Remote Patient Guide

Introduction

There's no doubt about it - health providers are turning to Remote Patient Monitoring (RPM) solutions. Why? Because they're cost-effective, improve patient care, and boost the revenue of their practices.

RPM is a program designed to support doctors treating patients with chronic illnesses. It offers the unique benefit of regular access to patient health data. Typically, doctors rely on test results from patient visits to monitor health conditions. But RPM changes the game. It delivers valuable data to the doctor directly from the patient's home, giving doctors a much broader picture of the patient's health.

The industry saw a big shift in 2019 when changes in CPT® codes turned RPM from a struggling sector into a genuine solution for patients. It led to better patient care, safer practices, lower healthcare costs, and less government spending. Plus, it made RPM a more profitable choice for doctors, especially those with many patients suffering from chronic illnesses. RPM is a fresh way to manage chronic conditions and has many benefits over traditional care methods.

Considering investing in a Remote Patient Monitoring system? We've put together a detailed guide to help. There are many reasons to make the leap, but we've highlighted some of the most crucial factors to keep in mind..

Chapter 1: What is Remote Patient Monitoring (RPM)?

What is Remote Patient Monitoring

Even though Remote Patient Monitoring (RPM) is standard in healthcare right now, many people still don't know what it is. That's why we've written this guide: to help you keep up with the latest trends in health care and understand what Remote Patient Monitoring is all about.

To understand what Remote Patient Monitoring is, let's review the definition of RPM and its significance as seen through the eyes of three different organizations:

“The ability to monitor certain aspects of a patient's health from their own home has become an increasingly popular telehealth option. Remote patient monitoring lets providers manage acute and chronic conditions. And it cuts down on patients' travel costs and infection risk.”

U.S. Department of Health and Human Services

“Telehealth and remote patient monitoring can provide alternatives to health care provided in person at a physician’s office, particularly for patients who cannot easily travel long distances for care.”

U.S. Government Accountability Office

“...the use of connected electronic tools to record personal health and medical data in one location for review by a provider in another location, usually at a different time.”

HealthIT

With these definitions, along with our research and further understanding of the program, we could come up with our definition and share this view with both patients and practices, so they do not feel overwhelmed or threatened by RPM.

“Remote Patient Monitoring, or Remote Physiologic Monitoring, is a tool that monitors patients with chronic conditions using remote medical devices such as blood pressure cuffs, glucose meters, and weight scales. With these devices, patient data is collected daily and provided to healthcare providers to see patients’ health trends. Medicare and many private insurances allow for CPT® billing codes 99453, 99454, 99457, and 99458 to be billed for the Remote Patient Monitoring service.”

But how does RPM work?

How Does Remote Patient Monitoring Work?

RPM operates in a straightforward way that benefits patients and healthcare providers. 

It all begins when a patient with a chronic condition, such as diabetes or high blood pressure, is enrolled in an RPM program provided by their healthcare provider. They are then given a particular medical device that will help their chronic condition. These devices, which could be a glucose meter for a diabetic patient or a blood pressure cuff for someone with high blood pressure, are quite extraordinary. They are engineered to collect the patient's health data daily.

After receiving their device, the patient must use it as prescribed. For instance, a patient with a blood pressure cuff would wear it on their arm and activate it to measure their blood pressure. The beauty of this process lies in its simplicity and convenience. As the device gathers this vital data, it's automatically sent straight to the RPM provider portal. The patient doesn't need to jot down any readings or remember any figures; the device takes care of everything!

This daily influx of health data revolutionizes healthcare providers' healthcare plans for their patients. The data grant healthcare providers the ability to monitor their patients without necessitating office visits closely. They can rapidly identify any alarming trends or shifts in the patient's condition, allowing for immediate response and intervention.

This swift reaction could entail adjusting a treatment plan or arranging a telehealth appointment to discuss the patient's well-being. The capability to make these immediate changes helps providers stay ahead of any complications that could escalate if left unchecked. It's a way of making sure the patient receives the best care possible as promptly as possible.

Overall, RPM enhances healthcare delivery, making it more accessible and efficient for patients and providers alike. It ensures constant monitoring, early detection of potential issues, and more effective management of chronic conditions. With RPM, top-quality healthcare is just a device away.

Remote Patient Monitoring vs. Telehealth

Remote Patient Monitoring vs. Telehealth

Regarding remote patient care, doctors use several branches of technology when treating patients. When navigating through the different options for remote maintenance, it can sometimes be confusing what the new programs a doctor may offer and how they may differ from others.

Telehealth and Remote Patient Monitoring (RPM) are similar products that are often confused. RPM is preventative care for a patient, like someone who may suffer from a chronic illness like diabetes and needs to monitor their glucose levels daily. Telehealth is reactive care for patients suffering from an infection requiring a doctor’s visit.

But, in-depth, what are the main fundamental differences, and who qualifies?

What is Telehealth?

Telehealth is a remote type of active care that is on-demand that a patient can use to get connected to a doctor. Patients can mimic a traditional doctor’s visit from their home's comfort. This is exceptionally good for patients looking for quicker, more economical, and unrestricted visits to a doctor when they need it the most.

Mobile devices usually use an app to access the telehealth doctor network. Most patients can access telehealth from their pc or cell phone regardless of whether it’s Android or Apple. Pricing tends to be usually per visit, but some providers might have a different plan, such as membership and an additional payment per visit.

Any individual that needs access to a doctor for a non-emergency consultation about their health or any topic regarding it is a prime candidate.

The main difference compared to RPM

Telehealth and remote patient monitoring (RPM) share many similarities, but they have a few distinct differences that set them apart.

RPM offers a personalized method of interaction between healthcare providers and patients, and the best part is, it can be experienced without leaving the comfort of your own home. It allows for constant monitoring and personalized care based on the data collected from medical devices you use at home.

On the other hand, telehealth is a broader concept that employs electronic information and telecommunications technologies to provide a variety of services. These include supporting long-distance clinical care, enabling health-related education for both patients and professionals, advancing public health initiatives, and facilitating health administration.

In a nutshell, while RPM is a more focused approach emphasizing patient monitoring and personal interaction, telehealth is a comprehensive term that encompasses a broader range of remote healthcare services and administrative functions.

Chapter 2: Benefits of Remote Patient Monitoring

Benefits of Remote Patient Monitoring

It makes sense that Remote Patient Monitoring has such high adoption rates. This service has several benefits for providers and can make their work much more manageable.

Healthcare providers who use RPM to keep track of their patient's chronic health conditions can do so with little hassle. They are not limited in how they can monitor their patient's condition by visiting an institution.

Remote Patient Monitoring is becoming increasingly popular, but don't take my word for it. Here are some benefits that prove its worthiness:

1. Reduced hospital admissions

RPM reduces hospital admissions and ER visits, particularly for COPD and heart disease. Since healthcare professionals monitor patient stats in real-time, they can immediately alter medication without needing patients to visit the hospital if there’s a worrying change in blood pressure, heart rate, or oxygen saturation.

2. Increased patient responsibility

Remote Patient Monitoring devices put patients back in control of their health, which is critical to effective disease management in the long term. For example, nurses can use medication alerts to ensure that patients take their medication on time, and patients can track their vital stats throughout the day. When patients see how well their body responds to medication, they’re more likely to take it regularly and finish their treatment programs.

3. Reduced demand for healthcare professionals

Unsurprisingly, chronic conditions place a massive burden on healthcare providers. RPM helps clinicians manage their time and resources more effectively. Studies show that RPM users report a 41 percent drop in patient telephone calls and 47 percent fewer patient visits. By freeing clinical hours, doctors can concentrate on their sickest patients with less interruption.

4. Enhanced Patient Care

Remote Patient Monitoring, through its consistent measurements, provides the doctor with a complete picture of the patient’s condition. It also eliminates the possibility of elevated “White Coat Syndrome” readings. After all, it is no secret that many patients may not tell the doctor everything (intentionally or unintentionally).

By patients taking their readings regularly, in the comfort of their own home, the doctor can make better diagnostic decisions thanks to the data collected through Remote Patient Monitoring.

5. Reduced Liability for the Practice

Remote Patient Monitoring allows you and your team to take control of your waiting room- particularly in a global pandemic. You no longer have to worry about the patients who feel “a little off” or “just not right” and demand an appointment- and will then add to the waiting room population. Or, do you have a mobility-challenged patient, yet you have to insist on them coming in for an office visit to check on them regularly? Again, this possibly exposes them to Coronavirus or other illnesses unnecessarily. Remote Patient Monitoring gives you the answers you need – in either case- without unnecessary office visits.

Practitioners have the benefit of consistent information on their patient and their condition. Regular measurements allow doctors and decision-makers to consider medicine changes and diagnoses with much more information. Better informed treatment plans help reduce the risk of mistakes – and reducing errors helps to minimize liability.

6. Increased Revenue

Did you know that, on average, Medicare can reimburse your practice $2,292 (national average) for each chronic patient in your patient population yearly? It’s true! However, it can increase your revenue in other ways as well. Through specific CPT® codes, Insurance will reimburse your office $191 (on average) per month per patient simply by adding Remote Patient Monitoring to your practice.

Chapter 3: Remote Patient Monitoring Devices

Remote Patient Monitoring Devices

The benefits of Remote Patient Monitoring devices are multifaceted. In addition to the convenience factor, there are some other key benefits for patients and providers.

Providers save time and money by being able to manage remotely from home or another location instead of having to travel back and forth from work or home visits. Patients have more options for care, including 24/7 access to providers near and far.

Patients can manage their docs and schedules with virtual visits schedule. Remote patient monitoring devices can also decrease hospitalization rates because patients can stay home longer and care for problems themselves.
Blood pressure cuffs

Blood Pressure Cuff

Blood pressure cuffs calculate a patient’s heart rate and blood flow by measuring changes in artery motion. The cellular blood pressure cuff is similar to the one we’ve used at the doctor’s—the key difference is that it sends the patient data in real-time to the clinician for review.

This monitoring technology allows at-risk patients and healthcare delivery to improve outcomes for patients with chronic conditions.

The cellular Remote Patient Monitoring device blood pressure cuff has become a popular home health device. It can be taken anywhere and is more accurate than an old-fashioned manual blood pressure cuff. It is a great way to monitor your blood pressure at home, but you should always check with your doctor before you rely on the blood pressure monitoring readings.
BGlucose Meter

Blood Glucose Meter

Glucose meters test a patient’s blood sugar through a small drop of blood on a test strip connected to the device. A patient with diabetes is obligated to test their blood glucose levels frequently. If the levels are too low, they will need to eat or drink something sugary as soon as possible for their blood sugar level to rise. If the levels are too high, they will need insulin or other medications to keep them from rising even higher.

The cellular Remote Patient Monitoring glucose meter is a handy tool for any person with diabetes. This device sends the reading results instantly via cellular signal directly to their healthcare provider, and they can track the results. No longer will patients need to carry additional booklets to keep track of their readings and not lose them.
Pulse Oximeter

Pulse Oximeter

The pulse oximeter is a non-invasive clip attached to the patient’s finger (or occasionally earlobe) to measure light wavelengths that determine blood oxygen level– how much oxygen is circulating in the patient’s red blood cells.

This is done by shining an infrared light through the skin and measuring the attenuation of that light as it passes through a person’s vascular system. The oximeter then displays two values: one for the arterial oxygen saturation, which is how much oxygen is in your arteries, and one for the venous oxygen saturation, which is how much oxygen is in your veins.
Wearables

Wearables

Often not remembered as one of the RPM devices, wearables are small, lightweight devices that people wear on their wrists like a watch or their clothes like a belt.

These devices connect to smartphones or have their cellular signal and send information to the system about how active the wearer is throughout the day, how many calories they’ve burned, and more. Some wearable devices can also track an individual’s sleep patterns, which can be helpful for patients with chronic conditions.
Digital Scale

Digital Scale

Cellular digital scales enable the patient to track changes in their weight over time, and the provider monitors those changes to ensure symptoms are not worsening and, if so, intervene.

For CHF patients especially, where weight fluctuations are often a result of water retention, this is essential to spot the weight changes and gain control over patient-reported symptoms of dyspnea, fatigue, and anxiety.

Digital scales enable healthcare organizations to track weight changes directly and identify potential symptoms of fluid retention or anemia. The patient can also use the scale for self-monitoring their condition and progress against recommendations from their clinician.

Chapter 4: Remote Patient Monitoring Applications

Remote Patient Monitoring Applications

As technology progresses, so do Remote Patient Monitoring (RPM) services. Using the available tools, team members can remotely provide care and deliver better quality of service.

To examine the impact of RPM on patient care, we have found 4 of the most popular applications for remote patient monitoring.

Chronic Patient Monitoring for Diabetes

Anyone affected by diabetes knows that using a glucose meter is essential to controlling their diabetes. After all, changes in blood sugar results in many significant health issues – including some fatal.

A key aspect of controlling a patient’s issues with diabetes is to ensure the patient’s blood sugar remains at an acceptable level. Using Connected Care AI Remote Patient Monitoring for Diabetes, a physician can quickly tell if a blood sugar level is concerned.

Treating diabetes is not easy but staying connected through Connected Care AI Remote Patient Monitoring for Diabetes makes it a bit easier.

Chronic Patient Monitoring for Hypertension

Hypertension (also referred to as high blood pressure) can damage the heart and even, in some cases, be fatal. If a patient’s blood pressure becomes too high, the risk is significant for a heart attack or a stroke. Connected Care AI Remote Patient Monitoring for Hypertension makes monitoring your patient's blood pressure easy and alerts them if a fatal event is starting.

Every doctor’s visit comes with a blood pressure measurement because high blood pressure is one of the critical factors leading to many deadly incidents. But it’s inconvenient for patients to travel to a doctor’s office regularly. Now, patients can use the Connected Care AI Remote Patient Monitoring for Hypertension program, which includes an easy-to-use blood pressure cuff connected to our team of health care practitioners.

Chronic Patient Monitoring for Obesity

The chronic disease of obesity has become a significant problem in the United States and worldwide. Obesity is rising due to several factors, including eating unhealthy food, lack of physical activity, and genetic predisposition. The prevalence of obesity is a significant concern for healthcare providers, who are tasked with improving the quality of life for these individuals by lowering their weight.

With Connected Care AI weight scale, health care providers can monitor sudden weight changes and quickly respond to patients' needs.

Chronic Patient Monitoring for COVID-19

With COVID-19 treatments, it is critical to know your health care statistics, especially with oxygen. Monitoring COVID-19 conditions are crucial in treating this deadly disease, and Medek RPM’s health care practitioners can ensure that COVID-19 patients receive that urgent care.

Even though COVID-19 is not considered a chronic condition, Remote Patient Monitoring can be used to ensure a patient’s care is managed at home and not in the hospital. The best way to use that is through Connected Care AI Remote Patient Monitoring for COVID-19 and its connected pulse oximeter because COVID-19 mainly affects the lungs.

Chapter 5: Financial Considerations for a Remote Patient Monitoring Program

Remote Patient Monitoring Applications

Patient care is always top of mind, but as most providers understand, taking care of the bottom line must also be addressed. CMS also understood this dynamic and allowed for a complete rewrite and addition to the existing RPM codes.

The new codes allow an additional $191 monthly billing per patient (national average). The financial benefits can be staggering if you practice with many Medicare patients with chronic conditions. Remote Patient Monitoring is issued monthly means revenue consistency over time.

With the benefits of Remote Patient Monitoring covering both patient and provider, it is a must for every practice working with Medicare patients.

Stakeholder Support

A recent report by Research And Markets, released in April 2023, predicts that the RPM sector will grow by a significant 60%! The market value, which was $9.55 billion in 2022, is expected to hit an impressive $15.2 billion by 2028.

Beyond these cost benefits, RPM offers patients the convenience of access to continuous professional medical care and monitoring in the safety of their own homes.

Remote patient monitoring will provide a new generation of healthcare tools and processes that radically reshape chronic care management.

Medicare CPT® Codes

By providing Remote Patient Monitoring, also known as Remote Physiologic Monitoring, a practice offers better healthcare and improves healthcare practice revenues. Physicians can monitor patients with diabetes, hypertension, COPD, and other chronic diseases using connected devices remotely and receive reimbursement through CMS’s CPT® codes for Remote Patient Monitoring.

CPT® Code 99453

Initial set-up and patient education on the use of equipment

Using CMS CPT® Code 99453, physicians will be reimbursed simply for starting a Remote Patient Monitoring service, also known as Remote Physiologic Monitoring. Using CPT Code 99453, CMS returns approximately $19 to set up connected scales, blood pressure cuffs, glucose meters, and more per patient. The reimbursement also pays to train patients on how to use the connected devices to help monitor chronic illnesses like diabetes, COPD, hypertension, and even some acute diseases like COVID-19.

CPT® Code 99454

Device supply with daily recording and programmed alerts

Under CMS CPT® Code 99454, physicians are reimbursed for the daily monitoring of patients using Remote Patient Monitoring, also known as Remote Physiologic Monitoring. Every day patients use their connected devices – such as scales and blood pressure cuffs for hypertension, oximeters for COPD, and glucose meters for diabetes – and healthcare data transfers to care professionals, showing the physician critical changes in a patient’s illness and allowing for new treatments to start before it becomes critical

CPT® Code 99457

The clinician spends 20 minutes in a calendar month on care management services.

With CMS’ CPT® Code 99457, physicians are reimbursed for doing what is at the heart of the practice – working with patients. This reimbursement does not require a patient visit. It is 20 minutes combined over one month to ensure the data being provided keeps the patient healthy while receiving treatment for chronic conditions such as diabetes, COPD, and hypertension.

CPT® Code 99458

The collection & interpretation of patient data by QHCP; minimum 20 min/month

While CMS CPT® Code 99457 reimburses physicians for the first 20 minutes of patient interaction, CMS CPT Code 99458 covers the additional time needed to properly care for patients with Remote Patient Monitoring, also known as Remote Physiologic Monitoring. This ensures patients treated with chronic illnesses and conditions such as diabetes, hypertension, and COPD can receive extra care by the team of care professionals working through remote patient monitoring to keep patients healthy.

Chapter 6: Choosing a provider

Choosing a provider
Even with all the information you've gathered about what makes a solid Remote Patient Monitoring program, you still might end up with one big challenge. Many organizations have found themselves with a lot of options to choose from when it comes to selecting a system. To simplify things for you, we’ve outlined five questions to help make your decision much more accessible.

What RPM services are you interested in offering?

Specialty organizations need a system that supports RPM equipment to collect and interpret patient data.

Every doctor has a different clinical focus. Cardiologists, for example, might be more concerned about blood pressure and weight. Many general practices will want to consider what services they're offering and choose RPMs that allow them to serve their target patient base and provide the treatments they are interested in.

It's not unusual to see organizations launch a Remote Patient Monitoring program for a specific condition. As the organization and its staff get more comfortable with their RPM program, other services may begin to be offered.

What are the RPM setup and usage difficulties?

Some RPM providers will provide organizations with the system and instructions, requiring them to do all or most of the setup work. Other vendors can provide setup support that will help your team. This includes answering questions and addressing barriers that could hinder the process.

If providers find an RPM system too hard to use, they might stop using the program and discourage others from implementing it.

A more complex system may not be flawed considering your team size and the RPM provider you're considering investing with. Before making any decision, it's best to ask whether they provide ongoing training and support.

What are the options for RPM equipment?

Your choice of RPM equipment will depend mainly on your available types and systems. This is important because it can significantly affect your RPM program's success.

Some providers will require that you provide patients with the provider's equipment to use the RPM system. Some also offer the option of "bring your own device" (BYOD) and choose whichever devices from different vendors are perfect for your hospital or company.

Depending on your needs, one option might be more beneficial at the beginning or later stages of your RPM journey.

What is the RPM coding and billing process?

Your monitoring provider will dictate coding and billing accuracy. With some providers, coding and billing may be included in the price, while others will let your team handle this responsibility. Asking providers how their RPM system supports coding and billing can help set up expectations for your team and plan accordingly. Regardless of either choice, a sound RPM system will make it easier for you.

You must be able to bill accurately and efficiently to minimize your staffing costs. This will maximize your earnings after paying the RPM provider for its service. The provider fees may depend on the program you use and can include pricing for the devices themselves, software hosting, customer support for your organization and patients, and cellular service.

Chapter 7: Executing a Successful Remote Patient Monitoring Program

Successful Remote Patient Monitoring Program

Patient buy-in is essential to having an effective Remote Patient Monitoring (RPM) program. To do that, you need to empower patients by educating them on the nuances of RPM and the benefits for your health and theirs. To ensure its viability, you need patients to agree to be monitored and continue their monitoring over time.

Educating patients on remote home monitoring is critical and making them aware of your RPM program. Here are a few ways to do it:

Patient understanding

The first step in any conversation should be for you to understand the patient’s conditions and all external factors that might influence their health.

When patients go in for a consultation, you first should find out as much information about their health as possible. This includes their family history and other external factors like pollution or stress that may affect their health. You will then be able to provide personalized treatment options tailored to them with RPM.

Once you understand their health history, you should make a health goal plan for the patient. This will vary from patient to patient due to different conditions but might include a diet plan, exercise regimen, skincare routine, and education about the common triggers for their condition.

A clear, realistic, and attainable goal is essential so the patient will not get discouraged. When creating the plan and health goals, having frequent milestones will make the journey easier for the patient.

Communication

Once you have all the necessary information to assist the patient better, communication is the next step. The patient must understand that this is for their betterment.

Effective communication is the key to establishing an effective physician-patient relationship. When a doctor and patient communicate, there is a better chance that the patient will understand their treatment plan and be more receptive to the medical advice. We recommend treating the 5 Cs of communication as a checklist when communicating:
  • Clarity
  • Cohesive
  • Complete
  • Concise
  • Concrete
Nonverbal communication is as important as your words to show and deliver the right message. Nonverbal behavior includes eye contact, facial expression, gestures, and posture. Your nonverbal behaviors can reveal more than you might realize, and verbal communication can seem incomplete without it.

Information

Patients need to be informed of their treatment options before making a decision. You are in charge of presenting the available options and answering any questions about those treatments.

All concerns are valid, even if they might not make sense to you. Problems can be due to previous experiences, ignorant views, or misunderstandings.

Some concerns that might come up with patients can be:
  • What is RPM?
  • Is RPM Secure?
  • How will this help me?
  • Does this cost me anything?
  • Will my insurance cover this?
  • Will I receive any support in using the devices and taking vitals?
As time goes by, you will be more comfortable sharing the answers with your patients and even be able to answer new questions once you know all the services. Your current RPM provider should be able to provide some solutions that might be specific to your RPM service.

No, no, no!

We must recognize that there will be patients who refuse to enroll in the RPM program, even when the benefits for their health are clear. There are many reasons why someone would refuse to enroll in the program, but some of the most common reasons are that they do not believe in the program, do not want their vitals taken, or have misconceptions about the program or the technology.

We know that these changes are causing many patients to feel uncertain and uneasy. You want to take the time to understand their fears and pain points so that you can continue providing them with excellent customer service and making sure they reach their health goals. Some tips to overcome no’s are:
  • Leading With Empathy
  • Practice active listening
  • Repeat back what you hear
  • Validate your prospect’s concerns
  • Asking Thoughtful, Open-Ended Questions

Communication helps the patient achieve their health goals and your practice in many aspects. With the Medek RPM team, we will provide educational training to you and your team before rolling out your RPM service.

We want to ensure that you know how the product works and what it does. This ensures that you are comfortable with the service and understand how to use it for maximum benefit.

A final word

A final word

It's not hard to see; Remote Patient Monitoring is here to stay. Even without a global pandemic, these services have been evolving for years and are very important. Improving access to RPM will lead to better health outcomes and good savings for the Medicare system.

As practitioners and patients become more knowledgeable about remote patient monitoring, technology will likely become even more sophisticated. This would result in the practice becoming even more popular, despite its current high adoption rate.

This is fantastic news for companies and represents a substantial growth opportunity for those that make the most of it. It's worth emphasizing, however, that success requires a good software partner to help you steer your way through this change.

As more and more government and commercial payers support RPM services, patient demand is snowballing. Now it's up to you to make sure your organization is ready.

We can support and help your organization get started today with Connected Care AI.