Remote Patient Monitoring (RPM) is a new and powerful reimbursable telehealth program changing the future of healthcare. Benefits of RPM include improved care outcomes, new revenue for your organization, and an improved patient experience.  

A successful RPM program requires software, devices, and people. 

When it comes to devices -- the good news is that there are more user-friendly and affordable devices available than ever before. And, the types of physiologic measurements that can be taken accurately and frequently are also increasing. However, these choices definitely create a need to understand your options, so that you can make informed, beneficial decisions for your business.

This article will provide a simple framework to help you determine the best possible current device(s) that you can offer to your patients, members, or clients.

[NOTE: If you need more context or background about RPM -- including how reimbursement works as a  part of your revenue plan -- you might want to first check out our 5 steps to getting started, and seven key updates to billing rules]

5 STEP FRAMEWORK OVERVIEW

1. What data/measurement types are desired? (i.e. blood pressure, heart rate, glucose, etc.)
2. What data frequency is desired (i.e. once or more/less a day, time of day considerations, or "continuous")
3. Ease of use for patient (i.e. Do they need a smartphone and/or internet? How easy is taking the measurement and sending the data? Does the device need to be recharged?)
4. Cost of device (i.e. $10/month, $20/month, $200/month)
5. Reimbursement/economic model (i.e. Standard RPM CPT code reimbursement:$100 - $200/month, Cash Pay/Concierge, Wellness/Prevention, Hospital at home, 24/7 Real Time Monitoring--and related, FDA approval requirements for reimbursement)

1. WHICH DATA TYPE(S) ARE DESIRED?

Common RPM data types include blood pressure, heart rate, heart rate variability, glucose, weight, pulse oximetry, respiratory rate, steps/physical activity, sleep/active minutes. The most common we see are blood pressure, heart rate, weight, and glucose. These create a map for the most common chronic conditions, and they are the easiest to use (see #3) as well as the most affordable (see #4), FDA approved (see #5) devices on the market. 

2. WHAT DATA FREQUENCY IS REQUIRED?

How many times per day or week will you collect data? Do mornings, evenings or other times during the day need special attention? Are you looking for before or after meals? Is a "continuous" measurement required, and if so, how will the monitoring team use that data? We support continuous glucometers, heart rate devices, and automated blood pressure and SPo2 devices. However a combination of these devices can be  very expensive, non-FDA approved, or difficult  for some patients to use because they require a modern smartphone with a wi-fi and/or cellular data plan.

3. HOW CRITICAL IS EASE OF USE FOR PATIENT? 

This is arguably the number one item to consider. If the patient doesn't use the device, and/or they do try to use it but the data never makes it to the care team, it becomes a useless tool in an RPM program. We see providers offering the highest quality RPM care which qualifies for reimbursements under CPT Code 99454 (see #5) focused on daily/close to daily measurements that are automatically transmitted to the care team. In these situations cellular devices are preferred where the devices (i.e. cellular BP cuff, cellular glucometer, and so on) -- have an actual cellular chip and cellular data plan IN the device itself. Cellular devices are the easiest for patients to use, as they do NOT require the patient to have a smartphone or wi-fi network. 1bios also supports bluetooth, wrist-worn, wearable devices that automatically track continuous heart rate, blood pressure, SPo2, steps, sleep, active minutes and more. The advantage with these devices is that the patient only needs to wear the device, and the measurements are automatically taken.  

4. WHAT WILL THE DEVICES COST

Who will pay for this device, and how much will it cost? In general, here is the breakdown from lowest to highest cost:

1. Devices that DO NOT meet the definition of a medical device per Section 201(h) of the Food, Drug & Cosmetic Act -- regardless of device type these will generally be less expensive and. DOES NOT QUALIFY FOR CPT 99454 AS OF 2021.
2. Devices that are not electronically transmitting the measurement to the care team. DOES NOT QUALIFY FOR CPT 99454 AS OF 2021.
3. Devices connected via bluetooth -- must pair to a bluetooth smartphone that has a wi-fi or cellular data connection.
4. Cellular devices (scale, bp cuff, glucometer, and "hub" that connects to bluetooth device) --has its own chip and data plan, so the patient doesn't need a smartphone or wi-fi/cellular data plan.
5. Continuous monitoring devices (glucometer, heart rate--these are bluetooth as of June 2020)-- a continuous measurement system will be the most expensive.They will cost an order of magnitude more than "once/a couple of times a day" type devices. For example a Continuous Glucose Monitoring (CGM) system will cost at least $150/month vs. a cellular glucometer is more like $20/month.

The most common we see in 2021 is the fourth option--the cellular devices. Then, the third option-- the bluetooth devices. 

5. WHAT IS YOUR REIMBURSEMENT/ECONOMIC MODEL -- WHAT CAN YOU AFFORD?

How will the providing organization be funding the RPM program, and how does that relate to which device options are available? In general, here is the breakdown of what we see across our customer base.  

1. RPM providers using CPT code reimbursement to fund program: Providers need high frequency measurements and get around $65/month for achieving this. This option will mostfrequently use cellular devices or bluetooth devices. 
2. RPM providers using other funding models. This scenario doesn’t necessarily need measurements as frequently, nor are devices required to meet the definition of a medical device per Section 201(h) of the Food, Drug & Cosmetic Act. Patients/clients might be more tech-savvy, making bluetooth devices potentially a good fit.
3. RPM specialty providers: Typically looking for a continuous, always-on model for post-discharge situations or other hospital-at-home scenarios with 24/7 human monitoring in order to immediately respond to any out of range data measurements.

SUMMARY:

The RPM device options have expanded significantly in the last two years, so that now there is a device or devices that should work for almost every patient. Devices are generally easier to use (cellular!) -- while competition among manufacturers is helping to keep prices in check. At 1bios we run a device agnostic platform, so that you are always assured of being able to have access to the best possible devices for your patients at the most affordable prices. If you want to see these devices in action, discuss the best approach for your patients, or receive our RPM devices catalog, book a virtual meeting with us, today!