Telemedicine and Remote Patient Monitoring

September 14, 2020, by Surendra Saxena

Introduction:

A proactive approach to managing chronic patients outside the perimeter of a Healthcare Clinic or Hospital

Managing Chronic Patients across the Care Continuum

CDC estimates that over 868,000 Americans die of heart disease or stroke every year. Over 34.2 million Americans have diabetes and another 88 million adults are pre-diabetic. The economic toll of these chronic conditions cost our healthcare system over $541 Billion. Chronic patient management has deeper challenges. The National Health Council estimates that over 30 Million patients have 5 or more chronic conditions and left unmanaged creates poor outcomes increasing the cost burden for both patients and the healthcare system.

Chronic patient health outcomes depend on a variety of factors- how they manage themselves, lifestyle choices that they make, compliance to medications, care plan, diet and activity. As the healthcare system moves from volume to value-based care they need:

  • Access to patients outside the perimeter of their facilities patient disease context as well as coordinate care across the care continuum
  • Proactive patient management, data driven and evidence-based practice
  • Patient 360- sharing patient context with all participants across the care continuum
  • Transform the patient experience and provide them an oversight and lifeline to better manage compliance

Telemedicine

Telemedicine or Telehealth is a very broad term and folds all technologies or processes that enable a patient to be treated virtually. Telehealth is commonly identified to interactive Video consults for managing patients. Examples of telehealth includes health education services, remote monitoring of vital signs, ECG or blood pressure and remote doctor-patient consultations (telemedicine). Telehealth technology enables the remote diagnoses and evaluation of patients in addition to the ability to remote detection of fluctuations in the medical condition of the patient at home so that the medications or the specific therapy can be altered accordingly. It also allows for e-prescribe medications and remotely prescribed treatments.

Remote Patient Monitoring (RPM)

Remote Patient Monitoring – or RPM – enables more effective chronic patient management as care teams are now armed with more context about a remote patient’s disease condition- context largely provided by receiving and analyzing a remote patients physiological data regularly in real time, outside of clinical settings. Care teams are empowered with patient condition, receive alerts from vitals, non-compliance to medications or care plans and engage with patients proactively rather than episodically to improve outcomes.

Patients send their physiological data using monitoring devices to an RPM platform.

  • Cardiac patients can measure weight, blood pressure, heart rate, oxidation level, fluid intake, sodium intake, EKG through inexpensive home-based monitoring devices
  • Diabetic patients can measure their blood sugar, blood pressure, weight, diet and activity

IntelliH RPM Platform

IntelliH is a SaaS based platform with a focus on managing CHF, diabetic and post-operative patients. It provides a risk stratified dashboard for care coordinators on PC, MAC as well as Android tablets. The patient App on iOS and Android devices, as well as an autonomous robot- TEMI from ConnectedLiving, wirelessly collects physiological data and sends that to IntelliH for analysis.

The IntelliH platform tracks care plan compliance, analyzes received vitals and generates alerts that are customized to individual patient. It prepares a comprehensive disease specific reports for doctors across any longitudinal period for data driven decision support.

The IntelliH solution enables immersive collaboration with patients, care givers and care teams through rich multi-party telehealth videos as well as secure texts.

IntelliH integrates to a wide variety of EMR systems such as:

  • EPIC
  • CERNER
  • CERNER
  • AllScripts
  • ATHENA
  • KINNSER

IntelliH uses a wide variety of monitoring devices from iHealth such as:

  • Wireless BLE Glucometer
  • Wireless BLE Pulse Oximeter
  • Wireless BLE Blood Pressure Monitor
  • Wireless BLE Weight Scale
  • Wireless BLE Thermometer

IntelliH will soon ingest EKG data from ambulatory EKG monitoring devices.

IntelliH across the Care Continuum

IntelliH is the most comprehensive platform for Care Coordination and management of chronic and post-operative patients in any setting.

  • Home
    • Physician practices are using IntelliH to manage diabetic patients at home. Customers are reporting better outcomes before the occurrence of adverse events
  • Home Health Agencies
    • Home Health Agencies are using the IntelliH platform to improve operational efficiencies, strengthen their relationship with their referral base. Customers have reported over 10% reduction in rehospitalization
  • Assisted Living and Skilled Nursing Facilities
    • IntelliH in partnership with Connected Living now provides Remote Patient Monitoring and rich multi-party Telehealth to patients in Assisted Living facilities, Hospices as well as Skilled Nursing Homes. The solution can be used for Patient monitoring, Virtual Physician and Nurse rounding as well as provide a rich social engagement platform
  • Accountable Care Organizations
    • The IntelliH Platform can be used by ACO’s to manage patient outcomes across their extended partner eco systems. IntelliH provides shared patient context to all participants managing patient care across the care continuum
  • IntelliH for Cardiac Practices
    • IntelliH provides one of the most comprehensive solution for Cardiac practices to manage their patients
    • Tracking of Blood Pressure, Weight, Oxidation, Heart Rate, Sodium and fluid intake
    • A 6-minute walk test
    • Subjective questionnaires
    • Comprehensive analytic longitudinal reports on patient vitals
    • Analytics that allow correlating a patient Vital to medicine dosage, medicine compliance, sodium intake etc.
    • Smart alerts and out of bound alerts
    • Comprehensive care coordination workflows for care teams

Reimbursement for Virtual Care

Physician that prescribe Remote Patient Monitoring for their patients can now be reimbursed by CMS for:

  • Remote Patient Monitoring
  • Chronic Care Management
  • Transition Care Management
  • Annual Wellness Visit
  • Telehealth Evaluation and Management
  • Virtual Check in
  • Patient Self-Management
  • Principal Care Management

Conclusion

Remote patient monitoring with immersive telehealth enables providers in value-based reimbursement models to better manage their chronic patients suffering from co-morbid conditions such as CHF, Diabetes or post-operative as well as seasonal flu conditions such as COVID.

RPM provides a much-needed context with the longitudinal clinical and behavioral patient data to proactively engage with patients and ensure compliance to care plans.

IntelliH’s alert system enables patients to be stratified by risk and allows care teams to reach out proactively to patients that need immediate attention.

Rich telehealth video transforms the patient experience as they avoid an unnecessary travel and wait.

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