Throughout the pandemic, leading healthcare providers and payers experienced firsthand how digital transformation can augment and protect their workforce, support the health needs of consumers, and improve health outcomes. Despite these early successes, many organizations still struggle with operationalizing digital health programs and meaningfully assessing their return on investment.
During Validic’s Best Practices for ROI and Clinical Operations for Remote Patient Monitoring webinar, Validic CEO and co-founder Drew Schiller sat down with Angie Stevens, chief strategy officer at Iron Bow; Nelson Le, associate vice president of product strategy, digital health and analytics at Humana; and Sara Vaezy, SVP, chief of digital and growth strategy at Providence Health. The panel shared their thoughts on approaching virtual care ROI, operationalizing RPM programs and how they hope perceptions of virtual care will change in the year to come.
Q: What criteria does your company use when thinking through the business case of remote monitoring and virtual care?
Sara Vaezy: The answer really depends on the patient and population type, alongside other factors. Most fundamentally, our organization is moving very intentionally toward building out the continuum of care — both physical and digital — that sits outside of our traditional acute settings. And the other main factor we consider is how can we think about this in a way that allows us to not have to time the transition economics of moving from fee-for-service to value.
Nelson Le: One of the things we really think about is how a program can help us take this data and really contextualize it for the patient. We know we can do remote monitoring and get this data in. But what are we going to do with it? And how does it allow you to get a better understanding of who your patient is?
Angie Stevens: There’s a couple of key considerations when you’re thinking about the operation workflow and how you operationalize for scale. One is that you want to make sure you can embed a program within existing workflows when it makes sense. I think it’s important to consider that you don’t want to just take a manual process and make it digital. Then, as you begin to collect this data, how are you leveraging it to really personalize care for people? There’s so much power there to the operational impact, especially if you’re able to find the right clinical leaders who are really bought into how this process will help them and their patients.
What are the use cases and populations that make the most sense for your organization’s initial investment in remote monitoring?
Nelson: Our approach is around how we can understand our patient’s health, how their disease may be progressing, and how to minimize the risks. We want to influence behavior change, so we identify what behavior we’re trying to change, look at the leading indicators of this behavior and whether they can be monitored, and finally if we can intervene. For us, that is a rubric that applies to conditions like COPD, CHF, diabetes and others while keeping the focus on the behaviors that are upstream.
What are realistic goals and ROI targets for RPM programs, and how might they differ between health systems and plans?
Sara: It is a good point about thinking long term, but cash flow is an issue, especially for providers. One thing that isn’t often talked about as the business case or ROI case for remote monitoring is the potential for digital and remote monitoring to increase clinical capacity and therefore be a vehicle for growth. That allows you to function in any economic environment and buys you time to get to the point where you have long-term value accrual across the population.
Nelson: Right now our way of keeping in touch with patients is telephonically, and that just isn’t sustainable over time. So if we’re able to stratify our population and optimize those interactions for certain segments of the population it increases our capacity. Another aspect is engagement. When someone is engaged in remote monitoring, that is an opportunity to get them engaged in other services as well. When our members are in a remote monitoring program, they’re going to take their meds, they’re going to exercise, they’re going to eat well because they know they are being monitored. And once a member is engaged in their own health it can be easier to bring them into other types of programs and help improve their health outcomes.
How can organizations begin to operationalize an RPM program in year one?
Angie: I think you have to start small. We began with a small group of highly-invested clinicians. They really wanted it to work, so they were willing to deal with the little bumps and bruises along the way. As we progressed, we were able to add capabilities and utilization across regions. It just takes time and you have to be patient, I think you also need clear goals and metrics you can manage to but it needs to be flexible. Measuring directional outcomes is important. Will every nurse have a panel of 400 patients up by month two? Probably not. But if you’re headed in that direction, good. If not, time to go back and adjust. It’s not a failure to identify your metrics aren’t going the way you want them to go, that’s a success. It means you’re actually looking at it objectively.
I want people to know that this isn’t a fad. Yes, we’re going to keep doing remote monitoring. Yes, it’s going to keep getting cheaper, better and more ubiquitous. This is how we’re going to manage care going forward.Angie Stevens, chief strategy officer at Iron Bow
Final thoughts: What’s your wish for how others will think about the opportunities around virtual care in 2022?
Angie: I want people to know that this isn’t a fad. Yes, we’re going to keep doing remote monitoring. Yes, it’s going to keep getting cheaper, better and more ubiquitous. This is how we’re going to manage care going forward.
Nelson: We think too much about remote monitoring and in-person as two things that can’t coexist. I want us to see these as complementary and integrated tools that are part of how we deliver care.
Sara: I want an overarching metric. Because if our big goal is something like, “We want to double access with no brick-and-mortar growth”, the obvious answer is that we need tech enablement.
This conversation was an edited selection from the third in Validic’s Best Practices webinar series. Watch the full series on our YouTube channel to hear more best practices and insights from industry leaders or connect with us at firstname.lastname@example.org.
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