coming soon...

a key thing with hospital at home that really is needed from the remote

patient monitoring perspective is more of a continuous monitoring capability.

And that's where that's very new technology.

But that, that can help provide more

. You could start it during a hospital

a patient transitions into that recovery and the home care RPM can

really provide a great transition there and take off and take over after

that intensive care leaves the home.

Welcome to a virtual view where we talk about tele-health

healthcare and everything in between.

today we're excited to have Bernard Banas on with

us today to talk a little bit about remote patient monitoring.

So Bernard, if you don't mind, tell us a little bit about yourself, so our audience

can get to know you a little bit better.

Thanks.

Cam and Danielle for having me on today.

I appreciate that.

So I'm currently with AMC health as VP provider telehealth solutions.

And I've got a long background working with digital health and

telemedicine solutions, starting with working with video integration

systems for operating rooms.

And then I transitioned into facility based telemedicine into

the post-acute care solution space in the virtual care area, mobile

telemedicine, and now I'm firmly into remote patient monitoring solutions.

So pretty much I've had a broad view from the digital health

perspective from the inner workings of a hospital clinical enterprise.

All the way out to the patient at home.

So it's really been an incredible journey to see all the ways that digital

health and virtual care can transform care delivery and patient outcomes

in so many settings and use cases.

Absolutely.

You've been able to see, the use in the development of telehealth as

well as remote patient monitoring.

Especially since we've seen the utilization, remote patient monitoring

has been around for a while, but we've seen the utilization of remote patient

monitoring, like telehealth really increase over the course of the pandemic.

And so for some of our listeners who maybe are a little bit newer or

are just learning about what remote patient monitoring is, can you explain.

What the service is and really, how does it.

Yeah.

Great starting question.

So remote patient monitoring in its most simple form is about

collecting and interpreting data.

From a patient that is dis that's at a distant location from the provider.

So that, along with a key piece, that includes acting on the data to advise

the patient, to take some type of action, like changing a medication,

scheduling a visit to their physician, or some other adjustment to maybe the

care plan that you've got for them.

It's when you look at remote patient monitoring, it's actually a pretty

broad term that encompasses a wide range of virtual care offerings that

can include, physiological monitoring, medication, adherence, diet, exercise,

and wellness tracking falls and personal emergency episodes, and even

digital tools to help with treatment like like for behavioral health needs.

But when the healthcare industry talks about RPM as a care model for high

need patients like those with advanced chronic illnesses they're primarily

referring to what the CMS is defined as remote physiologic monitoring.

So in, in its pure sense, when it talking about the CMS definition, it

RPM stands remote physiological monitor.

So sometimes that can get confusing, but this form of RPM really

specifies that, that FDA cleared medical devices must be used by

patients to collect their readings.

And then these readings must, automatically transmit from the

devices to the monitoring platform for review by the healthcare professional

and some of the medical devices that you might find in an RPM solution.

Blood pressure, monitor, weight, scale pulse oximeter, blood glucose

meter and some additional ones.

There's also some versions of RPM that don't include medical devices.

And, but because they don't, they're not covered under the CMS RPM definition

as a reimbursable service, but some examples that maybe that sometimes you

hear the word device list or really what they are a messaging based apps.

Or maybe self-reporting portals or applications for patients for for doing

their own self medical readings reporting.

So RPM can cover all that, but really the specific one that we talk about that's

reimbursable is designed for high need patients is remote physiologic monitoring.

That includes all those things.

I mention.

That sounds like something that's got a lot of

different moving parts and angles.

I'm sure.

A remote patient monitoring program.

How's that something you get set up and start working with.

Typically an RPM program would work.

Something like this, right?

A provider organization would identify a group of patients.

often like a high risk group, like heart failure patients, for instance,

and then you select patients within that group that you want to reach out

to and hope to enroll into the program.

And then you have monitoring devices to support that patient biometric data

that you want to collect for heart, patient type heart failure type patients.

And and along with a patient engagement tool.

So the tool might be a tablet with patient engagement, software installed.

It might be an app that can be downloaded to the patient smartphone.

If you have patients that are a little bit less technology literate,

you might even have a passive modem.

And all they have to do is attach the medical device to them.

And the readings automatically transmit through that device.

Typically, then you have a care plan that's set up for that.

and you might have a suite of available care plans and you can pick the one that's

designed to support the desired care goal.

And what this does is also acts as a guiding pathway for the patient

facing interaction and coaching, but it also provides like a monitoring

support dashboard and a set of tools for the clinicians to assess

the patient's current alignment or trending within the care plan.

Objective.

Some of the more advanced RPM systems even have automated interventional

tools that get triggered based on a, an intelligent understanding as

to where the patient's trending.

One way I speak to some relative newcomers like at conferences and other times is

I like to think of it as the way that you see some of these driver assist

features that are appearing in newer cars.

So a care pathway lane is set via the care plan.

And if a patient starts to drift outside of that lane, a gentle and

timely intervention can occur that nudges them back into the care lane.

This can be automated to certain extent.

It can also be more hands on and a nurse can, make that correction for

the patient once they receive some type of notification that patient is stray.

And some of these more advanced RPM systems, they've got a library of

care plans that, that can really be based on multiple components, right?

You can have the device selection, the frequency that you want

patient to take the readings.

You might have patient surveys that are customized for that condition, as

well as an assigned set of some video tutorials that you would prescribe

for them to see, and then have a set.

parameter monitoring thresholds put around that so that if the patient

is either, non-adherence, or they're just falling in ranges outside of the

desirable, and you could have alerts set up and be aware of their situation.

And then from an actual monitoring perspective you would have

like a monitoring center set up and staffed by care managers.

Typically nurses.

Their job would be to enroll in, in onboard patients monitor the incoming

patient data on a dashboard, respond to alerts by communicating with the

patient and advising on care plan adherence and do interventions.

This kind of monitoring center could be set up using provider,

organization staff, or it can be outsourced right to a RPM vendor.

Finally, typically the RPM vendor would offer a logistic service.

So that would include, managing patient device kits for the provider

including inventory, shipping, retrieval, refurbishment, et cetera.

And really this could be a no touch model for the provider so

that they don't have to mess.

Storing the equipment handling equipment, cleaning it between

patients worrying about calibration or maintenance or anything.

It can be kinda offered as part of a subscription model,

which we find works the best.

Yeah.

So there's a lot of moving parts to a remote patient monitoring program

to really get it up and started.

But really the ultimate goal is improving the information that providers can act on.

When they're working with patients that perhaps are struggling

with certain conditions.

So if you're working with a patient who has diabetes, being able to

have a consistent reading of.

What their A1C is doing so that there can be more timely intervention.

Especially if you're working with patients where perhaps it's really difficult for

them to come and get a biometric reading.

Being able to increase that access to improve provide better follow-up

care, provide more preventative care but ultimately improve some

of the decision making that those providers who are engaging with

patients are able to offer as well.

Yeah, it sounds like a great way to customize patient.

yeah, that's true.

That's true.

That's the promise of RPM.

If it's done right Absolut.

So with that, RPM is unique in what it can offer

as a virtual care solution.

And it's interesting because we see, remote patient monitoring and even

remote patient monitoring, depending on which state Medicaid you're

looking at, remote patient monitoring falls under the definition of te.

But it's very unique in what it's offering.

How does RPM differ from other virtual care solutions like

telehealth consults and how do those solutions work in tandem together?

I find it's important to mention that really RPM is really the only

virtual care technology that can achieve.

What's often called the triple aim in healthcare.

So that means that it has the most promise to improve population health, right?

Reaching patients where they live reduces per capita healthcare costs at scale

and improves the patient experience.

And they all fit hand in hand.

It's almost if you do one, the other kind of comes along to a certain degree.

But RPM does have some overlapping capabilities with live video

telehealth consults in that.

Often part of the RPM program is the ability to link a patient with a provider

for a live video telehealth session.

It may not happen as often as in just a model that's doing, I would say things

like because RPM is it's really its central purposes to gather, collect.

Patient generated data intervals over, a monitored time span and

give a view to that patient.

And really to collect that data in between those face to face meetings or in provider

visits face to face could be through live telehealth consults, but live telehealth

consults are typically used more for like real time patient assessment, right?

To address maybe an episodic condition that requires immediate observations such

as Maybe a throat or ear infection and chest digestion or a rash of some type.

Of course COVID really drove a lot of live telehealth consults, right?

To get that on the spot review of patient symptoms where RPM is viewed

as more collecting that data over time and tracking and trending it.

And RPMs really kinda looked at a bit more of a, primarily a store

and forward type technology with a dose of live video interaction.

, and when.

So with that, yeah.

And with storing forward, really being that.

For individuals listening to this podcast who maybe aren't familiar with that term

is similar to asynchronous telehealth.

It just means that information is being transmitted one way.

And it does not have a simultaneous interaction between

a provider and a patient.

There's a lot of different acronyms associated to remote patient

monitoring or even services.

Are distinct, maybe used interchangeably.

So you know, like CCM, chronic care management, RTM, remote therapeutic

monitoring, how do you help sort out some of this variety and terminology

and you know how some of these services can overlap with each other, but are

distinct from each other as well?

It can be hard to keep up with all the.

definitions and reimbursement and billing codes.

And, you almost need a algorithm or something just to stay on top of it all.

But yeah, it can be confusing.

What I'm, what I'll talk about is the different types of reimbursable.

Defined care models that CMS has put out really specifically

to talk about RPM CCM, TCM.

In RTM.

So the first we've talked a little bit about already is

remote physiologic monitoring, and it's fairly new in the group.

It was really defined first by CMS in 2019 for use.

It's relatively new, but really COVID drove a lot of usage.

So it's a little more widespread now, but really RPM involves the

use of connected medical devices.

Like we talked about to collect physiologic.

And typically a treatment plan would be set up so you can review

and manage the patient progress.

And RPM can be used really for any chronic or acute condition.

And it really would continue until the stated treatment goals are met.

It actually requires a minimum of 20 minutes of time per month spent

by clinical staff, reviewing the data or adjusting the care plan

and interacting with the patient.

There's billing codes, reimbursement for the initial setup of the

patient devices and for the monthly supply of those devices.

And you can get up to two 20 minute blocks for time spent by clinical.

So a good example of a patient condition that could be managed via RPM would

be like hypertension, for instance.

And then the next one is I'll talk about is CCM, which is stands for chronic

care management and CCMS actually been around a long time and it doesn't

actually require connected medical devices, although it can definitely

be enhanced via the use of device.

So that's a little difference between that and RPM requires the devices if

you want to be able to bill for it.

So you can actually have a model using both CCM and RPM together.

It's proven to be highly successful for most, at the most at risk patients.

And also lucrative for providers billing for both services together, but CCMS

really designed to be used and has to be used for patients with two or more

chronic diseases that are expected to.

12 months or longer, or until death of the patient.

So they're really lifetime type of diseases.

And CMS though, where it differs from RPM two is it really requires a very

comprehensive care plan for each of the chronic conditions that you're managing.

It's got special requirements for round the clock or 24 7 care access.

You also have to coordinate the plan with other care providers

involved in the patient's care.

So it requires a lot more work.

It actually can be quite lucrative as well.

But CCM requires at least 20 minutes a month spent by your clinical

staff, managing the patient's care, adjusting the care plan, et cetera.

There's also additional codes that cover additional 20 minute blocks

and also 60 and 30 minute blocks.

If you're doing what they call complex CCM, which requires

a whole nother level of.

Of care plan management, but in good, maybe a good example of a patient being

managed via CCM would be for instance, someone who has maybe both heart failure

and diabetes, cuz those often go hand in hand, and those are two lifetime chronic

type of diseases and they would qualify.

Then there's the next one's principle care management.

And that is also called PCM.

It's very similar to CCM.

So it tracks fairly similarly, but it's used for a lower acuity patient,

one with a single high risk disease instead of multiple and really designed

to last maybe three months or more, not really expected to be a long term.

Covers model and billing codes exist for 30 minute blocks of time, either spent by

clinical staff or or physician, I think you can do up to two 30 minute blocks

and a good example of a patient being managed via PC might be one that might

be recovering from a cancer diagnosis and just has been undergoing treatment.

So maybe they'll be in remission or be fine.

And you've done during the treatment period after maybe three

months or so, or maybe longer.

And then there's transitional care management and that's used for

short-term monitoring of patients up to 30 days after discharge from either

a hospital, like an inpatient stay at a hospital or at a rehab facility.

And it's really designed to support, transition back to a

stable self-care routine, like at a patient's place of residence.

And then there's there's special time requirements that have to be followed for

remote check in and follow up, like within two days and seven days of discharge.

So there's some pretty strict time zones you have to meet to get reimbursed.

And then a good example of a patient being managed under TCM might be one that's

just been discharged after potentially maybe a heart valve replacement or

a stroke or someone, something like.

and the last one, which is the newest of the remote patient

monitoring care models is called remote therapeutic monitoring or RTM.

And that's just been introduced and added to the physician fee

schedule this past January.

So it closely tracks RPM, but it really extends the range of

digital care applications to, to include non physiological.

Data monitoring for treatments of conditions like for respiratory

musculoskeletal type conditions.

It can also be used for like medication adherence and pain monitoring.

And it really gives a whole new set of practitioners, the eligibility to bill for

remote patient monitoring type services.

So now folks.

Physical therapists, speech therapists registered dieticians, and that

can all now bill for their types of services they provide and like

RPM there's codes for device setup and monthly usage of the devices.

And up to two 20 minute blocks of time spent on care management.

One really important difference is that RTM allows for more

flexibility in data reporting in that patients can actually self.

Their physiologic readings.

It doesn't have to be automatically generated from a connected device.

They can also update information on pain, status, medication

adherence, and other types of data.

And if you think of an example of a patient that would be a good fit for

RTM would be maybe someone with a chronic back pain maybe, or someone

recovering from, or maybe a recent joint replacement or something along those.

Thank you for that overview.

That was really useful for me as somebody who's a bit newer to the

field of telehealth to understand all these different applications

and the way that these are used.

I do think it's interesting that like these RPM models aren't necessarily.

Things that are used directly in the response to COVID, but thanks to the COVID

situation, a lot of these have come into the mainstream and become more publicized

in a way they just weren't before.

I just think a lot of people have become aware of them because of the

increased prevalence of telehealth in telemedicine in general.

Just beyond these specific use cases.

Can you share any ways that RPM is making a difference for patients and

any examples of cases you can think?

Yeah.

Yeah.

So RPMs reach really and its ability to make an impact is huge.

Especially for those with long term.

Illnesses and it definitely became a stop gap and maybe

a savior during during COVID.

Because a lot of hospitals wanted to avoid.

The the strain on the health system and having their hospital overrun

by patients with COVID coming in.

And not wanting to spread.

So it was really what was a, quite a a lifesaver during during COVID.

But when we look at it from a more of a long term chronic illness type

of treatment model when you look at, the us there's, according to CDC, at

least there's about more than 60% of.

Adults in the us have one chronic condition and 40% have two or more.

And a staggering 90% of our healthcare costs in the us are attributed to treating

folks with chronic health conditions.

Really using RPM to go after some of these high need patients, high

utilization patients is really the right place to, to start.

Even though it can have broad applications, right?

But it really drives, better patient engagement.

It empowers providers to help patients make better long term progress

and really reduce those avoidable high cost rehospitalizations or

other procedures, but regarding use cases they can be very broad.

We've seen use cases and we handle use cases from geriatric to.

age ranges, right?

You have your chronic diseases that can be addressed such as heart failures,

C O P D diabetes, hypertension.

But you can also find that RPMs very useful for a general post-hospital

discharge and other specialty care like li liver disease, cancer, obesity high risk

maternity pediatrics post NICU recovery.

Behavioral health and even primary care and wellness.

Yeah.

And looking at, where RPMs, really making a difference.

We've got a couple of examples where we can see a significant

outcomes improvement.

And Typically, what we see is there's a lot of programs out there that are

that are at a trial phase or ones that are moved beyond and are really scaled.

And those are the ones that are really producing good

outcomes at a successful scale.

But we have an example I can share of a large scale program.

in the TRC region, right?

It's a large payer in Michigan where we've had a highly successful

program in place since 2016.

It's a full service partnership and we provide the platform, patient

kits, logistic services, clinical monitoring services patient candidate,

screening, enrollment, and onboarding and some analytics reporting.

And this program's actually expanded to cover a large range.

High risk patient conditions, including heart failure, C O

P D diabetes and hypertension.

And it's got an average monthly enrollment rate of about a thousand patients.

That's what we're running at.

And the compliance across that group is over 80% on average and over the

life of the program this particular organization has seen a reduction in

hospital readmissions of close to 25%.

so that's an example of a scaled, highly scaled model in, in in Michigan.

Something to think about is that RPM really though, despite of some

of these bigger programs, they're really in their infancy, I think

regarding mainstream adoption.

So for all the large scale programs you might hear, or even

one that you might hear about.

There's probably dozens of small trial projects that really have

yet to be proven out, in scale.

And some of the reasons for that are that the solution may only support

a primary use case or disease focus.

Like you've got some diabetes apps out there that track, blood glucose

and that do a great job of it, but they're just limited to diabetes, or

a supplier chosen might be a relative newcomer or an under-resourced company

that doesn't really offer the full suite of support and services that.

Or really needed to take that program from trial to, to scale.

And that is a tricky transition to make for any provide organization

and partner that they choose.

So it's really gotta be done well, and I'll speak a bit more to that

later, but you know, if you go out and see all the RPM of RPM information

that's out on social media, on websites, et cetera you're probably.

See a lot of homepages on websites with a splash of claims regarding,

promising new revenues, revenue streams huge ROI, dramatic

hospital, re admission, reductions, happy patients, happy providers.

So you'd think after, seeing some of this chatter out there that RPM is just.

A rosy bunch of rainbows and unicorns, that, and all you gotta do is add water,

stir pop, you have outcomes, a successful RPM program, but really RPMs hard with

many variables, lots of stakeholders and operational kind of support elements.

It really all will have to work together when it works together, it's beautiful.

It's wildly successful.

And that's what we've been able to be a part of as.

Yeah, I think that's a great point.

And I think we see that in a lot of, virtual care programs you might read

research or hear things about it.

And every single circumstance is very different.

And there's some best practices.

Of course you can follow when it comes to implementing some of these

solutions, regardless of its remote patient monitoring or telehealth, but.

You're working with different stakeholders, you got different processes,

you got different patient populations and your patient populations may face

different barriers to the technology.

That's unique from, urban, rural, or Indiana to California.

Those patients are gonna look different based off of those demographics.

And, it's interesting that you say that too, Bernie, with all of these different.

Virtual care platforms.

I think one of the benefits is that we've been able to.

So many more use cases for a variety of different settings

that we've never seen before.

I'll use an example of, a group in Ohio who asked me to do a presentation

on remote patient monitoring.

And they asked me to, condense research on remote patient

monitoring specific to maternal care.

And I had to be, we've seen some, but this is still, really early in the process.

It's definitely.

Infancy.

We're not gonna see a deep bench of 20 plus years worth of research.

And there's gotta be some comfortability with, this is something that we

definitely see we've seen it a lot more.

It's still very cutting edge.

We still are, tracking it cuz just for the same ways with telehealth,

there may be certain circumstances.

Providing that particular service is gonna be the most

effective or the most appropriate.

And then through that, you may find that, okay, maybe this setting wasn't.

The appropriate setting to provide telehealth or remote patient monitoring.

But when there are new services like these you have to try it you have to

see what it looks like and to your point it they're, they can be difficult

programs to get off the ground, but once you get there, you can really

see how it impacts your communities.

Especially when it's done really well.

Yeah totally agree.

You're going into a totally uncontrolled environment of a patient's home and

every patient's home's different.

Every patient behavior is different.

So you're dealing with a lot of operational complexities assuming

that all the technology works great.

And that's probably the easy part.

It's all the other pieces and parts.

Exactly.

And you mentioned it.

With a lot of we're seeing now, That a lot more reimbursement structures for being

able to provide care in patients homes to be gen in general, we're having more

opportunities from payers to do that.

So with remote patient monitoring, there's a lot of activity around hospital

at home care models, how does an RPM solution fit into this more emerging care?

Yeah.

Yeah.

So great question too.

Yeah, hospital at home is interesting, right?

It's it is seeing rapid recent uptick, right?

In use cases and that, and.

It was actually developed over 20 years ago by Johns Hopkins medicine.

And so it's been around but its popularity recently has been driven

by, I think a number of things, not the least of which was COVID of

course, which drove it quite a lot.

But but also the technology's gotten so much better.

And then there's updated program modeling that has been used around

telehealth specifically that have opened the doors for it.

But I think a big reason you're seeing a lot of.

Come out now.

And the reason CMS really jumped on board mainly because of COVID they launched

their, what they call acute hospital care at home program, which was modeled

after Hopkins care at home program.

And that really allows approved organizations to receive

Medicare reimbursement for at home care services that are.

Normally done in a hospital setting for patients that are eligible

for an inpatient hospital stay.

And I think CMS has approved over a hundred provider organizations

to participate in this program.

So really are seeing not just a lot of provider organizations adopt a

model, but a lot of even new business models by suppliers, combining the

needed resources that visit the home.

In addition to some of the technology.

But the obviously the advantages are the patient's more comfortable

at home, but the costs are driven down by, moving the patient, having

the patient in a lower cost center.

Obviously it frees up more hospital beds and you have just re reduced

readmissions because the transition to home based care after that

hospital period is really smoother.

And you have.

Bounce backs.

But the hospital home model, it's a great fit for telehealth in general.

And to a certain extent, RPM, right there, there are requirements for

daily interaction, interactive evaluations by the clinical care teams.

And those can be completed via telehealth.

There's also some in-person requirements, but it can be a hybrid setup.

So nurses have to visit in person.

I think it's twice a day, but you also have two check-ins.

That can happen by a like a hospitalist type person.

And then a nurse each day, and those can be done via telehealth and it's

not designed to be a long-term program.

It's mainly equivalent to a hospital stay.

But be really RPM can be used to enhance that by keeping tabs on patients, vitals

and other things, including surveys.

but a key thing with hospital at home that really is needed from the remote

patient monitoring perspective is more of a continuous monitoring capability.

And that's where that's very new technology.

But that, that can help provide more of a period of time as to how a patient's

doing and give the nurses the ability to monitor, more more continuously.

But where RPM, I think really fits in the best is you could start it during

a hospital at home program, but then it's after a patient transitions from

that hospital eligibility coverage period into transitioning into that

recovery and the home care RPM can really provide a great transition

there and take off and take over once that monitoring period is needed.

After that intensive care leaves the home.

And I think this is in the same vein, but also slightly

different from that home care.

There's a lot of conversations about aging in place and being able to work

with individuals who don't want to be in a facility full-time to receive, full-time

care within that capacity, by being able to utilize, some of the technologies

like remote patient monitoring.

There's been, a lot of research and case studies that I've come across

with remote patient monitoring that, it, it can be easy to think.

Okay, we're working with an aging population.

They don't wanna mess with the technology.

But there's actually several cases that show that's not the

case that they actually do.

Enjoy using that technology, enjoy the benefits.

Especially if, it's very user friendly and perhaps maybe they have someone

who's helping them on the front end to really set up a lot of that equipment.

So it's easy to, for them to utilize, but I guess from your perspective, do

you see, more applications for remote patient monitoring, especially when it

comes to that aging and place perspective?

I think patients really want to have more engagement.

They really want to be met more at home.

It's just a lot less stressful on aging population.

They're not easy to get around.

And now with the risk of infections and now COVID and all the other

strains, it's just such a.

Model, there, there usually are some hurdles to get through for, from a

technology literacy perspective, but most of the vendors that are putting

out RPM solutions, there's actually been studies done and Measurements of the

literacy level of some of these apps that are being put in front of patients.

And I think a lot of them have tested around like an eighth grade reading

capability of friendliness so that not going to be that hard to learn.

You're always gonna have some patients that just can't handle a tablet.

Won't handle it.

So there's other options at least to engage with them through, live phone.

Surveys or automatic surveys, right?

IVR there's passive modems, just as long as you can get those readings up.

And then you can have a bit more of a high touch model through phone follow up.

But really the tablets and the user interfaces have gotten

pretty easy to use and more and more, I think elderly patients.

Especially the new ones that are entering the elderly ranks, are more accustomed

to some of the, more of the technology.

And a lot of times there's a caregiver in the home and in those

cases they can help them with the, with a digital tool or technology.

So I think there's a lot of options there, but I think that it is being embraced

and we're definitely seeing greater adoption even by quite elderly folks.

So I know that when we're talking about working with these aging

populations, we are also not just dealing with the technology literacy.

We're also dealing with problems in connectivity.

RPMs, how do they address that?

Cause I know that can be an issue for any sort of telehealth.

Exactly.

That's totally outside the the telehealth platform itself, right?

It's gotta work over whatever connectivity is present to reach these.

Patients where they live.

So that's a great question.

So really designed RPM solutions should have several options, right?

It can be combined and used together to reach the, to give the highest quality

experience to the most number of patients.

So obviously high speed connected patients.

Do you want that video capability and then the digital, responsiveness and all that,

but you also need a solution to reach the.

Those that are hardest to reach.

And really as is so often the case, right?

The patients that are the hardest to reach are probably the ones

that have the highest care needs.

So their needs aren't being met they're too far away or just in underserved

areas or don't have access to technology.

So what we're seeing from providers about the challenges and what they ask us about

is, how can I really best manage that variety of connectivity needs, with.

An operational model that I can manage.

How do I also accommodate the different levels of technology

literacy and literacy in general?

And then how can I also serve patients of different differing language backgrounds?

So you have a real mix of things that are beyond the technology, right?

So for patients that are more tech savvy, the tablet with the patient

facing engagement software, or even more savvy patients that are mobile, I'd

like to move around with their phone.

You could download an app and have the devices connected to that.

For those that are.

Less tech literate.

Like I mentioned before, we could have a, like an always on similar to an Alexa.

That's always listening, right?

And always on modem in the background that anytime it receives readings from

its connected community of devices that are supplied to the patient,

those readings will automatically get to the care dashboard.

And and all of these can come with integrated cellular connectivity

because you don't want to have to deal.

Thousands of different wifi setups across patients' homes.

So anytime you can have a universal standard way of connecting

cellular seems to be the best and most adopted of RPM solutions.

So having devices that come out with cellular built in whether it's the tablet

or course a patient smartphone has it, or whether it's got it's the modem, it's

ability to just automatically come out with cellular connectivity automatically

working is key, but then if you run into a situation, A patient's home.

Doesn't have cellular connectivity.

They're outside the reach of cellular.

Then solutions that work over even a patient's wired wall, phone, or

landline is also an option that should be explored and you can have automated

voice based interactive surveys and responses from patients on readings

that they've taken or other, just, survey content, just feel, see how

they're doing so automated phone based.

Solutions can be provided over wired phones as well.

So there's a lot of options there.

And then when you're looking at different language needs you wanna make sure

that a vendor offers, the onscreen content, if it, if they are using a

screen, survey content, if they're using digital surveys, IVR content for audible

surveys over the phone and all the educational content, you might want to

have them review on their, about their.

Management and even support.

So you wanna make sure all that's in the right language, so that

you don't have any gaps there.

That's a great point, Bernie.

And it's great to hear, that there's options around whenever patients

experience some of those barriers, whether it come to language, access,

or access to high speed internet or internet connectivity in general,

that there are still ways that.

They can still participate in a program like this.

As well as, take advantage of some of the benefits of engaging in a

remote patient monitoring platform.

But Bernie, we're really thankful for being able to talk to you on the

show today and to dive in a little bit about remote patient monitoring,

we're looking forward to having a.

A follow up episode with you for this.

But I wanted to give you an opportunity that we have a, you, one of your

organizations that you've worked with to start a remote patient

monitoring platform is actually gonna be speaking at the upper Midwest

telehealth resource center conference.

So why don't you tell us a little bit about what they're gonna be talking

about coming up here in September.

yeah, thanks for the opportunity to do that.

So yeah, we have a the largest independent physician group in Michigan, just

outside of Detroit has been using our solution in a really innovative model.

That's part of their they're actually working with some of their

patients that are covered under.

Value based care plan under blue cross blue shields blueprint

for affordability program.

So it's a shared risk value based payment model.

And they started using our solution to reduce the total

cost of care and obviously drive better outcomes for the patients.

They're seeing really good results from.

And we'll be talking about that.

I think they're primarily addressing right now, heart failure and C O P D patients.

So we'll be talking about that and their experiences as to how

they got their program defined and up and started working with us.

So, Yeah, we'll jointly be presenting at your conference in September.

We're.

Looking forward to that presentation, hearing a little bit more about it,

but with that, I'm gonna go ahead and conclude our time today and just want

to thank you again for joining us Bernie

Thank you for listening to a virtual view.

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Our podcast series of virtual view is sponsored in part by hearses telehealth

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