Chronic disease is a growing epidemic that is increasing the burden on our healthcare system. According to The Centers for Disease Control and Prevention (CDC), chronic diseases are responsible for 7 of 10 deaths, and account for 86% of our nation’s healthcare costs. The pervasive nature of these illnesses is prompting a new group of solutions that leverage the benefits of “population health,” which surveys and analyzes health data to detect patterns among groups of people. With a large subset of the population affected by similar conditions, analyzing and cross-referencing population health data is instrumental to identifying possible root causes, behavioral patterns, and differential factors. Data amalgamation and analysis aside, a population health approach to chronic disease necessitates an informed and engaged patient populace that makes healthy choices daily and actively manages its chronic health conditions.
Advances in healthcare technology, particularly in remote patient monitoring (RPM), are creating a new generation of population health solutions that can aid chronic disease prevention and management. A recent report from Spyglass Consulting Group found that the increased emphasis on population health management has incentivized healthcare providers to adopt RPM solutions, and as many as 66% of hospitals and health systems have done so. In a 2013 report, Berg Insight estimates that the number of patients using RPM solutions will grow at a compound annual growth rate (CAGR) of 44.4% to reach 19.1 million by 2018. RPM is an optimal population health solution for chronic disease because it offers healthcare providers several benefits, two of which are: better data for improved outcomes and increased patient engagement.
Better data for improved outcomes
Today, healthcare providers treating patients with chronic disease face multiple barriers when implementing treatment plans. The two most common challenges are infrequent follow-up with patients and limited access to clinical data that offers a precise, relevant, real-time, and integrated overview of a patient’s daily life. RPM helps healthcare providers overcome these issues by combining analytics with real-time data collected through continuous remote monitoring.
Healthcare providers who implement RPM technology ensure that their patients benefit from early intervention by catching vital changes, adjusting treatment plans in real-time, and detecting problems before they become serious.ithout RPM, healthcare providers are left with an incomplete view of a patient’s health from intermittent follow-up. Diagnosis and treatment plans are difficult and inefficient to implement when attempting to gauge a patient’s current condition with data pulled from one moment in time. If healthcare providers implemented RPM technology that could record a patient’s basic metrics and symptoms in real-time over a longer period, they could start building a holistic overview of a patient’s chronic health condition. They could also benefit from valuable insights such as the morphology and progression of a chronic disease, which are difficult to realize without proper data. Thus, with the aid of remote patient monitoring, healthcare providers would be in a better position to deliver the best care to their chronic disease patients.
Increased patient engagement
Unlike acute conditions whose onset is severe and sudden—such as an ear infection or a broken limb—chronic conditions are slow to develop, long lasting, and generally cannot be prevented by vaccines or cured with medication. Consequently, preventing the start of chronic disease and managing the disease post-diagnosis has become the focus of preemptive measures and treatment plans. Informed and engaged patients who make healthy choices and actively manage their own health outcomes are key to improving the baseline of population health as it relates to chronic disease.
Patient engagement however, is an obstacle in and of itself. Nonadherence and negligence consume an estimated half a trillion dollars in the U.S. each year, so overcoming this weakness in the healthcare system is paramount. Numerous studies have empirically demonstrated that chronic disease patients with high engagement are more likely to adhere to treatment regimens. A 2007 study found that adults with chronic health conditions who had a high level of engagement were significantly more likely to perform self-management behaviors, use self-management services, and report high medication adherence, compared to patients with the lowest engagement scores. A recent Health Affairs study also found that patients who were least engaged in managing their health incurred healthcare costs that were 21% higher than patients who were the most engaged with their health.
RPM technologies encourage patients to actively manage their own chronic health conditions by offering real-time, precise, clinically relevant data that is easy to understand and that supports lasting behavioral change through ongoing feedback. Studies have shown that ongoing feedback is a key factor in driving patient engagement. A large trial found that when RPM devices were given to patients with chronic conditions, the number of emergency room visits, hospital admissions, and one-year mortality rates decreased. The RPM devices provided ongoing feedback for patients by reminding them when tests were due, offered educational videos, and created a graphic chart detailing their recent clinical results. Patients were also able to ask questions about their symptoms, which were transmitted to monitoring centers and answered by specialist nurses and community matrons. When patients can track their progress, and see how certain choices have a direct and positive impact on their health, they are more likely to adhere to treatment plans, engage in their healthcare, and change their behavior.
How RPMs are supporting a value-based healthcare model
Within a value-based healthcare model, RPM offers shared advantages for both healthcare providers and patients: improved population health outcomes, efficiency, and overall cost effectiveness. The current healthcare system in the U.S. is shifting from fee-for-service to value-based models. Instead of being paid for the number of visits and tests they order, providers’ payments are now based on the value of care they deliver. If providers and health systems cannot meet the value-for-cost requirements, they can incur significant financial burdens due to penalties and lower reimbursements.
Healthcare providers can increase their revenue while simultaneously improving the efficiency of their workflow by implementing RPM solutions. Centura Health at Home (CHAH), the largest integrated healthcare system in Colorado, was able to reduce 30-day hospital readmissions and home nursing visits by remotely monitoring patients with chronic diseases. The year-long pilot study integrated a clinical call center with an interactive RPM system that allowed nurses to monitor patients’ vital signs and symptoms. The RPM system included medical peripherals such as a blood pressure meter, scale, pulse oximeter, and glucose meter. CHAH found that the integrated program improved efficiency by extending the volume of nursing staff, and led to a cost savings between $1,000 and $1,500 of total costs per patient. RPM allows providers to reimburse the cost of the device used, and with more patients monitored from home, providers can attend to new patients faster.
Integration of remote care and RPM within healthcare delivery will facilitate improvements in resource allocation, population health outcomes, chronic care management and patient engagement. Remote care management programs can enable nurses to continuously monitor patients using medical grade wearable devices, alerting both physicians and patients of any emergencies or necessary care adjustments. Through such approaches, physicians would be able to focus on patients who need intervention or require immediate assistance. Today, RPM solutions are being tested and implemented across the healthcare system in a variety of different ways. In the future, RPM solutions are likely to become an integral part of healthcare and may just be the catalyst needed to drive down costs and improve over-all care.
Waqaas Al-Siddiq is Founder and CEO of Biotricity, a biometric remote monitoring solutions company. He is a serial entrepreneur, a former investment advisor and expert in wireless communication technology. He has vast experience through executive roles within start-ups, mid-sized companies, and non-profits. For more information visit https://www.biotricity.com