By Joe McDonald, CareSignal Deviceless RPM
Healthcare providers were no stranger to telehealth offerings when COVID-19 arrived in the United States this past spring. In fact, between 2016 and 2019, healthcare practitioner adoption of telehealth services jumped from 14 percent to 28 percent. The pandemic, however, has shown that the ability to provide remote consultative services must now be a core capability for providers.
Eventually, the health crisis will pass, but the demand for virtual care — a category of provider services of which telehealth is just one part — is here to stay.
While the convenience of virtual care has driven its widespread acceptance among patients, it also shifts revenue incentives for providers. McKinsey & Co. estimates that approximately $250 billion of current healthcare spend in the U.S. could be virtualized. That being said, with the pandemic forcing permanent layoffs across many health systems, providers will have to find new ways to effectively implement digital care services for more patients and with fewer resources.
Telehealth is a vital part of any virtual care platform, but to bolster revenue and relationships while also maintaining clinical impact, providers must develop their remote patient monitoring capabilities and look for creative ways to drive virtual patient engagement.
Patient engagement in healthcare is critical to achieving optimal outcomes for both providers and patients. Telehealth removes many of the obstacles that might prevent patients from scheduling and attending regular health checkups — perhaps raising the average baseline level of engagement with each patient.
Still, a patient’s health could change drastically between visits, especially if he or she deals with a chronic condition. Remote patient monitoring allows providers to stay on top of those changes and represents a natural progression in the evolution of patient engagement solutions offered by providers.
Administering healthcare has historically been a hands-on endeavor, and some providers might balk at the prospect of digitizing more of the provider-patient interaction. However, remote patient monitoring most likely won’t have any negative impact on the quality of the provider-patient relationship.
If anything, giving providers better access to health data and an additional line of communication with patients will strengthen that relationship and lead to a more collaborative care model. Why? Because it gives patients opportunities to become proactive participants in their healthcare, not to mention more health-literate.
Room For Growth
So what technologies facilitate comprehensive remote patient monitoring in a truly viable way? Traditional remote patient monitoring devices are costly and complex, requiring Wi-Fi or Bluetooth to transmit data. Devices include blood pressure monitors, weight tracking devices, glucometers, pulse oximeters, thermometers, and heart rate monitors.
While these interventions can be useful (and undoubtedly improve the lives of many of the patients who rely on them), they offer limited utility to health systems and patients in a post-COVID world. Not only are self-management devices like these expensive to provide, but they’re also suitable for only a tiny segment of the patient population: the 3 percent to 5 percent of high-risk individuals who require constant monitoring to prevent serious health declines.
Further, a recent New England Journal of Medicine study shows that prioritizing high-risk patients does not lead to significant cost savings. Indeed, the results showed with statistical significance that when new and innovative interventions were focused on only the top utilizers, the outcomes were not materially different from the previous care delivery model.
The takeaway here is not that innovation should be avoided; instead, new technologies and improved virtual care models must be focused on the patient populations for whom there will be clinical and financial returns. Put simply, bending the cost curve requires focusing on the right part of the cost curve to begin with.
In the end, devising viable long-term patient engagement solutions comes down to unit economics. A health system could order 1,000 remote patient monitoring devices, but it won’t realize enough value from each device to make the investment acceptable. In general, the time to value (or the time horizon to ROI) for investments in remote patient monitoring must be shorter so providers are more incentivized to make them — and health systems should be making these investments to live up to their status as providers.
The future of remote patient monitoring might not mean expensive devices in every patient’s home, but providers must be searching for other solutions that extend their clinical relationship and impact into the digital world to drive revenue and preserve patient relationships by supporting improved outcomes. Here are three things providers should keep in mind as they embark on that journey:
1. Accessibility and ease of implementation are paramount. A remote patient monitoring system shouldn’t turn doctors into IT support — nor should it require patients to be constantly troubleshooting. The patients most suited for remote interventions are likely older, less-tech-savvy individuals who could have difficulty setting up Bluetooth or Wi-Fi connections. A more effective remote patient monitoring solution will offer frictionless accessibility and implementation from both a patient and provider perspective — one that does not require either group to learn how to use new technologies.
2. Aim for dual clinical and financial impact. In the wake of the pandemic, providers operating with fewer support workers and tighter margins must maximize the clinical impact they have on patients against every dollar spent. Health systems tend to pursue engagement strategies that are either high-cost, high-quality efforts (e.g., providing Bluetooth-enabled glucometers to diabetic patients) or low-cost, low-quality initiatives (e.g., sending out rarely opened patient portal reminders for flu shots). The future of remote patient monitoring will ideally marry the high-quality clinical impact of monitoring devices with the low-cost delivery of a text message.
3. Scalability requires inclusivity. Current remote patient monitoring strategies make financial and clinical sense only for a small group of high-risk patients, but health systems now have a much larger group of chronically ill individuals who need a layer of remote care due to COVID-19. Similarly, current solutions focus almost exclusively on patient biometrics but fail to capture qualitative symptomatology or deal with drivers of risk and morbidity, such as social determinants of health and behavioral health. A more impactful remote patient monitoring solution would allow providers to offer a suite of care modules that bring qualitative symptomatology and SDOH into greater focus.
The goal of health systems everywhere should be to generate revenue by creating clinical value. In an increasingly digital world, achieving that goal will require them to develop comprehensive virtual care offerings that center on remote patient monitoring solutions for upwards of 20 percent of their population. Providers that keep the above considerations in mind will be the ones leading healthcare into the post-COVID world.
About The Author
Joe McDonald is President and COO of CareSignal Deviceless RPM, a healthcare technology company that helps providers, payers, and employers succeed in value-based care by amplifying proactive care through lightweight, deviceless remote patient monitoring technology. He is driven by his passion for developing disruptive business models in healthcare to improve quality and reduce costs while bringing a systematic approach to innovation and strategy.