CHRISTUS Remote Patient Monitoring Challenge: Balancing Mission and Margin in Fee-Based World

Thursday, March 5th, 2015
This post was written by Patricia Donovan

CHRISTUS Health recently expanded its remote patient monitoring program from 24 to 170 participants.

In its initial months of coaching 23 patients to wellness at home via remote monitoring, CHRISTUS Health nearly halved participants’ average cost of care, experienced no 30-day readmissions, and realized a 100 percent patient satisfaction rating.

Now, having expanded its remote patient monitoring (RPM) enrollment to 170 high-risk, high-cost patients, the challenge for the multi-state and international integrated delivery network is scaling up RPM technology while balancing its mission of keeping patients healthy and in their homes with the financial fallout of keeping reimbursed patients out of the hospital in a largely fee-for-service environment.

“As a faith-based system, we are very passionate about keeping patients healthy and keeping them at the less restrictive, least risk environment. However, we also have to make sure our revenue stream is sufficient so that we keep our doors open,” noted Dr. Luke Webster, chief medical information officer for CHRISTUS Health during Remote Patient Monitoring for Chronic Condition Management, a February 24, 2015 webinar now available for replay.

Dr. Webster was joined by Shannon Clifton, director of connected care for CHRISTUS Health, who described the daily RPM program’s eligibility criteria and clinical workflow process as well as its clinical, financial and quality benefits.

Constructed around a Bluetooth®-enabled monitored kit sent home at hospital discharge, the RPM initiative is now supported by a team of six care transition nurses, up from a single nurse at the program’s outset, Ms. Clifton explained.

Other program elements include in-hospital kit delivery and patient education, as well as nurse coach monitoring following the patient’s return home.

Participants, who are identified via CHRISTUS’s care transition program, self-monitor key biometrics. A nurse coach responds to any alerts, coaching the patient back within wellness parameters and alerting the primary care physician if necessary to further engage the patient.

Patients remain in the program for up to 60 days. There are now 100 RPM kits in circulation, up from the initial ten in the program’s first phase.

While patient satisfaction remains high—98 percent currently in the expanded phase—CHRISTUS must also contend with the uncertainty of mobile health and a degree of provider skepticism and resistance. Another RPM-related hurdle is the additional workload it creates for care transition nurses.

With the support of its CFO, CHRISTUS Health is exploring options to optimize its RPM investment, including advocacy for expanded telehealth reimbursement; RPM subscription options for ‘the worried well’ who would pay for the monitoring; and development of a centralized e-hub, among other ideas.

Listen to Shannon Clifton describe the critical stage of the 60-day program that strives to keep high-risk patients within wellness parameters.

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