Remote Care Conversations for Health System Leaders

4 weeks ago

MD Revolution’s Chief Revenue Officer, Paul Huffman joins Neha Mohnot, Panda Health’s Director of Customer Success and Partnerships in a candid discussion about digital innovation and remote care, specifically for health system leadership.

Find this insight-packed discussion on-demand or peruse the highlights below such as the benefits of implementing at full-scale, considerations for both fee-for-service and value-based environments, and how patient demand and new devices are driving the market’s growth.

Q) Many health systems are either doing remote care and virtual care programs or are more open to it now. Why do you think that is?

Within health systems we’re seeing more digital innovation and even a lot of new titles geared those advancements. For example, the title Chief Innovation Officer is looking to implement some of these “newer” digital programs within the ecosystem. I think the market is catching up with some of the innovation that happened when remote care codes first came out in 2015 and then again in 2019 and 2020, when remote patient monitoring was approved by Medicare.

At the time it was very novel; it was one of the first codes that you could bill without seeing the patient face-to-face in the office. But my experience with health systems is that they have a wait and see approach to new programs. I think there was a lot of hesitancy in the market, especially before COVID. When COVID-19 hit and so did all the complications that came with it, innovations were forced to pause, because the hospitals were the backbone of the health system. We didn’t see a lot of new initiatives start during that time.

What has happened since then is that not only are patients more comfortable with virtual care, digital care and even telehealth, so are health systems. Health systems had to implement quickly, efficiently, and effectively in order to treat their patients during the pandemic, but we’re now seeing the dust settle. But what we also have is this residual effect where health systems and patients want to jump into digital care or remote patient monitoring and chronic care management, and even some of the other services available like transitional care management. Most of those services can be done remotely now, but with that comes a lot of questions.

Q: Now that health systems are looking beyond telemedicine at remote monitoring and care coordination, can you tell me a little bit more about how health systems can get started with these programs?

I think one of the misconceptions that we see from health systems is that they want to pilot, or they want to dip their toes into it a little bit. It’s an interesting conversation when we’re first either starting with a new client or starting implementation with the new client, because the pilot is just as much work to set up and implement as a full-scale program.

What we’ve done really effectively with health systems is work within departments and treat those as almost as different client partners. Even though they’re part of the health system, they’re going to have different implementation activities with Internal Medicine than they are with Cardiology, or than they would with Rheumatology or Endocrinology, so we try to treat each specialty within a health system a little bit differently. We design a cohesive plan for each department, and we might start within a certain specialty, department or location.

A health system will always have that clinic or those people that are willing to try something new, so that’s where we typically would start a “pilot.” At the same time, rolling it out with just a few patients or providers doesn’t usually equal more success; it just draws out the program’s ROI a little bit longer. The work to prop it up and to implement these programs is just the same as it would be if you went with the whole site or specialty at the same time. When we do that, we can not only connect CCM, RPM, and Principal Care Management but we can get connect Transitional Care Management so post-discharge, we’re getting patients either enrolled or set up with devices for remote patient monitoring. Now we can connect the dots between discharge and the ambulatory outpatient centers, and that’s where we can be most effective within a health system.

Q: So, what are some of the programs that health systems are utilizing, in terms of conditions or types of implementations you’re seeing?

We’re deeply integrated with all the major EHR systems and so the bulk of the implementation and getting started is usually propping up that integration. So, it’s really important to have that integration team, either internal with the health system or external with the EHR that they’re using, be onboard from day one while we scope out that project. Having that integration will help drive efficiencies down the road but it’s going to help immediately when we start enrolling patients. When we start new services within different departments, that integration is what will allow us to scale quickly.

I mentioned earlier that we have core remote patient monitoring and chronic care management programs, but within health systems, we also have post-discharge transitional care, from either the hospital or a SNF. During implementation, we can connect these dots from the start and show value right off the bat, but it’s really important to consider not only a fee-for-service environment but also a value-based world where we’re preventing hospitalizations and readmissions.

Q: Given your history, it seems that you have seen the evolution of remote care management in health systems. Outside of piloting programs, which you’ve mentioned as common misstep, what are some other pitfalls that health systems should avoid with remote care?

I think one of the other misconceptions is that it’s better to implement just one program at a time. When we see health systems roll out chronic care management with one department or remote patient monitoring with just cardiology for example, those programs do work on their own. But you really do get a synergistic effect when you add CCM and RPM programs together and we’ve had a lot of success in doing so. What we’ve seen is that patients that are in both programs have higher adoption and retention. They more regularly take their vitals if they’re also participating in health coaching and if they have device in the home, they’re more engaged and accountable. On top of that, if we let the providers choose if patients need to be in both programs, the overall program will be much more successful.

Q: Can you tell me more about some of your clients that have utilized multiple programs at once and have seen ROI? How many patients were enrolled and what outcomes or value have they seen?

From a health system point of view, we’ve been involved in a lot of integration projects but also a lot of migrations from one EHR to another, which can be more complex. What we’ve seen is that if we have the right people onboard with us for launch, we’re much more successful.

In the case of a large health system client in Memphis, they had two EHRs when we began our engagement, one in the outpatient centers and one in the hospitals, and now they’ve transitioned to Epic. Because we’ve always connected the dots within our ecosystem, we were able to launch a successful enrollment campaign for eligible patients to opt in. At the same time, we also implemented a TCM program for discharges, so we had enrollments from two different “pipelines.” In cases like this we’re usually able to enroll around 30 to 35% of eligible patients on behalf of the client. Enrolling patients on-site at the outpatient clinics can prop that figure up another 10 to 15%, and even more when enrolled post-discharge. So, having those two streams has been key for health systems to see the scale.

Q: We’ve spoken a lot about how health systems can adopt these programs and see outcomes, but for health systems that already have remote care programs in place, what’s next in remote care? In general, and at MD Revolution specifically?

From 2016 to 2019, it was mostly just phone calls for chronic care management, there were a lot of Bluetooth devices out there in the market, and often you had to use a smartphone to interact with the patient for vitals monitoring. That technology has really evolved over the years and we’re seeing more and more Medicare-aged patients that are comfortable with digital engagement. They use text messaging, they log their own activities within an app. These are really engaged patients that might not have been with just a phone call. We’re able to offer an enhanced experience as patients get more and more comfortable using smartphones and technology.

From another perspective, we’re seeing new devices on the market as well. We are integrated with over 250 devices including the two leading continuous glucose monitoring devices, and again, as patients get more comfortable with these technologies, we have to adapt to them as well. That allows us to drive more and more engagement, which creates value for the patient and value for the providers. We can use predictive analysis based on the patient’s trends from a CGM device; we can predict how certain diets and activities will affect their glucose levels throughout the day. A program that was just health coaching over the phone in 2016, is now getting all these extra interactions. Patients are more engaged, they know what their program is and what it’s for, and they’re using it on a more consistent basis.

Fast forward to 2024, where you must provide these options and services for the patient, but the providers also get better information for how they should treat their patients. That was the original goal for CCM when these codes were first approved. I think we’re getting to that at a much higher level, especially in the last two to three years.

Q: I believe you were referring to Dexcom as one of those partners, correct?

Correct, Dexcom and Libre. Both continuous glucose monitors provide valuable information for our patient conversations, but they also provide patient-centered goals that patients contribute to themselves. We try not to talk about how to treat their chronic condition, but instead we help them towards healthy goals in their daily lives. What we’ve tried to focus on is making lifestyle coaching centered around the patient. It’s more collaborative with the patient using the real time vitals; we’re coaching using insights and building really intimate relationships with our patients.

Q: This all sounds so exciting, is there anything else that you would like to share about MD Revolution?

I’m happy that we got to talk, and we’re really excited about our partnership with Panda Health. Obviously, health systems are a great opportunity to impact a lot of lives. It typically takes longer to get our initiatives through when we work with health systems, but they’ve been very successful. We’re excited to expand more.

About Panda Health

Panda Health transforms how health systems connect with, explore, and adopt leading digital health technologies that improve the lives of patients and providers. Panda’s deep market intelligence and personalized guidance de-risks the digital health procurement process. Panda was founded in 2020 through a partnership between CentraCare, Gundersen Health System, and ThedaCare, with the development and investment firm Fitzroy Health.

About MD Revolution

MD Revolution is transforming patient care through its remote care management platform that seamlessly integrates with an ecosystem of EHRs, data partners, and devices to power comprehensive remote care for large practices, health systems and healthcare organizations. MD Revolution offers software as a service or as an end-to-end program, including a clinical care team to manage remote care as an extension of the practice. MD Revolution powers programs for Chronic Care Management, Remote Patient Monitoring, Transitional Care Management, Annual Wellness Visits, and more.