Transforming Hospitals Post-Pandemic

The COVID-19 pandemic will one day be over, but its effects will linger. The crisis led to rapid changes in healthcare, and healthcare in the U.S. will never be the same. With concerns about overwhelming the healthcare system, and reducing the spread of the virus in hospitals, came a new focus on telehealth, or providing care remotely.

Post-pandemic hospitals and healthcare providers will undergo transformations in how they offer care on site and outside of traditional healthcare settings. Along with implementing new approaches to reducing infections among patients, hospitals will continue to provide remote services. Remote patient monitoring (RPM) is an increasingly common service that can keep patients healthier and benefit hospitals and providers.

Safely Treating Infectious and Non-Infectious Conditions

During the COVID-19 pandemic, hospitals and other parts of the healthcare system had some major concerns. There were worries about spreading the disease to patients who had been admitted for other reasons. This had devastating consequences for untold numbers of patients who may have delayed care for emergency events, such as strokes, and suffered permanent and preventable consequences.

Hospitals used strategies such as separating infectious disease patients from patients without COVID-19, and screening patients upon entry and directing those with symptoms of COVID-19 to separate areas. Successful practices for reducing the spread of disease in hospitals may continue in the future.

Hospitals and providers also tried to reduce the spread of COVID-19 in the hospital by reducing the number of patients who needed in-person care. Strategies included improving patient health to reduce the need for hospitalizations, and providing more options for remote healthcare.

There were also questions over the ability of hospitals to handle all COVID-19 patients along with their regular patient loads. Equipment was in short supply, and many providers left their regular posts and did rounds on COVID-19 floors or in hospitals within COVID-19 hotspots to lend a hand.

Officials claimed that shelter-in-place and safer-at-home orders, meant to “flatten the curve,” helped slow the parade of COVID-19 patients into hospitals, but how can hospitals still effectively treat their usual numbers of patients while stretched to the limit with COVID-19 patients? That is where remote care, including RPM, comes in. Patients are treated off-site, to reduce the resources they use, and patients are offered more preventive care, to stay healthier and avoid hospitalizations.

from the WSJ: "The aim is to be able to isolate and treat infectious patients while continuing to provide other vital services that keep people healthy and bring in the revenue hospitals desperately need to keep their doors open.

These changes promise to markedly reduce risk and disease spread—and change the way people experience care even in times when there is no crisis. More aspects of the health-care experience may become more automated and efficient—from check-in through follow-up—but it will also become less hands-on than people have come to expect."

Increasing Use of Remote Patient Monitoring

Remote patient monitoring is widespread and is projected to become even more so. In fact, 88% of healthcare providers use or are considering using RPM as part of their care for patients who are at high risk for hospitalizations or readmissions [1].

In RPM, patients have monitoring devices, such as glucose monitors, scales, blood pressure monitors, or thermometers, that collect data in a home or other non-traditional care setting. Qualified healthcare providers help patients set up their devices, then they analyze the collected data and communicate with patients about it.

The use of RPM helps enable hospitals to continue to treat a high number of non-COVID-19 patients even during waves of COVID-19. That is for two main reasons.

1. Patients treated off-site require fewer resources, including physician and other provider time, and space in exam rooms.
2. The use of RPM can lead to fewer emergency visits, hospitalizations, and hospital readmissions

Continuing to treat large numbers of patients can be necessary for hospitals who depend on them for revenue even as the hospitals are also isolating and treating COVID-19 patients.

Shift to Value-Based Care

Better ROI with RPM

Trends: patient satisfaction will matter, cost management, and AI for assessmsnet and documentation [2].

Increasing Recognition of Benefits of Remote Patient Monitoring in Hospitals

The benefits of RPM in hospitals come from improved patient outcomes and revenue streams. In one analysis, patients who were in RPM programs had 76% lower readmission rates as a control group [3]. These are some examples of how RPM might lead to improved outcomes - and less expensive care.

• A weight scale transmitting information about sudden weight gain in a patient with coronary heart failure, suggesting the need for immediate intervention and that may not have been caught as early without RPM.
• A doctor noticing data from a connected glucose meter about the patient’s increased blood glucose over the past week, leading to a discussion about taking medications and other actions much before the patient’s scheduled semi-annual glycated hemoglobin (A1C) tests.
• A hypertensive crisis leading to a phone call and immediate action to mitigate risks.

Another effect of RPM that can improve patient outcomes is increased patient engagement in their own care. This is especially important in chronic conditions such as diabetes and hypertension, where patient behaviors on a daily basis, such as what to eat, whether to take medications properly, and how often to test blood sugar or pressure, can have a major impact on management of the condition.

While RPM has the potential to improve patient outcomes and therefore feed into a value-based care system, it also has direct revenue streams. Medicare offers reimbursement for RPM with possible amounts of over $150 per month per patient.

Overcoming Barriers to Using Remote Patient Monitoring in Hospitals

Despite the promises of RPM, not all hospitals are using it yet. There are some barriers to incorporating it. For example, patients need to get used to remote care rather than having all interactions in person. The increase in emphasis on telehealth appointments can help patients change their mindsets about what healthcare is.

Another shift that is needed to successfully use RPM is the willingness to get (patient) or provider (hospital or provider) preventive care instead of waiting until there is an emergency. For example, with RPM, patients can manage chronic conditions better and lower the risk for expensive and devastating complications.

Advancing technology and economics are also breaking down barriers. Devices are simpler to use as technology advances. For example, Lark is wireless and accessible via the patient’s phone, so there is no inconvenience to the patient. It is infinitely scalable, so it is easy for payers to use for large populations. In addition, ongoing reimbursement for RPM makes it more attractive for providers.

The COVID-19 pandemic will pass, but hospitals will maintain many of the changes they made during the crisis. Transformations will include continued efforts to isolate infectious disease cases, as well as continuing to use technology, such as RPM, to improve patient health and provider revenue.