Thanks to the proliferation of efficient and affordable remote devices, patient monitoring in the service of everyday care delivery has skyrocketed in recent years. For providers looking to expand their offerings to senior care, or to more effectively treat chronic or other high-acuity patients, here’s a rundown of the difference between inpatient and outpatient remote monitoring devices and platforms — and how each is being used to drive cost savings and operational efficiency.
What’s the difference between inpatient and outpatient remote monitoring?
When it comes to patient monitoring, the difference between inpatient and outpatient is based on the same criteria as all other aspects of care. Generally, inpatient refers to care or procedure(s) delivered in the hospital, while outpatient is anything that doesn’t require hospitalization. Another distinction of inpatient is that patients must stay overnight in the facility; same-day discharges do not qualify.
Despite this fundamental difference between inpatient and outpatient care, monitoring is often a critical tool in both settings. Remote patient monitoring (RPM) has become the platform on which at-home care is based, especially for chronic care patients. And close patient monitoring is also standard for much inpatient care, especially for high-acuity patients, or those recovering from serious accidents or complex surgical procedures.
Need a primer on telehealth terminology? Get a definition of RPM, telehealth and other key terms here
On top of that, inpatient monitoring is increasingly delivered by devices that are often associated with remote care. In fact, the greater availability of remote blood pressure monitors, glucometers and pulse oximeters. and other devices that offer monitoring on a continuous or near-continuous basis has been a key component in the ongoing shift from hospital to long-term care (LTC), skilled nursing facilities (SNFs) and home health settings for high-acuity and chronic patients.
In addition to monitoring vitals like blood pressure and heart rate for at-risk patients, remote devices help providers manage patients recovering from minor surgeries and lesser-acuity conditions. For instance, diabetic patients can be more closely monitored with the help of remote weight scales. And remote spirometers are helping respiratory therapists better manage patients with COPD, emphysema and similar conditions.
Looking for more info on medical devices? Get an intro to RPM devices here
So, the primary difference between inpatient and outpatient monitoring is specifically how they’re used. Here’s a closer look at the details, and where RPM fits it.
Inpatient care describes an overnight stay in a hospital. Of course, it could also be a much longer period; some procedures require weeks of close monitoring as a follow-up, for instance. While that care is increasingly being delivered outside of the hospital to help manage costs, there is still considerable patient monitoring that happens on an inpatient basis.
For instance, close monitoring is customary following complex surgeries and medical treatments, or in other cases where the patient is considered to be high-risk, like acute illness or the onset of a chronic condition. Rehabilitation from traumatic injury or substance abuse may also be conducted in an inpatient basis (but is more often shifting to LTC facilities). Childbirth is also considered inpatient care that may also require close monitoring.
Also known as ambulatory care, outpatient care refers to all care that doesn’t require the hospitalization of the patient. This includes most non-hospital care, including long-term care and SNF stays, clinics, surgical centers, urgent care facilities, rehab centers, and a variety of other settings. (Under Medicare, stays in some these facilities may qualify as inpatient care, depending on the patient and situation.)
From a patient perspective, outpatient care can be appealing because it usually has fewer fees associated with it. Hospital stays can be expensive, and patients often have to pay a portion of those stays, even Medicare enrollees. So, outpatient care can be a way for people to receive crucial care not only more comfortably, but more affordably, too.
Outpatient care isn’t always at home or at a nursing facility, though. It also includes hospital-based procedures, including x-rays, emergency room visits, Annual Wellness Visits (AWVs), bloodwork and other in-hospital care or consultations — as long as it doesn’t require an overnight stay.
Remote patient monitoring (RPM)
The monitoring of patients on an outpatient basis is called remote patient monitoring (RPM). With the use of remote devices and a telehealth platform that includes video-enabled chat, clinical teams can keep watch over the vital signs and other essential information of patients who are in a long-term facility or even at home. Ideally, the system they use will organize data in a way that organizes data and helps caregivers more easily spot trends, helping to enable more interventive care for better outcomes.
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The use of RPM has grown considerably in recent years, due in no small part to the expansion of the reimbursable services that use RPM by the Centers for Medicare and Medicaid Services (CMS). The trend intensified during the Covid-19 pandemic, with remote monitoring enabling organizations to treat patients at home, instead of in the riskier inpatient setting.
Today, all types of care providers from hospital systems to private practitioners utilize remote patient monitoring solutions to improve their capability to treat creatin types of patients — especially seniors, high-risk patients, and those with chronic conditions.
Patient care models that use outpatient/remote monitoring
Remote Patient Monitoring (RPM)
As defined by CMS guidelines, Remote Patient Monitoring (RPM) covers the outpatient monitoring of patients with a variety of conditions. CPT® codes 99091, 99453, 99454, 99457 and 99458 cover the setup and use of devices, as well as patient onboarding and monthly consultations (also delivered remotely). You can find all the details on current RPM reimbursement codes and amounts here.
Chronic Care Management (CCM)
Chronic Care Management is another model of care that uses outpatient monitoring for the treatment of patients with two or more chronic conditions. CPT® codes 99490, 99491, 99487 and 99489 and HCPCS code G0506 cover processes and procedures like care coordination, patient management and monthly consultations. You can get more details on current CCM reimbursement codes and amounts here.
Transitional Care Management (TCM)
Because it reimburses care for patients during the immediate period of discharge from an inpatient facility, Transitional Care Management is a key example of outpatient monitoring. CPT codes 99495 and 99496 cover the creation and management of a personalized care plan for each patient, along with regular communications. Get more details on current TCM reimbursement codes and amounts here.
Principal Care Management (PCM)
Principal Care Management uses RPM for the treatment of patients with a single high-risk disease for at least three months, during the period that follows Transitional Care Management. CPT codes 99427, 99426, 99425 and 99424 covers the creation of care plan and time spent in patient consultation. You can find all the details on current PCM reimbursement codes and amounts here.
Remote monitoring is also the basis for many hospital-at-home (HaH) programs, which offer reimbursement for providing at-home care for patients who would normally be treated on an inpatient basis. Since Covid-19, CMS has encouraged hospital-at-home programs even further with the Acute Hospital Care at Home program, which waives Medicare’s 24-hour on-site nursing requirement. Read more about how RPM helps deliver HaH programs here.
Looking for a remote monitoring solution? Don’t miss our guide to choosing the right RPM services
Find your RPM solution with CareSimple
At CareSimple, we’re proud to offer RPM devices and technology that helps providers maximize their outpatient monitoring capabilities. Contact us today to see how we can put our expertise to work for your organization.
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