June 20, 2020, by Surendra Saxena
Introduction:
It took an epidemic to drive disruptive digital innovation in an Industry so used to episodic high touch interventions.
Consider that in 2016 adult patients in the US made 883.7 million visits to a physician’s office of which over 54.5% were to a primary care physician. The most common diagnosed complaint – cough and essential hypertension and other symptoms related to chronic diseases such as diabetes. There are over 157 Million chronic patients, 81 Million are co-morbid and over 30 Million have 5 or more chronic conditions. Chronic disease care sucks two thirds of the US healthcare spend, or over $2 Trillion annually.
Chronic conditions are impacted by lifestyle, social determinants, physical activity, diet and compliance to medication. The conventional episodic intervention based care does not bode well for managing chronic patients.
Chronic patients need constant reinforcement and healthcare teams need to be enabled, engaged and empowered to partner with them. Digital health can play a significant role in helping patients and care teams manage their condition by providing better insights into factors contributing to their current health situation.
As Healthcare systems move to value-based care they need care coordination solutions that provide patients right reinforcement with a lifeline to care teams at a moments notice should their chronic condition de-compensate. Care coordination not only streamlines patient care, proactive engagement improves both quality as well as patient outcomes and helps reduce the cost of patient care.
Wireless enabled inexpensive monitoring devices collect patient vitals and transmits them to the care teams who now have better insights and can direct care appropriately. Remote Patient Monitoring enables proactive interventions and patient care.
Remote Patient Monitoring solutions need to blend seamlessly into existing care coordination processes. The solution requires:
- A System of Intelligence: Care teams need more context about a patient’s current situation to respond proactively and intervene before an episode. Remote Patient monitoring with monitoring devices wirelessly tethered to an App on a smartphone provides care teams the needed context. A system of Intelligence analyzes physiological vitals and alerts care teams if an intervention is called for. It provides insights into factors that contribute to disease condition through longitudinal reports and correlates that bring out poor lifestyle, choices or lack of compliance as impediments to improvement.
- Stratifying Patients by Risk: A system that provides real time visibility and insight into patient’s condition and then stratify patients by risk allows the already stretched care teams to direct attention to patients who need it most.
- A System of Engagement: A system that enables patients to comply with the care or treatment plan. Care teams need to be engaged with patients taking care to where the patient lives. Immersive App enabled Video based collaboration, secure chat enables a virtual engagement. Remote Patient Monitoring and the system of engagement provides a lifeline to patients that results in better patient satisfaction, improves provider patient relationships, better compliance, improved outcomes and reduced cost of care.
- Built in Process workflows not bolted on: A solution that seamlessly integrates to the care coordination process enabling, engaging and empowering care teams to proactively manage patients.
COVID 19 brought about a dramatic uptake of Virtual Video visits as CMS relaxed HIPAA, demographic and reimbursement constraints. How much of this stays past COVID is yet to be seen.
CPT CODES FOR REMOTE PATIENT MONITORING AND VIRTUAL CARE
CMS has taken bold steps to incentivize providers by enabling reimbursement for Remote Patient Monitoring as well as Chronic Care Management.
Payment reform and outcome centric models- MIPS/MACRA, Value Based Purchasing, Primary Care First and Accountable Care along with new reimbursement Codes are leading providers to consider Remote Patient Monitoring and Telehealth as a strategic construct of care delivery.
IntelliH (www.IntelliH.com) – A platform for Remote Patient Monitoring, Telehealth and Care Coordination of Chronic, co-Morbid and Post-Operative Patients:
- IntelliH provides a Workflow enabled Care Coordination platform for Care Coordinators and Care teams across the care continuum. Its patient 360 provides a consistent view of a patient’s condition to all care teams participating in the patients care.
- Care teams interact through their dashboards on personal computers or Tablets
- Patients are provided with a Patient app on iOS or Android Smartphones or Tablets. The App is user friendly- interactions are through point and click as well as speaking instead of typing.
- IntelliH provides immersive access & remote patient monitoring through wireless enabled disease relevant devices (Blood pressure, Glucometer, SpO2, Weight scale, Thermometer) to patients in all settings outside of the hospital
- The system of Intelligence supports proactive care, monitoring and management of Diabetic, CHF and Post-Operative patients.
- The IntelliH System monitors patient context, stratifies patients by risk providing real time visibility into patient insights and enabling care teams to reach out to patients that need immediate care.
- IntelliH notifies through smart alerts to care coordinators who collaborate with patients as well as providers if an intervention is required
- iOS/Android based patient APP dynamically configures for co-morbidity enabling new monitoring devices without any new app download
- IntelliH integrates to a variety of EMR’s bringing a unified patient context to the diverse care teams
- IntelliH System of engagement includes a multi-party Telehealth video that brings patients, family care givers as well as care teams together as well as a multi-party chat
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