Implementing and scaling a successful remote monitoring program.
Dignity Health Medical Group-Golden Empire Cardiology's partnership with Rhythm Management Group improves care and reimbursement
Dignity Health Medical Group (DHMG)-Golden Empire Cardiology is a four-physician cardiology practice in Bakersfield, California. Made up of a general cardiologist, an electrophysiologist, and two interventional cardiologists, the practice is known for embracing the latest technology and providing outstanding care to patients.
In late 2019, just a few months prior to the COVID-19 pandemic, DHMG- Golden Empire Cardiology began searching for a partner that could help it create and manage a cardiac remote monitoring program. The practice was growing—they had just acquired their fourth physician, an electrophysiologist—and their physicians and staff knew remote monitoring could help ensure patients were receiving optimal care, says Cindy L. Welch, RN, Senior Director of Clinical Operations at DHMG- Golden Empire Cardiology. At that time, the practice had several patients with implantable cardiac devices, but those patients were regularly seen in the practice, rather than being remotely monitored. The practice’s pacemaker technician had also just taken an extended leave of absence.
“Remote monitoring requires significant bandwidth, and we would have had to hire an additional staff member to take it on,” explains Welch, who has been with the practice for more than 30 years and is a certified cardiac device specialist. “Still, best practices dictate remote monitoring, and we wanted to find a way to provide it to our patients.”
”We now have peace of mind that, if something is wrong, we’re going to catch it.Cindy L. Welch, RN, Senior Director of Clinical OperationsDHMG-Golden Empire Cardiology
After considering various remote management partners, DHMG-Golden Empire Cardiology selected Rhythm Management Group, which provides a unique blend of service and technology to help practices and health systems create, improve, and scale remote monitoring programs. “Rhythm was more responsive than the other companies we considered,” says Welch. “They answered our questions quickly, and we appreciated that they were founded by RNs with years of experience.”
The practice kicked off its partnership with Rhythm in February 2020, a few weeks before the COVID-19 outbreak. “One of the first things Rhythm focused on was engaging and onboarding patients into our program,” notes Welch. “This meant I could focus on other tasks, which was especially important during the pandemic since many of our staff began working flexible schedules and my workload increased.”
Rhythm’s connection and clinical teams, which continuously monitor patient devices and transmissions, also helped DHMG-Golden Empire Cardiology staff and physicians remain connected to patients despite the
unique challenges posed by the pandemic. These challenges included a two-month practice shutdown, staff furloughs, and several patients deferring in-person care.
“Without Rhythm, many of our patients would not have been monitored at all,” says Welch. This means serious health problems may have gone undetected and unaddressed, increasing the risk of an emergency room visit, hospital admission, or worse. In addition to enrolling, engaging, and monitoring patients, Rhythm provides DHMG-Golden Empire Cardiology with a technology platform where staff and physicians can review reports, report summaries, and transmissions. Rhythm also color-codes the transmissions—red, yellow, or green—to indicate the urgency with which they should be reviewed.
“This makes it easy to see which information to review and when,” Welch explains. “We have a high level of trust in the way they categorize information, because we’ve seen a high degree of accuracy.” As an added level of protection, Rhythm’s clinical team sends real-time alerts to physicians and staff whenever transmissions reveal potential serious health problems. The alerts are sent based on thresholds determined by the physicians and staff. “We have peace of mind that, if something is wrong, we’re going to catch it,”
As of June 2021, 16 months since DHMG-Golden Empire Cardiology began working with Rhythm Management Group, Rhythm has identified and enrolled more than 380 patients in its remote monitoring program.
Of the nearly 400 patients enrolled, 96% are connected to their devices and engaging with the program. That’s nearly double the typical connectivity and engagement rate of 40% to 45% experienced by most practices with remote monitoring programs. “We’re happy with the engagement and growth,” says Welch. “The pandemic served as an impetus for patients who were initially hesitant to join, and Rhythm played a role in helping get them, and other patients, involved.”
Rhythm also benefits the practice from a care quality perspective. Engaging more patients means more patients are likely to receive optimal monitoring and care, says Welch. “When you don’t do a lot of remote monitoring and you suddenly implement a program like this, you naturally receive more alerts and identify more device programming issues, which requires some time to determine what’s clinically relevant initially,” she notes. “But it’s more than worth it because remote monitoring helps us catch what we need to.”
Another benefit of remote monitoring is additional reimbursement, as more patient engagement means more billing for services with CPT codes 93294, 93295, 93297, and 93298. Of the patients who are engaged with DHMG- Golden Empire Cardiology’s program, 97% are on a regular transmission schedule, which helps optimize care insights and reimbursement. In fact, in the 16 months since initiating the program, the practice has completed 1,486 remote monitoring transmissions and billed an estimated nearly $90,000 for remote monitoring services (based on Medicare rates for the local MAC).
As noted earlier, a primary reason DHMG-Golden Empire Cardiology selected Rhythm was its superior level of responsiveness compared to other vendors. Sixteen months into the partnership, Welch says that commitment has never wavered. “If I ever have a question about anything, Rhythm responds that day. They’ve been great to work with.”
Key benefits for DHMG-Golden Empire Cardiology
- 380 patients engaged over a 16-month period
- $90,000 estimated billed for remote monitoring services
- 96% connectivity rate
- 97% transmission scheduling compliance rate
Rhythm Management Group Provides
- Patient identification, engagement, onboarding
- Ongoing monitoring for health and connectivity problems
- Immediate resolution of connectivity issues
- Real-time alerts when monitoring reveals potential health problems
- Enhanced scheduling compliance to ensure optimal reimbursement
- Detailed reports and report summaries
”We have a high level of trust in the way they categorize information, because we've seen a high degree of accuracy.Cindy L. Welch, RN, Senior Director of Clinical OperationsDHMG-Golden Empire Cardiology