Help patients get the most from their home health visits.
To illustrate the impact a remote care manager in a URAC-accredited health call center can have on healthcare outcomes, consider a patient with chronic obstructive pulmonary disease; by checking in to see if he is using his maintenance medications every day, the remote care manager can prevent problems that could eventually lead to a hospitalization. Consider the congestive heart failure patient; a recorded spike in the patient’s weight could transmit an early warning to the remote care manager that patient’s heart might soon have trouble pumping enough blood through her body. Finally, consider the diabetic patient with crashing blood sugar who would usually wind up in the ED; as the home caregiver/patient records the blood sugar data, it could generate an alert for the remote care manager, who then calls the home and suggests the patient drink some orange juice to bring the patient’s blood sugar back to normal range.
With recent technological advances, it has now become commonplace for telehealth technology to be able to record a patient’s vital signs, activities of daily living, dietary habits, medications compliance, and more, with this information easily accessed by and shared with the entire care team – including hospital case managers, home health staff, physicians, and family members. Built-in algorithms can trigger alerts and notifications, resulting in rapid interventions, significantly improved communications, better patient care, better results, better outcomes – and happier patients.
With these types of patient benefits – coupled with real improvements in healthcare outcomes – no wonder why we are seeing explosive growth in remote patient monitoring.
- CMS.gov: Home Health Value-Based Purchasing (HHVBP)
- Federal Register: Medicare and Medicaid Programs; CY 2016 Home Health Prospective Payment System Rate Update; Home Health Value-Based Purchasing (HHVBP) Model; and Home Health Quality Reporting Requirements
- NCBI: Patient Safety, Telenursing, and Telehealth
- NT Data: Trends in Telehealth