CTeL panel recap: Expert insights about RPM data management
Remote patient monitoring platforms collect vast amounts of data that can guide clinical decision-making and lead to more personalized, preventive care in the home. But to optimize RPM strategies, healthcare organizations must make sure the data they collect is meaningful and actionable, supported by a virtual staffing operating model that is efficient and scalable. Thoughtful monitoring, assessment and escalation strategies can make all the difference.
A recent panel discussion hosted by CTeL Digital Health shed some light on this critical topic. The panel featured Dr. Stesha Selsky, RN, DNP, a nurse informaticist at UCLA Health and Simon MacGibbon, CEO and co-founder of Myia Health. The following recap highlights best practice RPM guidelines to help your organization optimize patient outcomes through data-driven insights and technology enabled productivity.
Customize RPM monitoring parameters for each patient population
Every patient population has different needs. The most sophisticated RPM platforms are customizable to capture multiple patient parameters and attributes and support a variety of escalation protocols. This technology allows clinical teams to manage large patient populations efficiently, including patients with multiple comorbidities. Predictive Machine Learning (ML) risk models can reveal which patients offer the best potential for engagement with RPM and what data is needed to meet their needs.
Don’t go overboard on data collection
MacGibbon urged health systems using RPM to prioritize data collection intelligently, so they aren’t driving futile work and useless interventions.
“Some RPM platforms are alert-based, and others drive insights,” he explained. “Let’s take a patient with Type 2 diabetes as an example. An alert system will report blood glucose levels continuously so that the care team is alerted every time the patient is out of range. An insight system can show that a patient has been out of range 50% of the time in the last month. Insight systems tend to lead to better care [for lower acuity patients].”
Find efficiencies where you can
Doctors, advanced practice providers and nurses are stretched thin in today’s healthcare setting. Your RPM solution must have built-in efficiencies that drive productivity and save time. Selsky and MacGibbon offered these tips:
Determine how many RPM patients your team can manage, and develop protocols to prioritize which medically vulnerable patients can benefit most from RPM.
Stratify RPM patients according to their acuity level and use a tiered system. Patients with acute needs require a lower patient-to-provider ratio.
If you don’t have the funding, time or resources to create a centralized triage center, partner with a third-party clinical services partner to manage the monitoring and triage and escalate only when necessary.
Develop escalation protocols that empower treatment team members to act on alerts when appropriate (ordering labs, tweaking medication doses, etc.).
Automate everything you can — don’t have a human do what a computer program can do safely and efficiently, e.g., patient engagement, symptom capture
Efficiencies will streamline RPM workflows and enhance clinical decision-making. It will also help your organization scale up and achieve a return on investment — without creating an undue burden on clinical staff. MacGibbon cited a statistic that Mercy Health, a Myia customer, have driven an 80% increase in patients on an RPM based program without any increase in clinical headcount.
Assign RPM responsibilities appropriately
Remote patient monitoring should be a collaborative effort in which each care team member works at the top of their license when engaged in RPM tasks. Selsky pointed out that much of the routine work that RPM involves is logistical rather than clinical in nature.
“Someone has to inventory the devices, educate patients on how to use them, make sure patients do what they are supposed to do at home, troubleshoot technical issues and make sure patients return the devices,” she said. “When doctors and advanced practice providers do those non-clinical tasks, it can contribute to burnout.”
Develop a triage system
Not every home-based blood pressure reading or EKG result must be escalated to the care team right away, Selsky said. “Hospitals should have a well-trained triage provider who works in the clinic setting or for the RPM provider,” she explained. “When an alert comes in, the triage provider might ask the patient to redo their vitals and have a conversation with them about their symptoms, then decide whether to escalate to the care team.”
Escalate intelligently
Next-generation operating systems feature a clinical intelligence layer. It provides real-time insights and specific guidelines that inform the decision to escalate to the care team.
The goal of escalation is to make a clinical intervention. MacGibbon pointed to a statistic that as much as 90% of physiological RPM alerts may not result in a change in care. But a range of approaches can reduce the noise from alerts, for example: with multi-parameter alerting (physiological data plus patient-reported symptoms), alert specificity increases by 250%.
Work with a partner that can integrate your organization’s RPM platform and electronic health record
RPM and EHR platforms use different operating systems and workflows to achieve different goals, and seamless integration is not always possible. But a sophisticated RPM will allow for bi-directional integration. MacGibbon suggested a benchmark of 90/10: A nurse managing a patient with RPM should be able to do 90% of tasks in the RPM platform. The other 10% may be spent in the EHR — writing prescriptions, ordering tests or doing other tasks that the RPM system doesn’t handle.
“It’s important for the EHR and RPM platforms to talk with each other since the EHR is the patient’s master record,” MacGibbon said. “But remote patient monitoring requires a different toolset than the EHR to keep eyes and ears on thousands of patients at once. RPM is more than a technology platform — it’s the power behind a new model for health care that’s helping hospitals achieve better patient outcomes efficiently, effectively and with minimal strain on the clinical team.”
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A collaborative relationship with the right RPM partner is essential. Myia’s complete virtual care platform delivers scalable solutions that connect clinical actions with patient outcomes. Contact us today.