Small-Practice Remote Medical Monitoring Guide

By: Rahul Kumar on November 28, 2018

The health care industry’s constantly evolving dynamics has resulted in the rise of patient-centric and value-based care. This means that health care providers are heavily focused on delivering efficient patient care.

However, to achieve high quality of care, practices must deliver patient care even outside of their traditional health care settings, as there are patients who require constant monitoring of their health at all times.

Luckily, modern technology allows you to deliver patient care to remote patients and monitor their health from the comfort of your office. They can do this with remote medical monitoring software.

According to Gartner’s 2018 report, “Hype Cycle for Digital Care Delivery Including Telemedicine and Virtual Care” (content available to Gartner clients only), remote medical monitoring has a “high” benefit rating for health care providers. Gartner believes that advancements in medical devices (both mobile and wearable), mobile networks and sensor technologies have eliminated various adoption barriers.

Here’s what we’ll cover:


What Is Remote Medical Monitoring (RMM)?

Importance of Remote Medical Monitoring for Small Medical Practices

Recommendations for Adoption of Remote Medical Monitoring

Conclusion and Next Steps

What Is Remote Medical Monitoring (RMM)?

Also known as remote patient monitoring (RPM), RMM uses medical-grade mobile devices to constantly monitor patients’ biometric conditions.

The wearable devices capture patients’ physiological health conditions such as respiratory function, cardiac events, blood management or neurological conditions. This data is shared with their physician in real-time for further analysis and review.

The North American remote patient monitoring market is forecast to grow at a compound annual growth rate of 8 percent from 2018 to 2023. The major factors driving the market are the growing number of chronic diseases, lower health care costs, convenience of using home-based monitoring devices, government support and enhanced reimbursement plans.

Infographic-on-remote-medical-monitoring

How remote medical monitoring works (Source)

As seen in the graphic above, remote medical monitoring involves the following four steps:

  1. Schedule: Your staff or remote nurses schedule dates for patients to send data from their wearable devices.

  2. Send: Patients share the data from their wearable devices.

  3. Transmit: Data from the patients’ wearable devices is stored in your database.

  4. Review: Your physician reviews the data on a secure website such as an EHR interface.

The primary aim of this technology is to treat patients on time so that they don’t face severe health situations later in their lives. It also reduces their health care costs in the long run. For instance, patients suffering from chronic health conditions, such as heart failure, can be monitored remotely for signs of risk and be notified on time.

_For example, e_very year in the U.S., nearly a million patients aged 65 and above are treated for heart failure. By 2030, the cost of treating all such patients for heart failure is expected to reach $70 billion, from $30 billion currently.

But by implanting a small RMM cardiac device in the patient, practices can drastically reduce the overall cost of care per patient by catching early signs of heart failure.

Another study says that by focusing on just heart disease, chronic obstructive pulmonary disease (COPD) and diabetes, RMM could save up to $200 billion annually in health care costs in the U.S.

History of remote medical monitoring: The idea of remote patient monitoring technology dates back to mid-1990s in the U.S., when the Veterans Health Administration (VHA) reorganized its patient care processes and offered opportunities and rewards for these disruptive technologies.

In 2002, the VHA released a detailed evaluation report on RPM related to veterans suffering from congestive heart failure (CHF). It revealed a 60 percent reduction in hospital admissions, 81 percent reduction in nursing home admissions and 66 percent reduction in emergency department visits for 281 veterans who were being monitored by RPM technology.

Importance of Remote Medical Monitoring for Small Medical Practices

It’s not just large hospitals and health care systems—those with roughly 500-1,000 beds—that view remote medical monitoring as a valuable and efficient way to engage with patients outside of traditional settings. Even solo physicians and small practices can eliminate unnecessary patient visits, reduce patient wait times and enhance patient engagement.

Regardless of your practice size, the main benefits of using remote medical monitoring are as follows:

  1. Providing remote care means fewer people visit the practice, which reduces wait times and allows physicians to dedicate more time to each patient.

  2. Physicians are able to deliver higher-quality care to patients through real-time monitoring; this lowers the risk of physician burnout.

The main challenge for solo physicians and small practices when adopting RMM technology is their small budget. These buyers have to be smart: they should assess their patient population and select an easy and cost-effective service that can be run remotely online (such as follow-up visits, non-acute primary care or chronic care management).

As a small practice or solo physician, you must ask two key questions before incorporating remote patient care into your delivery model:

  1. What problem are you trying to solve? RMM can solve problems such as overcoming patient access challenges, reducing physicians’ workload or addressing patient retention. Assess which problem needs to be solved urgently in your practice so that you choose the platform that addresses it.

  2. Who are your patients? Different patients have different preferences for accessing remote care. Are they willing to share personal health data through mobile devices? Are they concerned about the accuracy of the captured data? Answering these questions will help you serve your patients better with RMM.

Also, you have two options when you implement remote medical monitoring:

  1. Buy and implement the technology yourself. If you have the resources and staff members, consider deploying the technology yourself. You’ll have to buy all the necessary wearable devices for your patients and medical-mobile devices for your staff who’ll remotely monitor the patients’ health situation.

  2. Lease or outsource to a third party. If you don’t think you can manage remote monitoring on your own, then outsource the services to a third party who’ll manage the services on your behalf. The third-party vendor would provide wearable/mobile medical devices to your patients and their remote nurses would track the patient health data in real time, then share the data with you on a regular basis for further action if necessary.

The choice to either “buy” or “lease” the remote patient monitoring technology depends on various factors such as your practice’s budget, the number of patients to be served (current and in the future) and the availability of your staff.

Here’s an example of what one small practice experienced by outsourcing its chronic care management.

Infographic-on-remote-medical-monitoring

Peter Weigel, MD, owner of a New Jersey-based small practice, Medical Associates of Westfield, outsourced his practice’s chronic care management services to a third-party service provider.

 CHALLENGE:  Peter was unable to manage chronic care for his patients on his own.

 SOLUTION:  Peter hired a remote chronic disease management service, provided by Wellbox, as an add-on to what he was already doing.

The service works through the following steps:

  1. Peter meets his chronically ill patients every three to four months and records their progress in the EHR system.

  2. Between visits, Wellbox’s remote nurses call those patients to track their medication and record their health status using the wearable and mobile devices provided to them.

  3. Wellbox’s staff documents all the recorded patient data for Peter to review. They store the records directly into Peter’s EHR using the interoperability feature.

  4. In the end, Peter refers to the documented patient data and offers the necessary treatment for patients.

  5. If a patient has an urgent issue, chronic care coordinators contact Peter immediately (via call or text message), as he’s the care team leader in any situation.

 RESULTS:  There was a marked improvement in the health of Peter’s patients. After he noticed this improvement, his trust in Wellbox’s remote care team grew further. He also noticed the following:

  1. The rate of patient hospitalization had gone down since starting the service in 2015.

  2. The patient wait time also went down as a result of fewer patients coming to meet him at the practice.

According to Peter, outsourcing chronic care management services was the key to his success. He suggests that developing a chronic care team is essential for small practices that are trying to do it alone.

Recommendations for Adoption of Remote Medical Monitoring

Here are some recommendations if you’re considering remote medical monitoring for your small practice.

When to Go for Remote Medical Monitoring

If you’re a solo physician or small practice owner, you may be wondering what’s the best time to implement remote medical monitoring technology or services. You should adopt remote medical monitoring when you’re dealing with one or more of the following issues:

  1. If the patient wait time in your practice is really high and it’s affecting patient satisfaction.

  2. If some of your patients who suffer from heart disease, COPD/asthma or diabetes are unable to visit the practice regularly, which means their health status isn’t being tracked properly.

  3. If you notice hospital readmission rates going up for some of your chronically ill patients.

  4. If you or your patients are unable to visit your practice frequently at certain times of the year due to natural causes such as floods, heavy rainfall or hurricanes.

Challenges to Keep in Mind

Adopting remote medical monitoring in your small practice won’t be as easy as it sounds. We’ve covered one example of the lease option above; if you’ve decided to go for the “buy” option, you may face some challenges such as:

  1. Higher initial investments. The upfront costs for the first year could range from $1,000-2,000 for every enrolled patient and your medical staff. But in the long term, remote patient monitoring has the potential to save more than $8,000 per patient annually.

  2. Staffing needs. You’ll need to hire medical staff who would frequently monitor the incoming patient data. They should be able to quickly identify if a patient needs urgent intervention, in which case they should contact you or a physician at your practice.

  3. Accuracy of captured data. This applies for both “buy” and “lease” options. The data captured by wearable devices and other mobile devices can’t always be termed as accurate.

Therefore, we advise that you carefully consider all your choices after thoroughly reviewing your specific practice requirements.

Additional Technology That Needs to Be Implemented

Other than the wearables/mobile medical devices and staff members (whether they’re newly hired or trained staff) who’ll monitor the devices remotely, you’ll also need the following:

  1. Sensors, which are usually placed in patients’ wearable or medical mobile devices to measure vitals such as heart rate, temperature and blood pressure.

  2. Local data storage at your small practice to store all the data coming from the sensors. Some devices will alert you every time a sensor sends or uploads new data.

  3. Centralized data storage to collect and store all the data from different sources such as sensors (through local data storage) and your own internal EHR solution.

  4. D**ata analysis software**, which will derive valuable insights from all the patient data stored in the centralized data storage. These insights could be in the form of automatic alerts to physicians, staff members and patients, in case of an urgent medical need. It’s a useful feature but requires a bigger budget.

Pricing Considerations

Your choice to either buy or lease remote patient monitoring technology will decide the costs you’ll incur. The pricing for the lease option would vary widely based on the services, technology and staff offered or required by your third-party vendor.

However, if you go for the buy option then there are two main categories of costs—labor and technology. Let’s look at them in detail:

  1. Labor costs: This includes payments to staff who’ll remotely track patients’ data from the wearable devices. Labor costs may differ among different small practices based on factors such as the number of staff members, staff experience level (expert, proficient or beginner) and statewide labor wage laws. Also, you’ll need to consider staff hiring costs (in case you don’t have the sufficient staff) and their training costs (to hire an industry expert).

  2. Technology costs: These include the cost of buying wearables/mobile medical devices, sensors, data storage equipment etc. But these costs vary significantly based on the price offered by different vendors. Other than the purchasing costs, you should also consider the cost of transporting wearable devices to patients, sensor installation costs, and patient training costs (on how to use the wearable).

All the recommendations and considerations in this article should hopefully help you adopt remote medical monitoring with confidence.

Conclusion and Next Steps

As you can see above, remote medical monitoring is beneficial for both physicians and patients. Physicians can use the technology to reduce patient wait times, eliminate unnecessary patient visits and enhance patient engagement. Meanwhile, patients are assured that they’ll get real-time care.

So, what you should do now? If you’re regularly facing trouble attending to patients (with chronic health conditions), consider going for remote medical monitoring. Being a small practice, we know you’ve got limited budget and resources. Here is what you should do next:

  • If you’ve got sufficient staff members (2-3) and the budget to buy the necessary hardware/software, then purchase the technology. After the implementation, your per patient total cost would normally range between $1,000-2,000 for the first year.

  • If you feel it’ll cost a lot to hire staff members and purchase the technology, then consider the “lease” option. Talk to a third-party service provider to get an ideal deal, then enjoy the benefits of remote medical monitoring.

  • For any other questions related to EHRs that support remote monitoring, call us at (844) 686-5616 for a free consultation with an EHR software advisor. Also visit our EHR software page to learn about different EHR systems.