RPM:The Crucial Link to Moving Healthcare to the Home-The HSB Blog 11/3/22




Our Take:


The remote patient monitoring (RPM) industry is growing rapidly with significant implications for healthcare as a whole. RPM has been proven to help lower hospital readmission rates, and unnecessary care utilization, and decrease overall costs for a variety of chronic illnesses. As a result, providers are increasingly looking for ways to deploy RPM technologies and take advantage of a number of new reimbursement schemes that have been put into place. While RPM devices such as blood pressure cuffs and glucose monitors have been around for a number of years, many of these new devices are incorporating new technologies such as artificial intelligence, and touchless sensor systems and integrating seamlessly with mobile devices like cell phones, tablets, and laptops already in the home. As a result, RPM is becoming an increasingly attractive option for patients and care providers looking to save time and money on routine follow-up care which can easily be moved to an outpatient setting through the deployment of continuous, accurate, instant physiologic measurements.


Key Takeaways:

  • Chronic disease accounts for 40% of all deaths in America according to the Journal of the American Medical Association (JAMA), with heart disease, cancer, stroke, COPD, and diabetes representing the top five contributors to mortality

  • For heart failure and COPD patients in particular, RPM saved almost $3K per patient according to an article published in the Journal of Digital Medicine.

  • Remote patient monitoring has significantly helped lower hospital readmission rates and mortality for a variety of chronic illnesses, including diabetes, hypertension, cancer, COPD, and congestive heart failure.

  • Advanced medical devices have proven successful in predicting upcoming episodes of illness for both COPD and heart failure patients according to articles published in the Journal of Respiratory Medicine Case Reports and the Journal of Current Cardiology Reports, respectively.


The Problem:


There is a growing need for technology that enables the monitoring of patients in an efficient, convenient and effective way, particularly for lower-income individuals who may not be physically close to or able to obtain care easily. Chronic diseases are both prevalent and costly, with nearly 45% of all Americans suffering from at least one chronic disease according to a study published in the International Journal of Environmental Research and Public Health. Moreover, chronic disease can have a high clinical toll, accounting for 40% of all deaths in America according to the Journal of the American Medical Association (JAMA), with heart disease, cancer, stroke, COPD, and diabetes representing the top five contributors to mortality. As an increasing number of Americans are forced to deal with chronic conditions in their everyday lives and the impact of rising medical costs become an even greater burden on patients’ minds, there is a renewed focus on developing resources and services that are both affordable and effective to monitor health.


The Backdrop:


To help facilitate this, the Centers for Medicare, and Medicaid Services (CMS) issued new guidelines and regulations in the aftermath of the Pandemic that helped eliminate some barriers to coverage of RPM services and loosened reimbursement eligibility, providing greater access for patients who could benefit, according to a report published by the Association of American Medical Colleges. Along these lines, RPM services have shown great promise in reducing hospital readmission rates and mortality for numerous chronic illnesses. For example, according to a study published in the Journal of Telemedicine and e-Health, diabetes patients with greater levels of RPM participation were found to have lower blood sugar levels at the conclusion of the program. In addition, 81% of hypertension patients enrolled in RPM programs achieved their blood pressure goal by 7 weeks on average as noted in a study from the Journal of Clinical Cardiology. Similarly, a study published in the Journal of the American Society of Clinical Oncology found cancer patients enrolled in home monitoring programs were 58% less likely to be admitted for unplanned medical emergencies than those not enrolled in these programs. Finally, advanced medical devices have proven successful in predicting upcoming episodes of illness for both COPD and heart failure patients according to articles published in both the Journal of Respiratory Medicine Case Reports and the Journal of Current Cardiology Reports, respectively.

Remote patient monitoring has also proven to be a very cost-efficient method for follow-up care and to improve the cost-effectiveness of checkups for recovering patients. For example, for every 500 high-risk Medicare patients suffering from multiple chronic conditions, health systems can save an estimated $5.2 million annually using RPM devices and software according to an article published in HealthcareITNews. A literature review published in the Journal of Value in Health had similar conclusions, finding that a review of 34 economic evaluations of RPM programs for chronic disease saved significant amounts of money in hypertension, heart failure, and COPD treatment. In fact, for heart failure and COPD patients in particular, RPM saved almost $3K per patient according to an article published in the Journal of Digital Medicine. As reimbursement eligibility for these services expands and new technologies such as artificial intelligence are combined with smaller and faster processors the applications and effectiveness of RPM are bound to increase.


Implications:


As care continues to move out of facilities driven by the need to bend the cost curve, competition, and the increasing desire of seniors to age in place, it is clear that there is growth potential in the RPM market. As the number of elderly Americans increases, especially those with chronic disease conditions that necessitate frequent monitoring, the demand for both medical devices and RPM software will continue to multiply. Moreover, as both consumers and providers become more comfortable and accustomed to the data these solutions provide, additional proof points will be developed. Many high-tech medical devices combine several of the functions that traditional vital sign or patient monitors fulfill in the hospital, because of technologies and features borne from competition that frequently yields new innovations. New software allows patients to easily access their health information and send it to their care providers. AI technology can then be applied to these newly created data sets to do population health and predictive analytics leading to improved health outcomes. For example, Cadence Health uses AI and machine learning to predict future exacerbating health events using real-time data collected from medical sensors and devices according to an article published in Athena Health Marketplace.

Of course, CMS’ guidelines and regulations also play a substantial role in the speed of this adoption, and should CMS decide that more patients should be reimbursed for their RPM medical devices and software enrollment by relaxing eligibility for reimbursement, RPM could even more dramatically impact the process of delivering follow-up and outpatient care. Moreover, while there has been some debate over the difference between consumer-grade and medical-grade devices, a study from the Journal of General Internal Medicine found that home-based measurements collected with such devices as blood pressure monitors have been found to be more reliable and accurate than measurements recorded at medical clinics and kiosks. If the demand persists and the clinical data support their effectiveness, the market competition and innovation will continue and ultimately lead to huge benefits for patients and the hospitals they are treated in alike.


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