COVID-19 has forced healthcare providers to move care beyond the clinical setting.
Not only are health systems currently tasked with treating the rising number of COVID-19 patients, but all providers – including hospitals, large provider groups, and small clinics – are facing massive challenges with staffing furloughs, appointment cancellations, revenue losses, and even shutdowns. In response, providers have quickly moved virtual.
The critical urgency to move from in-person to virtual care was caused by the dramatic drop-off in inpatient visits over the last month as COVID-19 quickly spread across the U.S. Patients who were afraid of getting ill stayed away from their doctor’s office. And as a result, many physician practices experienced in-person patient visits drop by 50 or even 75 percent. According to Evidation’s COVID-19 impact study, about 33% of patients reported they have abstained from or canceled a scheduled appointment within the last two weeks – and numbers continue to rise. Concerningly, those with acute and chronic conditions rely on these standing medical services to adjust treatments and manage their health.
Many providers that treat individuals with chronic conditions are trying to quickly put measures in place to prevent their patients from experiencing a relapse in their illness or from new complications arising. Because those with chronic conditions are at an increased risk of getting severely sick from COVID-19, and the mortality rate is higher, the need to closely monitor these individuals is even more important during this time.
Chronic Conditions in the U.S.
Chronic conditions affect 133 million Americans, representing more than 40 percent of the total population of this country. This year, according to the National Health Council, that number is projected to grow to an estimated 157 million people living with a chronic condition, and 81 million of those individuals living with multiple conditions.
More than 75 percent of all healthcare costs are used to treat chronic conditions. And, four of the five most costly health conditions are chronic conditions – heart disease, cancer, mental disorders, and pulmonary conditions.
For hospitals and health systems, a key strategy to help patients is to extend chronic condition management to the home through telehealth and remote patient monitoring. According to a report, 70 percent of patients with a chronic condition said that they want more resources or clarity to help manage their disease, and 91 percent said they need help to manage their disease.
The Intent and Value of Chronic Care Management
Chronic care management (CCM) helps patients better understand the progression of their condition so that they can better identify abnormal or concerning symptoms, biometric readings, and behavioral trends. This understanding and behavior change often comes from support delivered by the patient’s care team; those care managers, or in some instances, physicians are actively monitoring the person’s biometrics readings, reported symptoms, and associated lifestyle behaviors. CCM programs help patients and providers identify irregularities or concerning trends before a condition progresses to a life-threatening or debilitating level.
Results from these programs have been proven to benefit patients and providers. In one example, patients managing diabetes who were enrolled in a remote patient monitoring program utilizing Validic Impact saw a decrease in their a1C levels by nearly one point. Across all patients enrolled in Impact-supported programs, the average patient with hypertension moved from stage 2 to normal ranges within 45 days. Additionally, after three months, 70 percent of the enrolled patients were still submitting physiologic readings at least twice a day. By allowing patients to have a more longitudinal relationship with their care teams and deeper visibility into correlating trends between their outcomes and readings, over half said the program helped them improve their health and overall wellbeing.
Why Remote Monitoring Matters Now More Than Ever
As hospitals and health clinics try to keep patients out of the healthcare setting, and as states implement social distancing guidelines, patients are finding themselves isolated at home. This isolation is not just people being cut off from their social networks, but also their support networks. A national study conducted by Cigna found that loneliness can wreak havoc on an individual’s physical, mental, and cognitive health. Additionally, social isolation can lead to adverse health consequences including, depression, poor sleep quality, impaired executive function, accelerated cognitive decline, poor cardiovascular function, and impaired immunity at every stage of life.
Patients with a chronic condition who are self-isolating due to COVID-19 may find their conditions worsening over time without those critical check-ins and touchpoints with their provider. Remote patient monitoring (RPM) enables providers to routinely monitor and manage their patients, with either acute or chronic conditions, between inpatient visits. In fact, RPM combined with virtual check-ins can replace many of the current inpatient visits related to adjusting and managing treatments. Remote monitoring programs and connected in-home devices allow providers to:
- monitor patients’ progress and adherence with treatments and programs;
- understand daily biometrics in relation to prescriptions and/or lifestyle behaviors;
- automate and act on alerts to easily identify concerning readings and/or trends;
- eliminate much of the manual data collection and data entry required of providers today – allowing more time to be spent on using the data to make better clinical decisions and allowing all clinicians to operate more at the top of their license;
- more regularly adjust treatments and recommendations to improve outcomes;
- improve the number of interventions and the timing of interventions with patients – and reduce associated hospitalizations;
- prioritize resources and attention on patients that need more focus, resources, and support.
Through virtual care services like RPM, providers can get a holistic and comprehensive picture of a person’s health and a deeper understanding of how their health has evolved over time. Are the medications they’ve been taking working as needed? Have they had enough physical activity today? Are they getting the recommended amount of sleep? How much food are they eating and what kind of nutrition are they receiving from their food choices? How have they described their overall mood and energy levels?
These data can help drive detailed conversations between patients and providers that initiate lifestyle and behavior changes and ultimately make the patient feel supported during this difficult time. A patient activation study found that highly engaged patients are two or more times likely to prepare questions ahead of a visit to their doctor, to understand treatment guidelines for their condition, and to seek out additional health information.
Not Just for Large Health Systems
As health systems and clinics rapidly deploy virtual services in response to COVID-19, consumers are becoming accustomed to the ease, convenience, and benefits remote offerings deliver, and we can expect this to become the new normal for patient expectations for care going forward.
According to a survey, 70 percent of patients are more likely to choose a provider that offers reminders for follow-up care via email or text, and more than half are more likely to use a provider offering remote or telemonitoring services.
One-fifth of primary care practices say they could close within the next month as COVID-19 continues to hurt providers financially, according to a new survey of clinicians. Primary care practices that utilize virtual care services can make up for lost revenue through reimbursement available via CMS and some commercial insurers.
With CMS reimbursement available for remote monitoring, providers can use CPT Code 99457 to bill for remote patient monitoring services and 99453 for patient education and set-up. These two codes allow for quick deployment and scaling of remote monitoring programs by providing the financial structure for physicians and qualified medical professionals to be reimbursed for their time spent on patient care.
Remote Patient Monitoring through Validic Impact
Validic Impact offers chronic care management (CCM) and population health management (PHM) teams the ability to utilize data, reports, and alerts to better manage populations with chronic conditions. These data – generated by the patient’s activities outside the clinical care setting – provide insights and visibility into the patient’s routine, activities, and lifestyle, not available within a traditional inpatient encounter.
Validic accesses personal health data from hundreds of wearables, health apps, and in-home medical devices – like weight scales, blood pressure cuffs, and glucometers – and integrates these data via a single API connection into the provider’s existing electronic health record (EHR), care management platform or other clinical systems. Validic Impact provides visualizations and RPM functionality within the existing clinical workflow. Care teams can use the solution to build and customize virtual care programs to monitor conditions like hypertension or diabetes – that can quickly scale as population needs grow.
The solution has proven to reduce the cost and burden that lifestyle-driven chronic health conditions place on patients, providers, and caregivers by enabling early diagnosis and prevention, and proactive, personalized care management.
Maintaining Chronic Disease Management
Concerningly, many patients are not able to easily access needed care due to COVID-19. Similarly, many care providers across the country are unable to provide needed chronic care management and acute care services. Deploying a strong virtual care strategy to supplement and replace in-person services is essential to keeping the patient at the center of care.
At Validic, our goal is to continue to serve people with technology that makes care delivery more effective, efficient, affordable, and accessible. By keeping people that do not need emergency medical attention out of hospitals and health clinics, telehealth and remote patient monitoring can help reduce the spread of COVID-19 and ensure limited healthcare resources are put towards the most critical and urgent needs. Virtual care services are needed now, and in a post-COVID-19 world to radically improve patient care and outcomes, provider burnout and shortages, and worsening capacity issues.
For more information on Validic’s COVID-19 response, please visit https://www.covidmonitoring.com/ or learn more about Validic’s remote patient monitoring solution at https://validic.com/solutions/impact/.
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