Kevin Quinn, the new Chief Commercial Officer (CCO) for CareSimple, first entered the remote patient monitoring (RPM) solutions space in 2009, which happens to be the year where CareSimple was founded. Here’s what he has to say about what he’s seen in the industry since then, what health care organizations should know about the state of RPM today, and what they should anticipate in the years to come.
What’s changed in remote patient monitoring (RPM) since 2009?
I first entered the field of developing RPM technology in service of post-discharge transitions of care and chronic care management when I joined AMC Health in 2009. Having then worked in another industry from 2015 until I joined CareSimple last year, it’s been interesting to come back and see what’s changed since my early years of RPM program development, and what hasn’t changed.
The biggest difference I’ve noticed is reimbursement. From 2009 to 2015, we were selling RPM as a means to lower costs through enhanced clinical outcomes and greater clinical efficiencies. We were also helping care teams, and health plans, see how interacting with patients via RPM programs would improve patient satisfaction and drive meaningful behavior modification at the patient level.
Because RPM solutions enable people to live healthier lives with fewer clinical interventions, we were building our return on investment (ROI) proposition on the value of the “cost avoidance” we saw by the decrease in the overall cost of care for the patients enrolled. Although these outcomes are still being achieved today, the ROI discussion is much more meaningful when reimbursement for the services provided are also included in the evaluation.
Another significant development is that, back in those days, the biggest RPM programs were government organizations like the U.S. Department of Veterans Affairs (VA) and the Ontario Telemedicine Network (OTN). With today’s reimbursement opportunities, the pool of stakeholders that benefit from the improved clinical efficiencies and reduced cost of care that RPM programs can offer now includes individual private practices as well as large health care delivery systems and health plans.
As a result, RPM is now being implemented by more private organizations to improve care and outcomes, and to expand the geographical areas they serve — which is increasing their revenues and the volume of patients that are benefiting from RPM programs.
I’ve also noticed since my return that the industry’s key players have almost entirely been replaced by newcomers. When I first started in 2009, Care Innovations, Honeywell, Bayer/Viterion, Cardiocom, and Philips were everywhere. By 2015, companies like VRI and Vivify were also competing consistently. Most of these companies, or at least their RPM divisions, have endured significant changes in their senior leadership primarily because of a merger or acquisition, and several have exited the market altogether. As a result, the vendors leading the RPM market today are completely different than those that were in leadership positions in 2015.
What hasn’t changed?
Unfortunately, what hasn’t changed as much as I expected are the challenges we hear from prospective customers who are struggling to improve patient adherence and compliance, as well as clinician adoption. Many are reporting challenges with the devices they deploy, which is causing patients to become disenchanted with the RPM program. The absence of a solution that’s truly integrated with their EHR can also make it difficult for clinicians to participate.
Neither of these challenges should exist anymore. Current technologies and integration capabilities can and should address and eliminate them. Unfortunately, though, many RPM vendors aren’t investing the resources necessary to make this happen.
I’ve also noticed the persistence of a tendency for vendors to think these programs are all about the technology. In doing so, they often lose sight of the primary objective of RPM programs. In my opinion, the focus should be enabling clinical care teams to better connect with patients not only when they’re needed most, but also in a way that provides the greatest impact on outcomes and behavior modification by leveraging timely intervention and education opportunities with their patients.
This is a goal that RPM is uniquely suited to meet. For instance, RPM programs can provide patients with access to a “personal coach” for the first time. This lets them receive valuable insights and learning opportunities regarding their day-to-day condition, medication requirements and other care needs much more frequently than with traditional care. In the end, it all adds up to more engaged patients, fewer trips to the hospital or emergency department, and a better quality of life for the patients.
As a tool, then, RPM has tremendous potential to enable clinicians to work more effectively and to better engage patients. Yet at the same time, it is a tool — the advantages it offers don’t necessarily come automatically. It takes expertise during the implementation process to build in the kind of user-friendly interactivity that’s needed to engage patients and empower clinicians, as well.
How can RPM better meet its potential for chronic care management?
The potential for RPM has yet to be fully realized, even at a time when that potential is rapidly expanding. By empowering clinicians to take the corrective action that prevents unnecessary admissions, RPM also enables hospitals to dedicate more resources to those patients that truly need acute care. In addition, it can help facilities better manage the elective services that have been postponed so often lately, thus offseting some of their current staffing challenges.
In the past, this failure to use RPM to its full potential often came down to technology and resources. For instance, many RPM enrollees suffer from multiple chronic conditions. Unfortunately, though, the care management programs they’re enrolled in through their health plans are often focused on a single, primary condition — usually the one that was designated as the cause for a recent hospitalization.
Patients can often lose sight of other care needs in these situations, which can further jeopardize their health. Supporting them with clinicians who can leverage remotely gathered data helps ensure that doesn’t happen. But that level of support takes time and resources, especially for high-acuity patients with multiple conditions. It’s also much more difficult when RPM solutions are not integrated with the clinicians’ EHR in a way that provides easy access to data and minimal disruption to existing workflows.
This is a significant challenge, and if you will forgive the “plug,” it’s one of the things that attracted me to CareSimple. Our success, in part, stems from our ability to integrate our software with our customers’ EHR and streamline the patient enrollment, data capture, data review and documentation processes. All of this contributes to a better clinical user experience, which is leading to greater clinical adoption and an increased ability to scale our RPM programs.
How RPM is set to expand in the future
The ability to scale is quickly becoming a priority. Many organizations that do have RPM programs in place now seek to scale them up so they can handle more patients remotely and focus their clinicians on more acute and emergent cases and, in some instances, more elective procedures in their hospital settings. This is all further fueled by new CPT reimbursement codes for remote monitoring, which are making the revenue gains on these investments even more tangible and immediate.
Aside from the quality-of-life benefits to patients and financial advantages to providers, more organizations are realizing other benefits of scaling up their RPM programs, too. Doing so enables greater geographical reach, for instance, and can help address social disparities in health by better enabling them to reach and engage patients who may have historically had difficulty accessing care.
Ultimately, it’s a digital world, and patients are seeking an experience with their healthcare that’s as fast, responsive and high-quality as the many online consumer experiences they engage in every day. And the organizations who understand and embrace this today will be the leaders in their field tomorrow.