Remote Patient Monitoring – or RPM – can give your staff a lot of leverage in managing patients with chronic conditions or those that have been recently discharged and need to follow up. RPM programs aren't trivial to set up – they require thoughtful patient selection, provider and patient education, and an effective rollout and engagement strategy. However, the results can be worth the effort – providers' returns can exceed 3:1, and there are abundant soft benefits for staff and patients besides the financial returns.
But scaling your initial deployment – with additional patients with the same or a new medical condition – can be challenging. So you'll need to focus on a few primary questions as you progress down the program expansion path.
Is My RPM Program Working As It Should?
Well-designed RPM programs have clearly established goals, and these are the best place to start when evaluating the performance of your RPM program. Usually, you can only measure performance to plan after some time since the benefits of RPM accrue over time as patients remain stable and healthy. But once your first cohort has progressed far enough, you can often assess progress. You will likely need access to data and analysis (your RPM provider can assist in creating a practical analytics framework) that evaluates progress. For example, if your goal was to reduce a 30-day post-discharge rate, you'll need to compare the subject cohort's readmission rates in a control group. If your goal is to reduce ER visits, that's where you'll build your analysis. Goal achievement is an excellent place to start because it addresses the primary driver(s) underpinning the deployment decision.
Is My RPM Program Generating a Return on Investment?
If you're hitting your goals, it stands to reason that the RPM program is generating a return. Uh, maybe. Calculating an RoI, while conceptually straightforward, involves collecting hard and soft benefits and costs. On the benefit side, your goals presumably have a financial impact. Let's say you're trying to earn an MSSP incentive bonus on 90-day readmissions that amounts to $1,000 per patient for readmission reductions below 10% in your cohort. With a 100-patient cohort, you stand to earn $100,000 if you can hit the bogey. If you had a 20% readmission rate in the control group, you need to use the RPM platform to avoid readmission on ten patients. There are "soft" benefits also – staff satisfaction, patient engagement, etc. – but let's stick with the "hard" benefits. The RPM program might cost $100 per month for each patient. Since it's a 90-day rolling rate, you'll have some patients monitored for four mos. And overall, you'll spend $40,000 for RPM on the cohort for the monitoring period. There will probably be some supervisory allocations – may be case management or escalation review. But it still looks like the RPM program is delivering an RoI of at least 2:1. But you can also see how you might reduce readmissions but have a weaker or harmful RoI if costs are higher through patient churn or if you don't make the readmission target. For example, if you only reduce readmissions to 15% and the incentive shrinks to $500 for each patient in the cohort at that readmission rate, you're pretty close to breakeven. So, the details matter of your goal achievement matter.
How Should I Consider Expanding my RPM Program?
If you're achieving your goals and showing a positive RoI, consider expanding to a larger cohort or a new group of patients. Best practices matter when you're doing this. You (and your RPM vendor) probably learned a lot in the initial deployment that will make an expansion or a second deployment more successful (think inclusion/exclusion criteria, provider outreach, etc.). As you incorporate these best practices, it's usually good advice to expand an existing cohort since goals, returns, and challenges are better known. In addition, there are often scale efficiency overheads your team can realize as you grow. For example, triage teams become more efficient as they expand (up to a point).
If you still need an expansion cohort opportunity, consider deploying an RPM program into a new cohort with similar but different medical needs, so your previous experience will be as applicable as possible. And start from the same building blocks: goals, inclusion criteria, cost estimates, return, workflows, and kickoff practices.
If your RPM program is achieving goals and delivering an RoI, and if you have an expansion cohort or a new cohort to deploy, expanding your program can make great sense clinically, administratively, and financially.