It’s only a matter of time before the exam-room-centered focus of patient care gives way to management of assigned populations to maintain or improve health. That’s not to say physicians won’t be actively treating sick patients every day, but new payment models, with financial incentives and disincentives for physicians, call on healthcare providers to better manage patient populations as a way to prevent health problems and improve outcomes.
This emerging business and clinical need has stimulated the growth of a class of technology that connects patients’ current medical status to physicians and other caregivers in hospitals and primary care practices. It’s a collection of vital-sign takers, activity trackers and other devices to step on or strap on, then transmit the readings to a collection point in a computer or secured site in the Internet “cloud.” At its best, such technologies can pick up weight gain, elevated hypertension or other concerns before they become serious threats to health or life.
“Remote monitoring is extremely important and probably in the forefront of mobile technologies now,” explains David Lee Scher, MD, FACC, a Harrisburg, Pennsylvania cardiologist and mobile-tech consultant, “because of its potential importance in decreasing hospital readmission rates, which are a big headline because they are responsible for penalties that the Centers for Medicare and Medicaid Services (CMS) is now imposing on hospitals that have readmissions within 30 days for certain diagnoses.”
Whether the goal is preventing readmissions or maintaining medical stability among the chronically ill, “what remote monitoring does is it keeps the patient more in touch with the physician over a period of time outside of the acute-care setting, such that you don’t have to wait for disasters to happen” to bring the deteriorating condition to a provider’s attention, Scher says.
And patients want access to these remote monitoring technologies to improve their health. A 2012 eHealth patient survey by the public relations agency Ruder Finn found that 33% of patients want their physicians to have access to remote monitoring technologies. Older patients want these technologies even more: 40% of older patients want access to technology that can alert physicians and other caregivers if they are having a health emergency.
For now, establishing—and being paid for—a remote monitoring program remains a challenge, especially for small and solo independent practices. Physicians are already dealing with, and being overwhelmed by, a bevy of technology systems that they are required to understand and invest in, from electronic health records (EHR) systems and patient portals to telemedicine platforms and social media.
Instituting remote monitoring, experts say, will require a change in how a medical practice conducts its business, and may require joining a clinically integrated network of providers in order to scale the monitoring process appropriately. Physicians will have to develop new ways of interacting with patients, and institute new processes and responsibilities for staff members to take on this flood of data and make it practical and useful for improving patient care and reducing costs.
– John Morrissey
