Keys to Effective Remote Patient Monitoring in the COVID-19 Pandemic

COVID-19 has impacted our health system in some very clear ways and in ways that we are only beginning to predict the longer term impacts. It has led to exhausted clinicians, delayed care or treatment for patients with non-COVID-19 health issues, and many more stresses on our health ecosystem.

The pandemic has also forced many changes on the health system, some of those which may actually result in better patient care now and post-pandemic. One of those positive changes is the growth in Remote Patient Monitoring (RPM) , digital health, and virtual visit solutions for chronic condition management, behavioral health, and other non-emergent episodes of care.

The coronavirus pandemic has been a game-changer for RPM. As stressed health systems limit in-person care to mitigate COVID spread, RPM has become a viable option for patients who still need regular critical support from health care providers.

The CDC estimates that telehealth use rose by 50% in just the first quarter of 2020 and 154% in the last week of March 2020 alone. While telehealth has been an important tool in maintaining connection to healthcare professionals during the pandemic, clinicians seeing patients over a video link are missing data like blood pressure, weight, sleep, physical activity, etc., that would normally be collected in person.

RPM solutions can enable clinicians to collect this important information while still meeting with patients remotely. While the near-term benefit is reducing the risk of the patient contracting COVID-19 in the healthcare setting, the long term benefits of RPM are that it can improve quality of care, reduce costly ER visits, and potentially improve health outcomes. With the drive to value-based care in government supported health plans, these measures are particularly important.

Health organizations that had RPM solutions in place pre-pandemic have been more successful at scaling up than organizations that were starting from scratch during the pandemic. Before the pandemic started, organizations deploying RPM were able to get into people’s homes to set up monitoring tools and show them how to use the new technology. They had time, whether in person or remotely, to onboard patients, coach them on self-efficacy in managing their condition, and empower them to play an extremely active role in the daily management of their health.

Both clinicians and patients had time to get comfortable with the RPM tools and processes, which made them more effective and useable once the pandemic made them necessary. They also were able to learn what worked, what didn’t and make updates to their onboarding approach and the efficacy of their overarching solutions accordingly. With clinicians already at a certain comfort level, taking an RPM program and expanding it to a larger patient population would be relatively easy in comparison to rapidly launching and scaling a new RPM solution during the pandemic, when both patients and staff would face a steep learning curve without access to training, troubleshooting support, and other necessary tools due to the rapid uptick in demand.

Given the persistent duration of the pandemic and the continual increasing need for remote monitoring, examining pre-Pandemic success criteria and transferring them into Pandemic-era practices can help make your remote patient monitoring programs successful despite the challenges, and position them for continued use post-Pandemic.

Lessons Learned from Pandemic-era RPM Rollouts

In spite of the challenges of the pandemic , it is still possible for health care organizations to successfully launch and scale RPM programs, with a little patience and determination. Some key learnings that are already emerging include:

• Solutions informed by research on barriers and obstacles ensures utilization - A truly successful RPM solution will be preceded by research on barriers or obstacles related to utilization for both patients and clinicians so they can be mitigated for the best possible outcomes. These barriers and obstacles may be psychological, social, environmental or motivational and the design of the solution should help patients to overcome them.
• Solutions that connect with devices people already have are going to do better - Leveraging the screen that a patient is already familiar with (like their own smartphone or tablet) will make adoption easier than introducing a new device with an unfamiliar interface.
• Integration with other digital health tools supports success - Linking out to or integrating with other clinically-relevant digital health tools and applications that may address co-morbidities or related lifestyle behaviors through partnership and new agreements will also support patient success, particularly if they are with programs patients are already using.
• RPM devices that are integrated into the flow of care are more effective - RPM data collection needs to be paired with regular contact with clinicians and health coaches, and the data must flow to the patient’s physician so they are in the loop and are set up to reach out and intervene as necessary. Special attention needs to be paid to updating relevant EMR data as well as a process for handling emergent situations.
• Remote training, coaching, and support are critical to adoption – As the pandemic endures, designing and implementing effective remote training, coaching and support will be critical. A broad return to in-person engagement between clinicians and patients is still a way off and identifying ways to replicate this in-person experience virtually will be important to adoption of the solution. Longer term it will position your program for broader reach to patients who may be distant from clinics are lack transportation.
• Consider the digital divide – As COVID has highlighted the disparity in access to healthcare via technology, it is important to consider how you might make the RPM solution accessible to all the segments of your target patient population. Depending on the chronic condition the solution addresses, it is very possible that the condition may occur at a higher incidence in more vulnerable populations. With CMS relaxing guidelines of what insurance companies could give to members last year, this introduced some opportunity to fill this gap by enabling insurance companies to provide technology to their patients who lacked it. Exploring these and other novel solutions to bring RPM to the patients who need it most can help you overcome the digital divide and improve patient outcomes in an equitable manner.

Healthcare Organizations Innovating in RPM

There are a number of healthcare organizations already innovating creative ways to care for patients without seeing them face-to-face.

Insurers like Humana are focusing on addressing Covid-19 gaps in access to care that are being experienced by people with a chronic condition by helping them to receive the care they need in a virtualized environment including the set-up of remote patient monitoring solutions.

RPM and digital health solutions have the potential to help transform health care, by providing access to needed tools and resources in the home - giving patients a more active role in their own health maintenance and empowering them to make focusing on wellness part of their daily routine. COVID-19 has forced some health organizations to turn to RPM unexpectedly, but with the right approach, embracing RPM and digital health solutions could improve the health of many over the long term.

Amy Heymans, founder and chief experience officer, Mad*Pow and Tiffany Mura, VP Client Experience & Strategy, Health, Mad*Pow.