In this article, we’ll discuss RPM and examples of remote patient monitoring. We’ll also cover questions like “What problem does remote patient monitoring solve?” and “What conditions qualify for RPM?” Let’s start with defining RPM and what it means for healthcare providers and patients.
What Is Remote Patient Monitoring?
Remote patient monitoring tracks and collects patient medical and other health data using digital technologies like home-based or mobile monitoring devices. Remote patient monitoring devices like heart rate monitors and blood glucose monitors can be used for RPM for consistent vital health information. Then RPM devices and programs electronically send this data to medical experts in primary care facilities and hospitals for analysis. Without RPM, it can be challenging to have access to and collect patient data outside of a conventional medical environment.
RPM devices are meant for interaction between the healthcare provider and the patient. It is especially important once a patient is released from care, as it enables clinicians to keep track of their medical data in near real-time. By receiving information about the patient between visits, a doctor can gain a better understanding of their health outside of in-person appointments. Based on the analysis of this data, the clinician provides the patient with recommendations and instructions for their health and wellness.
What Is the Purpose of Remote Monitoring?
One of the main benefits of remote patient monitoring is the ability to manage the health of patients outside of the traditional medical setting. Because remote patient monitoring is so versatile in the information it sends to providers, it can be used for observing patients with several different medical conditions. Remote patient monitoring best practices include developing detailed wellness plans for patients using the data collected. With data collected from patients, providers can determine which (if any) patients need a follow up to avoid further health deterioration.
What Is Remote Patient Monitoring Used For?
Remote patient monitoring platforms use devices to collect and send any information regarding a patient’s health so that doctors and nurses can have access to their patients’ data at any time. For example, if a patient is newly diabetic and struggling to keep their blood glucose levels in a healthy range, a monitor would send that information through an RPM program directly to a physician, who can help develop a wellness plan immediately (rather than at the patient’s next appointment).
A variety of patient health data may be gathered by providers through remote patient monitoring, including:
Blood Pressure
Blood pressure indicates the force of blood pressing against the artery walls as it leaves the heart. Chronically elevated blood pressure, commonly known as hypertension, stresses the heart and arteries and raises the risk of cardiovascular disorders including heart attack and stroke. For illnesses including hypertension, coronary heart disease, diabetes, and kidney disease, you could advise home blood pressure monitoring using RPM.
One advantage of recording blood pressure with RPM helps your patients avoid inaccurate readings in single visits. RPM allows patients to take their blood pressure at any time, despite any changes of behavior or diet. According to the Center for Disease Control and Prevention (CDC) blood pressure readings can be affected by factors like:
- How you are sitting. Crossing your legs and letting your arm droop at your side rather than rest on a table at chest height can make your blood pressure go up.
- What you ate, drank, or did before your reading. If you smoked, drank alcohol or caffeine, or exercised within 30 minutes of having your blood pressure measured, your reading might be higher.
Because of these anomalies, having a consistent blood pressure reading outside of scheduled doctor’s visits will give a more accurate and thorough picture of any blood pressure issue that a patient might be experiencing. This can help with an early diagnosis and assist in treatment to give them better control of the condition.
Heart Rate
The number of times a heart beats in a minute is known as the heart rate. A healthy resting heart rate for the majority of individuals is between 50 to 90 beats per minute (BPM). However, studies have shown that a higher resting heart rate increases the risk of death. Researchers found that:
- A resting heart rate between 51 and 80 BPM was linked to a 40 to 50% elevated risk of death.
- A resting heart rate between 81 and 90 BPM doubled the risk, compared with those with the lowest rate.
- A resting heart rate over 90 BPM tripled the risk.
Every 10 to 22 additional beats per minute in resting heart rate raised the likelihood of death by 16%, overall, according to the authors.
To observe a patient’s heart rate, using a monitor is the best way to gather data on their resting heart rate and detect any arrhythmia, or irregular heartbeat. Using RPM, a heart rate monitor can send you the data, so you can see any concerning changes in real-time.
Weight
Because there are several health risks associated with obesity as well as being underweight, managing a patient’s weight might be a priority for some physicians. Tools like a weight scale can provide healthcare professionals with up-to-date information and progress tracking of a patient’s weight management plan. Having this data can help providers develop:
- Customized diet plan to help patients gain or lose weight by ensuring they get proper, nutritional meals.
- Customized exercise plan to help patients gain or lose weight by building endurance and muscle, as well as combat other health conditions.
RPM gives healthcare providers the ability to tweak these plans on an as-needed basis. However, it is important to keep in mind that some patients, such as those with eating disorders, might not benefit from monitoring body weight alone.
Blood Glucose Levels
Diabetes is a chronic medical condition that impairs the body's ability to convert food into energy. Diabetes causes the body to either produce insufficient insulin or utilize it improperly. When there is not enough insulin or when cells cease reacting to insulin too much blood sugar remains in the bloodstream. That can eventually lead to major health issues like kidney disease, vision loss, and heart disease.
While diabetes types 1 and 2 are prevalent in the United States, African American, Hispanic or Latino, American Indian, or Alaska Native people are the highest risk for developing type 2 diabetes. Outside of family history for type 1 diabetes, the CDC states that patients at risk for type 2 diabetes:
- Have prediabetes
- Are overweight
- Are 45 years or older
- Are physically active less than 3 times a week
- Have ever had gestational diabetes (diabetes during pregnancy) or given birth to a baby who weighed over 9 pounds.
Blood glucose monitoring helps patients keep track of their insulin levels, and if they’re too high or low, serious health issues can present themselves. By updating this data using RPM, a physician can keep track of insulin levels daily to better understand how to manage a patient’s diabetes.
Dementia Observation
The World Health Organization (WHO) rated dementia as the seventh leading cause of mortality globally and one of the main causes of dependency and disability in the elderly. Dementia is defined by a deterioration in cognitive function, or the capacity for thought processing, that is greater than what is typically seen in elderly patients. Neurodegenerative dementias like Alzheimer's have no known cure, although there are medications that can help protect the brain or manage symptoms like anxiety and behavioral issues.
All of the following brain functions are impacted by dementia:
- Memory
- Cognition
- Orientation
- Understanding
- Computation
- Learning ability
- Language
- Judgment
The ability to get treatment and be monitored remotely with RPM may be especially helpful for older people with limited mobility. Dementia patients and their caretakers may find it challenging to leave the house, or they may lack adequate transportation to make regular appointments. In addition to maintaining quality care, RPM reduces changes that can cause unfavorable patient behaviors or reactions, such as anxiety, confusion, or agitation. RPM allows patients to stay in their homes or assisted living facilities while receiving treatment.
How Do You Implement Remote Patient Monitoring?
Without the proper preparation, it might be difficult for a provider to start remote patient monitoring services. Introducing remote patient monitoring as a healthcare service provider starts with forming a team, setting goals, and establishing workflows for your organization to adhere to throughout the process. As a team, you should:
- Understand the availability of RPM services and devices for all patients on individual private plans or those with Medicare benefits to provide the latest monitoring solutions.
- Determine your patient base. First, consider who is eligible, who would benefit, and the best solutions available. Thiswill give insight to the needs of your patients and whether or not RPM will be a worthwhile investment for your practice.
- Choose specific devices for your patients, considering things like reliability, ease of use, and affordability.
- Create a process to intake patients who qualify for RPM services.
- Develop policies and procedures for physicians to ensure the highest quality of care for patients.
- Train staff to understand the data produced and be able to make decisions based on that data for patients’ wellbeing. Patients might also require training to use their devices correctly.
Some RPM vendors might assist with these steps to ensure providers are properly introducing RPM services within their healthcare system.
Implementing a platform like Harmonize Health to assist organizations in staying connected to their patients—and enabling data flow between the two—is another crucial step for the majority of healthcare providers. RPM platforms are built to increase engagement between providers and patients. And the patients can participate with their treatment protocols instantly.
What Qualifies as Remote Patient Monitoring?
Treatment qualifies as RPM any time patient health data is collected remotely instead of inside a healthcare facility. In particular, RPM is useful because doctors can receive accurate daily information about a patient while they’re at home or unable to travel to a hospital or other location.
Remote patient monitoring is especially beneficial when data is transmitted using programs that allow both the physician and patient access to health data gathered by measurement devices like a heart rate monitor or weight scale. This means as long as health data is collected using one of these devices or reported using other methods electronically, it is considered RPM.
Who Pays for Remote Patient Monitoring Devices?
Depending on the patient’s insurance, the use of RPM devices and services could be totally covered or might require fees throughout treatment. It’s possible to have a small registration cost for new patients as well as a minimal monthly fee for monitoring the device and patient readings. However, most insurance companies reimburse patients for their remote patient monitoring costs.
Every state has different requirements and qualifications for their Medicare and Medicaid programs regarding RPM and who is responsible for payment. Most often these programs cover the cost of RPM technologies as long as other qualifications, like an inpatient hospital stay, are met.
Can Hospitals Bill for Remote Patient Monitoring?
Remote patient monitoring billing depends on the insurance coverage of a patient, whether it is private or through Medicare.
With private insurance, the payments are determined through their system and can be different depending on the company and patient. It is advised that you contact the patient's insurance provider to learn more about their billing and reimbursement procedures regarding RPM.
According to the Health Resources and Services Administration, guidelines for Medicare coverage with an established patient-physician relationship of RPM state:
- Physiologic data must be electronically collected and automatically uploaded to the secure location where the data can be made available for analysis and interpretation by the billing practitioner.
- The device used to collect and transmit the data must meet the definition of a medical device as defined by the FDA.
- Remote physiologic monitoring data must be collected for at least 16 days out of 30 days. During the public health emergency for COVID-19, if a patient is suspected or diagnosed with COVID-19, data can be collected over as few as two days.
- Remote physiologic monitoring services must monitor an acute care or chronic condition.
- The services may be provided by auxiliary personnel under the general supervision of the billing practitioner.
RPM as a Health Solution for Patients
At Harmonize Health, we’ve seen a 61% reduction in hospital admissions, 43% reduction in ER visits, and over $7,000 cost savings per patient per year, all with our remote patient monitoring system. We use innovative, adaptable, and user-friendly technology to seamlessly integrate clinical workflows with RPM programs. Medical organizations can perform triage and provide care within customized clinical pathways thanks to our technology. Visit our website for more information on how RPM can help you and your patients.
