By Robin Hill, Chief Clinical Officer for Vivify Health
The last year has certainly seen a lot of changes in provider, health plan and patient attitudes toward remote patient monitoring (RPM). Once considered a “nice to have” in all three circles, the global COVID-19 pandemic has created a tremendous demand for RPM after demonstrating how effective it can be in helping patients manage chronic and multiple comorbid conditions away from the physician’s office.
One thing that hasn’t changed, however, is the most common chronic conditions providers are managing with RPM. Back in 2009, the top three pathways implemented by health plans and health systems were chronic heart failure (CHF), chronic obstructive pulmonary disease (COPD), and diabetes.
Today, those three remain the leaders by far. In fact, nearly 70% of patients using Vivify’s RPM solutions have one or more of these three conditions, although hypertension is rising rapidly.
The reason is fairly obvious: these are three of the most prevalent chronic conditions in the U.S., according to the Centers for Disease Control and Prevention (CDC). They are also some of the costliest, accounting for nearly $700 billion in direct medical costs and lost productivity on the job.
Given that 90% of America’s $3.8 trillion in healthcare expenditures are for people with chronic and mental health conditions it’s easy to see what a difference bringing these conditions under control can make from a dollars and cents perspective alone. Not to mention the human cost in lost lives and patient quality of life that occurs when these conditions go unmanaged.
The point of all these facts and figures is that as health plans and providers begin looking at how to take advantage of RPM for more than just their COVID-19 patients, many might wonder where to begin. After all, they may have thousands of members/patients across dozens of populations who could benefit from daily or even near-real-time monitoring of their conditions.
Select the right population
This is where it makes sense to follow the tide. For most healthcare organizations, the largest impact can be made by improving the health of members/patients with CHF, COPD, diabetes or some combination of all three.
By selecting the right populations within those conditions, i.e., the subsets of populations for whom early intervention can make the biggest difference in avoiding an unplanned hospital readmission or emergency department (ED) visit, healthcare organizations will be able to demonstrate significant cost savings and/or reduction in penalties from the Centers for Medicare and Medicaid Services (CMS) to justify the initial investment in RPM. With those early wins they will then have the track record to expand the RPM program to other conditions while meeting less resistance.
A natural question at this point is, if RPM is so great at making an impact on chronic conditions, why are the country’s expenditures on them still so high? The answer goes back to the beginning.
Up until recently, most health plans and providers had only experimented with RPM on a small scale. It is only now that RPM is beginning to experience more widespread acceptance.
It’s also important to understand that RPM is not a silver bullet. Most RPM programs are designed to give patients who just suffered an acute incident as a result of their chronic conditions a 30- or 90-day head start on making the lifestyle changes that will keep them out of the hospital or the ED.
After those 30 or 90 days the RPM program ends, which makes it easier for those individuals to fall back into old habits.
That’s why it’s so important to supplement the monitoring portion of RPM with counseling and educational materials, to help members/patients learn how to modify their lifestyles to create healthier long-term outcomes. The more that can be done while members/patients are in the RPM program, the less likely they are to have to return to it later.
While attitudes toward RPM may have changed for the better in the last year, the most prevalent needs remain the same for most healthcare organizations. By addressing CHF, COPD, and/or diabetes first, health plans and providers can launch themselves on a journey toward achieving better health outcomes for members/patients and greater satisfaction with the quality of care at a lower cost.
About the author
Robin Hill is Chief Clinical Officer for Vivify Health (part of Optum), an innovative leader in connected healthcare delivery solutions. The company’s mobile, cloud-based platform powers holistic remote care management through personalized care plans, biometric data monitoring, multi-channel patient education, and functionality configured to each patient’s unique needs.