It is important for medical organizations to know how to set up an efficient remote patient monitoring (RPM) workflow. As a result, healthcare teams will experience minimal impact on clinical staff workflows. In fact, with proper implementation, RPM can increase healthcare organizations’ revenue. This article uncovers how to set up an efficient remote patient monitoring workflow in 5 easy steps.
CMS updated CPT Code 99457 in December 2021, which allows ‘incident to’ billing under general supervision instead of direct supervision. General supervision means the physician or other qualified healthcare professional does not need to be in the same building as the clinical staff performing remote patient monitoring workflow services.
As a result, clinics can easily outsource remote patient monitoring services to third-party vendors to minimize changes to existing workflows. Healthcare teams new to the remote patient monitoring space may wonder about the roles and responsibilities involved in remote patient monitoring and the options available to help reduce clinic workload while creating efficiency.
Understanding the Remote Patient Monitoring Workflow
Before determining how remote patient monitoring affects existing clinical workflow, it’s important to understand the operations behind remote patient monitoring. This easy 5-step guide will help you understand the procedures and responsibilities required for remote patient monitoring.
Step 1: Establish a Patient Base to Start a Remote Patient Monitoring Workflow
First, to establish efficient remote patient monitoring workflow, clinicians must review their patient base. Next, identify which patients can benefit from remote patient monitoring. To do this, a physician or other qualified healthcare professional must pinpoint which conditions they want to manage within their remote patient monitoring workflow. Some common health conditions where remote patient monitoring services are appropriate include:
- Hypertension
- Congestive Heart Failure
- Diabetes
- Chronic Obstructive Pulmonary Disorder
- Kidney Disease
- Cancer
- Sepsis
All Medicare beneficiaries are eligible to participate in remote patient monitoring. However, patients must opt-in prior to ordering any RPM devices like blood pressure monitors, blood glucose meters, pulse oximeters, or scales. Additionally, new patients or patients who have not seen their provider within the last 12 months must opt-in in person.
Step 2: Supply and Set Up Devices
The next step in setting up an efficient remote patient monitoring workflow begins once clinicians have established their patient base. Next, decide who will supply the RPM device and help with the setup. Clinics can supply their own remote patient monitoring devices, but they will have to figure out details such as:
- How will patients get the remote monitoring device?
- Who will guide them through rpm device education and setup?
- What will happen if the rpm device breaks or has problems?
- How will information from the monitoring device be sent to the clinician?
One option is to research remote patient monitoring vendors like Tenovi that provide an array of RPM devices, aggregate health data and billing and ship FDA-cleared devices directly to your patients. On top of this, Tenovi can guide patients through device setup and education, troubleshoot any difficulties, and answer any ongoing questions through HIPAA-compliant technical support.
Step 3: Manage Patient Data
After patients receive and set up their RPM device, they are responsible for using it at least 16 days a month. This means that patient data will be frequently added to the remote patient monitoring platform. While remote patient monitoring may initially appear to be a lot of work, the physician or qualified healthcare professional does not necessarily have to be the one person to manage the entire workflow. With this in mind, clinicians must determine who will manage which stage in the remote patient monitoring workflow. These are helpful questions to ask:
- Who will be monitoring patient data?
- What happens if the patient has not been using their rpm device?
- Who will inform the physician if a patient’s condition escalates and needs medical attention?
- How will patient data be integrated into the electronic health record (EHR)?
- Who will train the clinical staff on using rpm hardware devices and software services?
- Which actions should be documented?
Step 4: Decide Who Will Review Patient Data
Clinic time and resources must be used efficiently. To do so, healthcare teams must create an RPM program roadmap to ensure they work at the top of their licenses.
The physician has 4 options:
- Assign patient data review to in-house clinical staff.
- Perform patient data review alone.
- Hire additional in-house clinical staff to perform data review.
- Outsource data review to third-party remote patient monitoring companies.
All clinical staff are qualified to review patient data, but only a physician can diagnose and treat patients. Therefore, it is ideal for clinical healthcare staff to perform data reviews and alert physicians as necessary. Assigning data review to in-house clinical staff may negatively impact current workflows, and hiring additional in-house staff can ultimately be more costly.
Outsourcing RPM services to reputable third-party companies is beneficial because the clinical staff is already familiar with remote patient monitoring procedures. This option helps with healthcare staffing challenges and ensures the smoothest transition into remote patient monitoring.
Step 5: Determine the Billing Protocol to Conclude Setting Up Your Remote Patient Monitoring Workflow
Lastly, clinicians must determine the billing protocol for Medicare reimbursement. At the end of every month, they must gather all necessary documentation and determine which CPT codes to bill for each patient. Most dependable third-party vendors do not require payment for their services until after Medicare reimbursement is received. Once outsourced services are paid for, the remaining revenue will be the return on investment for remote patient monitoring.
Maintaining Efficient Remote Patient Monitoring Workflow
One of the major benefits of remote patient monitoring for doctors and healthcare organizations is more efficient work flow. Although the physician or other qualified healthcare professional does not need to be the same individual treating patients, they are more broadly responsible for understanding what is going on with their patients and making changes to treatment plans as necessary. Therefore, making time for weekly or bi-weekly briefings with clinical staff is good practice to see how patients are doing and to request feedback on RPM procedures and workflow. This will help identify what is or is not working so that the clinic can fine-tune the new remote patient monitoring workflow. Lastly, continuously gathering feedback, analyzing outcomes, and refining the workflow to ensure optimal patient care as you move on to scaling the remote patient monitoring program.
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