Elevating Patient Outcomes: The True North for Remote Patient Monitoring

The Peterson Center on Healthcare's recent report sheds light on the growing adoption of remote monitoring technologies, both Remote Physiologic Monitoring (RPM) and Remote Therapeutic Monitoring (RTM), and their evolving role in healthcare. While the insights are valuable, it's crucial to frame the discussion with a central tenet: the ultimate goal of all digital health tools, whether clinical, administrative, or for patient engagement, must be to improve patient outcomes. This is the core mission of healthcare, our shared purpose.

RPM is a Bridge to Value-Based Care

I've long interpreted CMS's efforts in establishing RPM and RTM programs as a strategic move to enable fee-for-service practices to proactively manage chronic conditions, driving better outcomes and cost-efficiency. It's my assumption that CMS views these programs as a bridge to a value-based care future. The experience, knowledge, and infrastructure developed through RPM and RTM can pave the way for a broader transition to value-based contracts, aligning incentives around quality and efficiency.

The report rightly emphasizes that selecting appropriate patients is paramount to achieving improved outcomes. RPM and RTM can be particularly beneficial for patients with poorly controlled conditions, those initiating new medications, and individuals facing barriers to care, such as those in rural communities. As I highlighted in a recent HIT Consultant article, these technologies can help to overcome obstacles to access.

Detailed Documentation and Coding Will Improve Patient Selection for RPM

However, it is equally important that regulations and guidelines do not unduly restrict clinical judgment. Healthcare providers must retain the flexibility to determine which patients are medically suitable for RPM and RTM, while documenting medical necessity and anticipated clinical benefits.

To truly gauge the success of these programs in improving outcomes, robust data is essential. The OIG's 2024 report underscores the need for coding improvements to capture key details: specific conditions being monitored, types of medical devices used, and the identity of the ordering provider. This level of data granularity is crucial for analysis and quality improvement.

A Personalized Approach to RPM Duration is Important

The report mentions diminishing returns after six months of monitoring, citing ‘alert fatigue, lack of habit formation, and lack of integration with other tools.’ While these are valid concerns, the market has matured. Successful programs today incorporate health education and coaching to foster habit formation and long-term behavioral changes. Leading solutions are integrated with EHRs and other patient care systems, and alerts are personalized to enhance relevance and minimize fatigue.

I disagree with the notion that longer average durations of monitoring are inherently problematic. Patients vary significantly in their journey to health and condition management. Time is essential to assess whether improvements in blood pressure or glucose control are sustained when "life happens" – during travel, illness, or stressful events. Many patients may experience setbacks and require ongoing monitoring, coaching, and support to develop effective coping strategies.

Finally, I strongly endorse the report's call for aligning payment with both patient need and outcomes. Most fee-for-service groups are already participating in value-based care arrangements that incentivize positive outcomes for conditions like hypertension and diabetes. Further aligning RPM and RTM reimbursement with these value-based models will drive greater accountability and a stronger focus on what truly matters: improved patient health.