My first thought was to wonder why insurers would care about revolutions per minute, then I feared it related to the revolving door of shorter lengths of stay and more readmits.
Only then did it occur to me that it was remote patient monitoring! Our org is just starting to consider RPM so I'm just getting up to speed....
The previously announced plan would have been a show stopper except for a few niche areas. Even with insurers relenting on reimbursement for the time being, adoption will depend on a combination of technical feasibility, integration with a multiplicity of existing systems, and whether the compensation offsets the hassles to clinicians and added staff costs needed for monitoring. On the patient side, utilization will depend on actual benefit to health and whether it offsets the added hassle of monitoring. Unintended consequences also need to be considered. For example, does remote monitoring make patients more anxious about minor fluctuations in their parameters? What happens when patients want to go on vacation away from their monitoring devices or when there's a power outage? Will everything go haywire a la Waymo in SF? Many systems aren't even doing a good job of getting patient reported rating scale outcomes entered as discrete and trackable data elements so how do they think they'll be able to handle remote monitoring data in a manner that is clinically meaningful and accurate? What will be done to keep inaccurate data from cascading through the chart? If you do a spot check of a pulse ox that registers as low because it was not seated fully over the nailbed (or because the fingers were cold or the nails painted), you reposition it and mark it in error (or never enter it). Will it now be listed as an episode of hypoxia? Bottom line is that we need reimbursement to drive tech development and adoption but we shouldn't let the latest shiny objects draw our attention away from the research and infrastructure that are still needed for clinically useful innovations.
My first thought was to wonder why insurers would care about revolutions per minute, then I feared it related to the revolving door of shorter lengths of stay and more readmits.
Only then did it occur to me that it was remote patient monitoring! Our org is just starting to consider RPM so I'm just getting up to speed....
The previously announced plan would have been a show stopper except for a few niche areas. Even with insurers relenting on reimbursement for the time being, adoption will depend on a combination of technical feasibility, integration with a multiplicity of existing systems, and whether the compensation offsets the hassles to clinicians and added staff costs needed for monitoring. On the patient side, utilization will depend on actual benefit to health and whether it offsets the added hassle of monitoring. Unintended consequences also need to be considered. For example, does remote monitoring make patients more anxious about minor fluctuations in their parameters? What happens when patients want to go on vacation away from their monitoring devices or when there's a power outage? Will everything go haywire a la Waymo in SF? Many systems aren't even doing a good job of getting patient reported rating scale outcomes entered as discrete and trackable data elements so how do they think they'll be able to handle remote monitoring data in a manner that is clinically meaningful and accurate? What will be done to keep inaccurate data from cascading through the chart? If you do a spot check of a pulse ox that registers as low because it was not seated fully over the nailbed (or because the fingers were cold or the nails painted), you reposition it and mark it in error (or never enter it). Will it now be listed as an episode of hypoxia? Bottom line is that we need reimbursement to drive tech development and adoption but we shouldn't let the latest shiny objects draw our attention away from the research and infrastructure that are still needed for clinically useful innovations.