Should I consider a RPM program in the COVID-19 reopening phase?

States are gradually opening back up all operations, but the COVID-19 pandemic is far from over.  For months, practices overcame loss of revenue, dramatic capacity constraints, and reduced patient visits. Unfortunately, the reopening of states  & ramping up phase doesn't mean that physicians practices should expect operations to resume as normal.

COVID-19 is here to stay for the foreseeable future. The first thought that some managers at outpatient treatment facilities have are, “It’s not a good time to consider any new programs.”

This is a completely understandable position. However, there can be substantial benefits to practices that are able to launch a remote patient monitoring program during their ramp-up phase. Even under normal circumstances, launching a successful program may not be feasible without adequate support. With the right RPM partner, launching a program during the reopening of states can be an asset to your practice.

Problems Caused by COVID-19

Practices in Seattle (where we're headquartered) and other places hardest hit by COVID-19 have reported many of the following issues, all of which have potential to be disruptive:

First, a significant number of patients are cancelling appointments that are not urgent. While this makes sense, it’s leaving a large number of people with reduced healthcare, and their conditions are not going away. At the same time, these cancellations can be taxing on the finances of the practice, both due to increased administrative costs and reduced revenues.

Second, the number of staff who are available to see patients will most likely decrease. As healthcare professionals become more and more exposed to patients carrying COVID-19, some will inevitably succumb to the virus and be forced to quarantine themselves. As a result, the remaining healthcare workers in that community will become overworked, being asked to do more with less.

Lastly, when COVID-19 hits a community, there can be a sharp increase in the number of phone calls received by the practice. This anxiety escalates as people start to realize that they know people who have tested positive, and try to seek testing for themselves and loved ones.

Reasons to Consider Remote Patient Monitoring

Given these problems, a well-designed remote care program can help to alleviate them in a several ways:

1. Maintain relationships with patients who don’t have COVID-19. A remote care program can help practices stay engaged with, and treat their patients, even if they are not able to come into the practice. This engagement helps patients feel cared for, even if they are cancelling their in-person visits. While some things can wait, patients’ chronic conditions cannot. Chronic conditions are not going away and still need to be monitored. With the COVID-19 crisis predicted to last quite some time, these conditions will need to be managed. Social distancing may lead to other negative impacts for most at-risk patients, such as an increase in depression and anxiety, increased difficulty managing their medications (e.g. if they normally receive help from a family member), or a reduction in physical activity.
2. Treat patients who have COVID-19. If the predictions hold, nearly every practice in the country will find themselves with patients who have tested positive for COVID-19. While it’s possible in the early stages of an outbreak to refer patients elsewhere, specialists will become overburdened and all practices will likely need to provide care. In this case, remote patient monitoring and telehealth provide a means for monitoring patients who are at greatest risk during their period of self-isolation; protecting staff and patients alike. For example, a patient with hypertension could be monitored remotely with a pulse oximeter for potential respiratory failure. This could be done by a clinic. Alternatively, it could be performed by a subcontracted clinical call center that is trained to notify the practice, the patient and emergency personnel if needed. Even if subcontracted, this could potentially be reimbursed through an unlimited number of 20-minute interactions (99457, 99458).
3. Add bandwidth to overburdened staff. Medical practices are normally extremely busy places. COVID-19 threatens to push internal staff resources to the limit. One often-overlooked benefit of Remote Patient Monitoring (RPM) and Chronic Care Management (CCM) is that it can be used to bring in outside resources. Because these programs are listed as being under general supervision, remotely-located Qualified Healthcare Providers (QHPs) or clinical staff (e.g. RNs, LPNs, MAs) can help an overburdened practice provide remote care services, with those services being billed through the original ordering physician. This model became available in 2020, and the timing couldn’t be better. Well-established RPM companies, like optimize.health, already have partnerships with clinically-focused call centers that are ready to add bandwidth to overburdened practices anywhere in the United States where resources are already stretched thin.
4. Protect your practice's finances. Many practice's finances are taking a hit as patients are cancelling their routine visits. Remote Patient Monitoring provides a means to generate additional income. Because there is reimbursement carved out specifically for the technology component of the service, Remote Patient Monitoring programs can be more profitable than traditional telehealth services.

Should I consider a program now?

It’s never the perfect time to set up a new program of any type. On the one hand, preparing to deal with COVID-19 is a lot to manage for any practice, and launching a new program may seem like a distraction. On the other hand, you might not be able to afford not to. If you run or manage a medical practice you may want to ask yourself a few questions to help make the right decision:

• Do I have a way to engage and treat patients who are stuck at home?
• How long can my practice survive like this financially? Can my practice sustain this method of operations for up to 12 months?
• Will I have enough bandwidth to run my practice if key staff members are out for a 2-3 week period?
• Do I have a good system in place for managing an increase in phone calls?

What should I look for when evaluating RPM vendors?

The right remote patient monitoring vendor will be more than a software seller, they will be a partner. optimize.health’s client success team is run by Registered Nurses who will take responsibility for training your team and helping to manage the program. Our clinically-focused call center is staffed by RNs and is overseen by a MD. Without the right support, a remote patient monitoring program will feel like a distraction. A well-designed remote patient monitoring program can be an added resource that can help your practice survive this crisis.