Three barriers to effective remote cardiac monitoring and how to overcome them
 

By Rhonda Bray at Rhythm Management Group

For cardiac device patients, it’s comforting to know a medical professional is keeping an eye on your device. For physicians, remote monitoring brings peace of mind that any abnormalities or events can be addressed as quickly as possible, optimizing patients’ health outcomes. And, as the current healthcare crisis has shown the industry, remote solutions are more important now than ever before.

The Heart Rhythm Society’s 2015 Expert Consensus Statement on Remote Monitoring (RM) concluded that RM’s early detection capabilities provided numerous meaningful benefits—supported by a wealth of large, international, randomized, prospective trials. Findings across the studies included:

·      Remote monitoring decreased risk of death by 50%[1]

·      62% of remote monitoring alerts were ‘meaningful’ vs. in-office rate of only 24%[2]

·      Remote monitoring reduces time to clinical decision from 22 to 4.6 days[3]

There’s clearly concrete proof around the benefits of RM – but many practices haven’t adopted or optimized an RM program yet because of the significant challenges to delivering this gold standard of care. In cardiology practices that have adopted RM, many are only able to monitor less than half of the patients that are appropriate for remote cardiac monitoring. And too often, those who are being monitored suffer from disconnected equipment and other issues that place a burden on the practice.

Here are some of the reasons that launching and managing an RM program is challenging:

1.) It takes a substantial investment in staff time to plan, launch and manage a program effectively. RM requires dedicated staff, and practices may have to start their program over again if they lose a key staff person. Recruiting qualified staff for this program is often difficult because a high level of clinical expertise is needed to be able to accurately interpret data and respond promptly to red alerts. Staff are also needed to schedule and reschedule patients following complex schedules for each device, log into each of four manufacturers’ portals to get data on patients, and triage all alerts to the managing physician.

2.) Enrolling, connecting, and monitoring patients is hard. Patients will need significant initial education, from understanding how RM will contribute to higher quality care to understanding how to connect their device and ensure it remains connected and accurately transmits data. If practices don’t stay ahead of disconnections, patients can easily be lost to follow up.

3.) Billing for RM takes time and expertise. A practice will need to bill insurance at the appropriate time for each type of implanted device, requiring coordinated scheduling and billing across complex, very different schedules for each device and each patient.

 
 

Considering your options: Owning RM vs. seeking a strategic partner

 

Option 1: Owning RM

The main decision a practice faces is whether to do RM themselves or partner with a professional RM company. The main benefit of owning RM itself is that a practice can keep 100% of the revenue it collects. However, given the challenges detailed above, this isn’t always the best approach. By owning the RM program, the practice must assume the risk of staffing with skilled people, scheduling and educating patients, monitoring devices, billing, meeting regulatory standards, and ensuring high enrollment and collection rates. On average, practices are only enrolling 40-45% of all appropriate patients and are only able to maintain connectivity rates of around 50% of those patients enrolled. As a result, many practices have found that owning the RM program produces less revenue than anticipated while the costs of maintaining the program are higher than expected.

 

Option 2: Partnering

The alternative to running your own RM program is to partner with an experienced RM company to manage the program. While this partner will collect a portion of revenues, they will also take all of the headaches of managing the program off the practice’s shoulders. A partner can more efficiently manage operations to leverage economies of scale and high care standards, and may include a software platform to more efficiently manage the program. In addition, an experienced RM company may also be able to increase – even double – enrollment rates. That can increase collections for the practice while relieving it of the burden of overseeing the program to ensure quality.
 

What to look for when hiring a RM company

The key in selecting a RM partner is to look for one that maintains high standards for recruiting and monitoring highly skilled staff. Human expertise is the most important factor in delivering high quality RM care; it is what will engage and keep patients monitored over time. Ask prospective RM companies for details about :

  • The training, credentials and experience of their staff
  • Their processes and system for monitoring critical alerts 24/7 and their ability to quickly connect with your team to prevent and address issues.
  • Their technology platform’s ability to manage data for all patients and vendors. A sophisticated software program that can integrate data from all vendors and provide data at-a-glance will help make your life easier.
  • Their track record of penetration and connectivity rates. The best RM companies can demonstrate that they’ve been able to keep their client practices at or above 90% penetration and connectivity.

Working with an experienced remote monitoring company with proven results may actually increase revenues for your practice. Projected net revenues for a practice with 500 remote monitored patients nearly doubled the practice’s net revenues from $133,000 to $248,000.

Updated-proforma-slide-01162020.png

Decide what’s right for your practice – owning the RM process, or engaging a strategic partner. Every practice is different. I hope this discussion of barriers and opportunities helps you make the decision that’s right for you.

For more information, please contact us at (888) 948-7884.

 


[1] https://www.hrsonline.org/clinical-resources/2015-hrs-expert-consensus-statement-remote-interrogation-and-monitoring-cardiovascular-electronic

[2] ibid.

[3] ibid.