Introduction
Remote Patient Monitoring (RPM) is the collection of health data by the patient, often from outside conventional care settings, which is then electronically and securely transmitted to the provider for use in care and related support.
Remote Patient Monitoring can:
- Empower the patient to better manage their own health and participate in their treatment plan
- Increase visibility into patient adherence to treatment and enable timely intervention
- Strengthen the relationship between the patient and the provider
- Optimize health appointments by encouraging the patient to connect with their provider before it’s too late, and to reduce unnecessary routine appointments.
Vivify Health, an established platform for Remote Patient Monitoring, has published a number of case studies from clinics that they have worked with to showcase the effectiveness of Remote Patient Monitoring. A summary of these case studies is presented below.
University of Pittsburgh Medical Center
The University of Pittsburgh Medical Center (UMPC) used RPM to reduce avoidable hospital admissions, which led to a reduced cost of care, and to give clinicians confidence to discharge patients from the hospital sooner.
Over 12 months, 1100 congestive heart failure patients over 65 years old took part in RPM post-discharge from the hospital. Patients were sent home with kits of educational materials, instructions, and virtual support. Materials were improved over the 12 months and program compliance is now at 92%. The program gives clinicians the information that they need to quickly intervene and help prevent unnecessary hospitalizations.
UPMC health plan members ages 65 and older are now 74% less likely to be readmitted to a hospital within 90 days of discharge and Medicare patients are 76% less likely.
Trinity Health
Trinity Health is a non-profit, multi-institutional Catholic healthcare delivery system. Trinity Health’s goal was to reduce preventable hospital readmissions and unplanned visits to the home by nurses. Previous to their intervention, hospital readmissions were between 13-15%.
Trinity Health started implementing RPM technology for 60 days post-discharge to more than 80% of their patients, providing that they met a series of criteria. Following discharge, an “At Home Nurse” visits the patient at home, and provides the patient with a health kit and teaches patients and/or caregivers how to use it. The kit includes a blood pressure monitor, digital scale, and a tablet. They are also instructed how to make a video call, since video calls have been highly successful in driving better health outcomes than voice only calls. This visit helps build rapport between the patient and nurse, and increases compliance to the program.
The RPM program requires the patients to take daily readings including blood pressure and weight and submit the results through the tablet. The patient also completes a questionnaire for information on how they are feeling. The At Home Nurse reviews the results daily and follows up with the patient if they are not submitted on time. If required, the nurse will intervene and have a video call based on the information submitted. Compliance on submitting daily data was at 90%.
The first in 60-day readmissions was reduced to 8%. Patient satisfaction with the program is greater than 90%. Patients report that they are getting answers faster, staying healthier, and avoiding more disruptive trips to the emergency department.
Trinity Health and Vivify Result Data:
- Patient age range: 25-103
- 1,600 avg. daily patient census
- Over 44,000 patients served
- Over 90,000 virtual healthcare visits completed
- 375,000 minutes of “face-to-face” on-screen time
- Up to 16% reduction in readmissions
- 275 Monthly ER visits prevented
- 98% of patients would recommend the program.
Ontario Telemedicine Network
Ontario Telemedicine Network Telehomecare began as a pilot in 2007 as a remote patient monitoring program for people with chronic obstructive pulmonary disease (COPD) and/or congestive heart failure (CHF). In addition to RMP, trained nurses provided regular health coaching aimed at giving patients the skills they need to manage their own health.
The Telehomecare program has been shown to reduce hospital admissions and ER visits among this patient population by over 60%. 98% of patients reported satisfaction with the program and 95% indicated that the program improved their ability to self-manage their condition.
Memorial Hermann
Memorial Hermann launched RPM in their Post Acute Department (Home Health and Hospice) in 2013 and is now used enterprise-wide including physician community and commercial payer reimbursement. Key outcomes include:
- 50% reduction in readmissions (from greater than 17% to less than 5%)
- Reduced nurse visits by 3.6 per episode
- Home Health services reduced from 82 to 48 days
- Cost savings of over $8,500 per patient
- Patient satisfaction exceeding 90%
Union Hospital
Union Hospital (UHCC) used RPM for CHF and COPD to deliver health improvements. Key outcomes include:
- Avoided 48 30-day readmissions, with an estimated cost savings of $336,000
- CHF Prevention Quality Indicators (PQI) decreased from 141 to 111
- COPD PQIs decreased from 205 to 177
- 0.27% RPM patient readmissions compared to 10.27% of patients with similar conditions who were not being monitored remotely.
Children’s Health in Dallas
Children’s Health in Dallas used RPM across cardiac, pulmonary and home case services including their post organ transplant program. Key outcomes include:
- Virtual visits replacing in-clinic visits by 50%
- 100% Staff Satisfaction
- 95% Patient Satisfaction
Munson Healthcare
Munson Healthcare initially launched RPM for CHF, COPD, and CABG and then expanded to Palliative and Hospice Care. Key outcomes include:
- 4.5% readmission rate within 30 days (reduced from 12.8%)
- 3% readmission rate, post 30 days (reduced from 11.8%)
- 0% readmission rate for CABG patients
- 91% patient compliance
- 95%+ patient satisfaction
Christus Health
Christus Health RPM reduced the barrier of in-home nurses. They used bluetooth enabled personal health devices: weight scale, blood pressure monitor, and pulse dosimeter. The application used was simple and easy for patients to answer questions, send biometric data, and view educational videos. Additionally, they used video conferencing with caregivers.
The implemented RPM program for patients resulted in:
- Reduced readmission from ~20% to 9.1%
- ROI, including clinical staff, was $3.19 for every $1.00 invested
- Reduced average inpatient cost from $16,647 to $6,430
- Over 95% patient adoption
- 98% patient satisfaction
CloudDX and Population Health Institute
CloudDX provided patients with a Connected Health Kit to monitor their vital signs at home. Heart rate, blood pressure, oxygen saturation, respiration rate, body temperature, and body weight were measured. Patients could also send nurses photos of surgical wounds and had virtual access to a nurse or doctor 24 hours a day.
Virtual care prevented and resolved 24% more medication errors during patient care transitions than the standard care cohort. Patients under virtual care also reported 10-14% less pain. With 5% fewer patients returning to hospital compared to standard care, the study indicated a possibility of reducing readmissions and emergency visits.
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