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Remote Patient Monitoring
- 1. Remote Patient Monitoring Sheri Dodd, VP and General Manager, Medtronic Care Management Services Otávio Berwanger – MD, Diretor do Instituto de Ensino e Pesquisa do HCor - Hospital do Coração de São Paulo -SP Evandro Tinoco – MD, Diretor Clinico do Hospital Pró-Cardíaco - RJ Associate
- 2. A Universal Problem Associate
- 4. Definitions.... Associate Telemedicine Store & Forward TeleCare Remote Device Monitoring Remote Patient Monitoring Point in Time Point(s) in Time Just in Time Over Time Over Time TELEHEALTH CONNECTED CARE: Use of Electronic information and telecom technologies to support and promote long distance clinical health care (including medical/patient education)
- 5. Remote Patient Monitoring Associate RPM: Monitoring and assessing patient’s health outside of acute care facilities using technology - Symptoms - Biometrics - Medication Adherence - Social/Behavioral 1 365 HC Provider Access Pt Self Management GOAL: Access, Quality, Affordability, Sustainability The Opportunity
- 6. Associate 1.Cohort and Care pathways 2.Technologies and Services 3.Processes
- 7. 1. Cohort & Care Pathways Associate Monitoring and assessing patient’s health outside of acute care facilities using technology - Symptoms - Biometrics - Medication Adherence - Social/Behavioral Who is at Risk? Why are they at Risk Enable “Right” Time Clinical Action
- 8. 2. Technologies and Services Decisions Associate Monitoring and assessing patient’s health outside of acute care facilities using technology - Symptoms - Biometrics - Medication Adherence - Social/BehavioralWired Platform Wireless Platform (Blue Tooth) Consumer vs Medical Grade Peripherals Patient Goal based or EBM based Single disease vs Complex Comorbid General or Discipline Specific Clinical Call Center Logistics Role of Pharmacy, Therapy Role of Social Services
- 9. 3. Processes Associate Monitoring and assessing patient’s health outside of acute care facilities using technology - Symptoms - Biometrics - Medication Adherence - Social/Behavioral Patient Identification Patient Activation Patient Engagement Data Interoperability Workflow Care Pathways Patient Outcomes System Outcomes
- 10. Associate REMOTE PATIENT MONITORING EVIDENCE June 2016: AHRQ Comparative Effectiveness Technical Brief 1494 Citations 58 Systematic Review Telehealth used or communication and counseling or Remote Monitoring in Chronic conditions such as cardiovascular and respiratory illnesses reduce mortality, improve Quality of Life and decrease hospital admissions.
- 11. Evidence: BEAT HF Proportion of Calls Completed at 30 days Overall <50% >50% Proportion of Days Monitored <50% >50% Associate
- 12. RPM at Scale Associate Monitoring and assessing patient’s health outside of acute care facilities using technology - Symptoms - Biometrics - Medication Adherence - Social/Behavioral
- 13. HF/Chronic Comordids Associate Monitoring and assessing patient’s health outside of acute care facilities using technology - Symptoms - Biometrics - Medication Adherence - Social/Behavioral Source: Dickinson, Michael G., and Kevin L. Vos. “Home Telehealth Done in an Integrated Disease Management Program Results inSubstantial Cost Savings and Reduction in Healthcare Utilization.” Journal of Cardiac Failure, vol. 21, no. 8, Aug. 2015, p. S78.
- 14. View from the Payer lens Associate Monitoring and assessing patient’s health outside of acute care facilities using technology - Symptoms - Biometrics - Medication Adherence - Social/Behavioral From $2.6M to $1.7M spend in 7.5months Increased from $1.4M to $1.9M in 7.5 months
- 15. Focus on the right patient... Associate Monitoring and assessing patient’s health outside of acute care facilities using technology - Symptoms - Biometrics - Medication Adherence - Social/Behavioral 0% 10% 20% 30% 40% 50% 60% 70% 80% Very High High Medium Low Percent(%) Risk Level Transmissions (%) Patients (%) 44.0 % identified as low risk, requiring no unscheduled follow-up 11.1 % identified as very high risk Small RS, Samara M, Sarkar S, Kofflin P, Norman HS. Remote Heart Failure Management Utilizing a Risk Stratification Algorithm Incorporating Device and External Diagnostics. J Cardiac Failure. August 2017 Volume 23, Issue 8, Supplement, Page S57 http://www.onlinejcf.com/article/S1071-9164(17)30379-2/fulltext
- 16. Associate Barriers and Guiding Principles
- 17. Associate Monitoring and assessing patient’s health outside of acute care facilities using technology - Symptoms - Biometrics - Medication Adherence - Social/Behavioral Barriers Policy and Payment Data Intraoperability Tech vs System Approach Measuring Impact
- 18. Associate Monitoring and assessing patient’s health outside of acute care facilities using technology - Symptoms - Biometrics - Medication Adherence - Social/Behavioral Design Principles 1. Make it easy 2. Team based care model must accountability for clinical action 3. Beware of data overload; focus on data intraoperability 4. Envision care pathway expansion for an expanded care team 5. Patients are consumers: put them at the center