Population health insights

KLAS debuts remote monitoring report; Philips assessed by customers

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Oct 16, 2018

We know from our customers – hospitals, multidisciplinary health systems, group practices, home health or post-acute care – that remote patient monitoring (RPM) is a growing answer to readmission rates, patient engagement, ACO regional depth and the very real issue of bed space.

 

KLAS, the independent health IT rating organization, recognizes these dynamics and the emergence of remote monitoring as an essential solution, just as payers such as CMS are expanding reimbursement. This has led KLAS to issue its first-ever report on RPM, based on customer assessments.

 

And KLAS puts it very well as to how market dynamics are creating an embrace of RPM:

 

  • Faced with rising costs, the demands of value-based care, and pressure from growing competition, today’s healthcare organizations often find themselves pursuing complex, strategic initiatives such as population health management, patient engagement, and telemedicine. One strategy, remote patient monitoring, touches each of these areas, but stands on its own as a simpler, more tactical way of controlling cost and improving care.

 

For the report, KLAS spoke to 25 healthcare organizations - large IDNs, smaller health systems, clinics, home health organizations and payers - utilizing RPM solutions by just seven “leading” vendors, as the report qualifies.

Only seven?

 

To be assessed, the report states vendors must offer automated data collection, data uploading and alerts, just as a baseline. From there, the report focuses on market leaders based on self-reported capabilities matched to customer reactions to those self-reported features.

 

In terms of report highlights about Philips’ eCareCoordinator, the report shows:

 

  • Philips received a “high” mark on platform capability transparency
  • Philips is the only vendor in the report whose solution is being used for all eight patient condition categories cited
  • Philips is one of only two vendors offering a medication dispenser solution
  • Philips has by far the most patients receiving care via RPM per vendor
Number of patients graph

Treating multiple conditions, adding patients

Let’s focus first on clinician needs from the report, both in terms of the patient conditions they are treating and plans for growth, along with categorized factors in making RPM selections.

 

Healthcare organizations reported their top patient condition use cases for RPM, in order, as

  • heart disease
  • COPD
  • diabetes
  • hypertension
  • mental health
  • surgical recovery
  • dementia
  • cancer

 

And it’s important to note the report states that healthcare organizations are using RPM for multiple conditions, on average three to four of those listed.

 

In terms of patients, on average the 25 organizations interviewed plan to double the number of patients receiving RPM over the next “year or two.”

Key patient conditions graph

Here is one very telling customer quote from the category of patient conditions:

 

  • I would say we need to grow by 500%. Right now, we use eCareCoordinator as a secondary diagnosis, but our plans are to really expand it. We want to capture as many patients as possible that may have COPD or CHF. Our goal is to have 100 monitors in use at all times.

Measured success and other category assessments

Also within the report, customers were asked to react to their vendor in terms of several categories, including:

 

  • workflows
  • patient conditions
  • software integrations
  • vendor selection
  • measurable success
  • challenges

 

Here is a sampling of Philips customer quotes responding within those categories, and to be fair, they are not all rosy, (though we’re humbled that the great majority are). Still, one great aspect of KLAS reports is a reminder that we can always get better. And I was struck by how our customer quotes also relay a broader perspective on remote monitoring as a clinical tool.

 

  • Workflow

- We were a little concerned that the population we serve might be a little fearful of virtual visits… But it has been quite the contrary. They love the telehealth visits. The patients would do the visits everyday if we were able to do that…These visits have made a big difference in patient engagement, and the staff members definitely feel it.

  • Software integrations

- One reason we went with Homecare Homebase is because they told us we could get our interfaces completed with Philips within just a few months. It has been several months, and we still do not have our interface. Not having that interface has increased our workflow tremendously. We had an interface with Philips with our previous EMR. Not having that integration makes it difficult for us to track visits. That tracking has to be done manually.

  • Vendor selection

- We have been with Philips for a long time. Last year, we upgraded to their eCareCoordinator platform to allow us to do virtual visits. This platform also gives us a lot more capabilities for patient education, and there are a lot fewer connectivity problems because of the Bluetooth devices.

- Has algorithms built in and does the work for us. It takes the guesswork out for our users

  • Measurable success

- Our biggest success is that we have managed to reduce our readmission rate by fifteen percent.

- One of our biggest successes using the Philips tool is with our hospital’s frequent fliers. These patients go in and out of the hospital regardless of whether they need to be there… when we implemented the Philips tool, we put those patients on the monitors and were able to keep them out of the hospital for 30 days.

  • Challenges

- Apparently the platform would update without anyone knowing, so we had to suffer the consequences of whatever happened as a result of those upgrades. All those issues have worked themselves out over the years, though. We have worked alongside Philips to get the system’s platform in a good place.

- I would like Philips to reach out more often.

- We have had to switch up the software pieces with upgrades, we have encountered learning curves.

 

Finally, the report notes that healthcare organizations have historically funded RPM through capitation and bundled payment models, state Medicaid grants, FFS revenue set-asides and value-based purchasing reimbursements.

But direct reimbursement is on the way.

The growth of RPM reimbursement

For 2019, CMS is expanding RPM reimbursement codes from one that is available this year to three next year.

 

These codes would follow the steps of RPM care, from setting up equipment and educating patients ($20 per incident), to the ongoing monitoring and use of the equipment ($70 per patient per 30 days), on to clinicians taking action on the data via communications with patients, caregivers or peers ($60 non-facility/$33 facility per patient per calendar month).

 

All three can be billed per time period when appropriate.

 

The RPM codes are part of a new virtual care ecosystem CMS is also putting forth, with news reimbursement codes for virtual patient check-ins, virtual peer consulting and the remote assessments of patient-generated photos and images known as “store and forward.”

 

Also within RPM expansion, CMS in its separate home health agency rule for 2019 is allowing agencies to include the costs of RPM technology into cost reports.

 

All told there are 13 new telehealth, RPM and virtual care codes for 2019 within the fee schedule, with more implementation to come in 2020 for telehealth within ACOs and Medicare Advantage.

About the author

Niki Buchanan
Niki Buchanan, 
General Manager & Business Leader, Philips
Niki Buchanan is General Manager & Business Leader for Philips PHM. A dynamic and versatile healthcare executive, Niki uses her distinctive customer satisfaction and product optimization methodology to lead improvements across the Health IT spectrum.

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