Monthly Writings

Evaluations and reviews of the latest in the field.

5 Enablers Needed for RPM Success

To be successful, RPM systems need to to be designed with the best design & implementation practice

Summary

  • Remote Patient Monitoring (RPM) is a telehealth innovation with significant opportunity for early intervention and prevention of disease exacerbation.

  • Most of the attention has been on development and design of RPM technology.

  • Clinical and cost-effective benefits have produced mixed results to date.

  • The following 5 areas have been identified for successful RPM interventions.


Review

5 ENABLERS NEEDED TO DECREASE ACUTE CARE USE WITH RPM

APPROPRIATE PATIENT SELECTION:

  • Appropriate patient selection for RPM is crucial.

  • The target population for RPM should be those at high risk for hospitalization, NOT all patients

    • Patients with moderate to severe disease

    • Multiple co-morbidities

    • High likelihood of multiple hospitalizations

  • The first 90 days post index event are the highest periods of high-risk readmission

DETECT PREDICTABLE DISEASE DECLINE

  • RPM needs to accurately predict disease exacerbations by detecting TRUE changes related to health deterioration.

  • Conditions with unpredictable disease progression (e.g. COPD, heart failure) may be challenging for RPM systems.

A NEW CARE MODEL:

  • A response system which provides timely care

  • RPM alerts must be timely and appropriate.

    • This requires a dedicated care team actively reviewing data and improving response times

  • Automated data entry is preferred to decrease errors and delays

    • If manual data entry must occur, it needs to provide ease of use and efficient data entry

    • Will require regular monitoring to ensure data is entered.

  • Ability for bi-directional communication

INDIVIDUALIZED PHYSIOLOGIC THERSHOLDS:

  • Using individual data to determine alert thresholds for each patient.

  • Determine appropriate risk level and parameters for each patient to enable the clinical team to be appropriately alerted

  • Alert thresholds need to be sensitive enough to identify true physiologic changes without being too high.

    • Ideally, tailored to the patient and their disease state.

ENHANCED SELF MANAGEMENT:

  • Education:

    • Patient and caregiver for increased awareness of signs and symptoms of disease progression

  • Ongoing support

  • Shared decision making

  • Avoid patient being “lost in the data”

  • Building rapport

Conclusions

  • To be successful RPM needs to be coupled with a new model of care rather than simply implementing a new technology.

  • RPM interventions have the potential to reduce acute care use when targeted to the appropriate population, designed well and implemented with patients and providers in mind.

Contact me to learn more about optimizing your Telehealth Strategy

Erkan Hassan