Example of RPM work
RPM works by allowing health care professionals to receive biometric, symptom, environmental compliance, and other important data from patients who are being monitored from the comfort of their own homes through a variety of technologies. This data is transmitted in near-real-time, securely, through the cloud, where it becomes actionable information once analyzed and triaged by automated processes governed by best practices. These same technologies also serve to impart automated, focused health education at the best moments, within the context of a patient’s unique disease expression. None of this is meant to supplant face-to-face care, but to inform the care team of how the patient is faring and complying with the plan of care in between in-person encounters, and to greatly expand the number of touches.

New York City Health and Hospitals Corporation (NYC HHC), the nation’s largest municipal, integrated delivery system (with 11 acute care hospitals, five nursing facilities, six large diagnostic and treatment centers and more than 70 community-based clinics), was an early adapter of RPM and enjoyed phenomenal outcomes as a result.
NYC-HHC was looking to improve the care of patients with poorly controlled diabetes, which continues to be an acute problem among the city’s Medicaid population. Working with AMC Health, NYC-HHC developed a unique HouseCalls Telehealth Program that uses RPM in patients’ homes to track blood glucose, weight, blood pressure, as well as self-reported information on symptoms, care asset availability and behavior around diet, exercise, and medication adherence. Data was sent to AMC Health’s secure web portal, with clinical decision support tools that provide customized alerts for each patient, trending analytics and population-wide benchmarking.

Of over 700 patients monitored, 81% had significant and sustained improvement in glycemic control with HbA1c reduced by an average of 1.8 percentage points, with program graduates averaging an astounding 3.3 percentage point reduction, representing over a halving of risk for microvascular complications and peripheral vascular disease. For those who also had baseline hypertension, diastolic BP reduced by 5 mm Hg, representing a 21% reduced risk of cardiac events.

NYC-HHC is just one example. RPM is currently helping at-risk organizations around the country reduce the number of ED visits, hospitalizations (especially readmissions), and lengths of stay in hospitals, all of which help improve quality of life and dramatically contain costs for a wide range of diagnoses and morbidity profiles. We can expect RPM to continue to evolve during the next 5 years, as we will see greater incorporation of RPM into practice management, while the monitoring technologies themselves continue to get more accurate, user friendly, less costly and more informative as the data science evolves.

Jonathan Shankman is senior vice president of Clinical Innovation for AMC Health

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