CENSON has been providing remote patient monitoring and virtual care for more than ten years, and over that time we have monitored close to one million patients.
When we started all those years ago, there were only a couple of connected devices, and ‘connectivity’ was really a challenge. Today we connect to well over one hundred devices, and all the major device eco-systems.
However, the underlying value of remote patient monitoring is still misunderstood, or even worse, misrepresented.
Here is our contribution to the ongoing efforts to bring the facts to light, and to dispel the myths that abound.
Remote Patient Monitoring can be just as applicable for acute care patients. As an example, a patient has just had a hip replacement, and need wound management, need to follow medication and exercise protocols, and need to be monitored for infection. These are all possible with RPM, and in addition RPM can provide the social support often missing with isolated patients. RPM is CMS reimbursed in this situation, as long as the monitoring is medically necessary.
RPM collected data is NOT to be used for medical diagnosis or treatment. It is to be used to decide if medical diagnosis or treatment may be warranted, or medically necessary. The reason is simple; while devices and wearables are extremely accurate, they are not being used by clinicians, in a clinical setting. A reading taken while a patient is sunning him/her self on the back porch, while smoking a cigarette, and drinking a double shot espresso coffee, will be accurate – but it is NOT medically relevant. This is important to make clear as folks like to blame wearables for bad data when it is nothing to do with the wearable – it is the situation of the reading. The best medical device in the world would still produce a worthless reading.
Prescribing physicians are responsible for ensuring that patients are educated on using the devices, and care related to their care plan. That is what they are getting paid to do (CPT Code: 99453). They can instruct others to provide this service, but they are responsible for making sure it happens, and that it is correct for the patient and the situation. This goes a long way to making the collected data as valuable as possible.
While individual data points may not be medically relevant, a trained eye will be able to see trends and progessions in the data that allows for early intervention. As an example, over a few days you notice that a patients blood glucose levels are trending upwards, you may intervene by contacting the patient to assess the situation, remind them to stick to their dietary plan, and medication and exercise regime, getting them back on track – before an emergency develops.
The true, underlying value of remote patient monitoring is being presented with sufficient data to be able to identify trends, before they require medical intervention.
Medicare supports remote patient monitoring directly, and through State Medicaid programs. Most private insurers also support the use of remote patient monitoring, and virtual care.
Also keep in mind that RPM may be used in conjunction with teleheath CPT and HCPCS codes to provide patients with a complete virtual care offering.
And don’t forget that patient reported data may be used in certain scenarios such as blood pressure monitoring, and blood glucose level reporting, to enhance or replace RPM data.
Remote patient monitoring is not a technology solution. The majority of the ‘cost’ are process costs – cost of monitoring, the cost of developing the processes and relationships in order to implement an RPM solution. Necessary device and platform costs are minimal. As an example, we provide our platform for $19 per patient per month, and a wearable device from $39 once off cost.
The cost of monitoring can be expensive, or not, it will depend on your situation. Often it is cheaper to outsource the monitoring.
However, in every situation we have been able to help a clinic or facility to implement a solution that is profitable. Done properly, that should always be the case. And the solution should provide higher levels of patient care, reduced emergency admissions, and enhanced mental health for your patients.
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Food prescriptions are part of a broader concept of social prescribing. Pioneered in the United Kingdom and growing in popularity in the United States and Canada, social prescriptions are issued by health-care practitioners to provide patients with non-pharmaceutical interventions, including dance classes, walking groups, volunteer work, art lessons and, of course, fresh fruits and vegetables.
Medical nutrition therapy (MNT) is a key component of diabetes education and management. MNT is defined as a “nutrition-based treatment provided by a registered dietitian nutritionist.” It includes “a nutrition diagnosis as well as therapeutic and counseling services to help manage diabetes.