What is RPM?
RPM is the use of digital technologies to monitor and capture medical and other health data from patients and electronically transmit this information to healthcare providers for assessment and, when necessary, recommendations and instructions. RPM allows providers to continue tracking healthcare data for patients once they are discharged. It also encourages patients to take more control of their health.
What are common patient data types collected via RPM?
Providers can use RPM to collect a range of patient health data, including blood pressure, vital signs, weight, heart rate, blood sugar levels, and physical activity.
What are common examples of RPM devices?
RPM can employ wired or wireless measurement devices. The most common RPM devices are blood pressure monitors, weight scales, cardiac implants, and blood glucose meters. Pulse oximeters have also become more common due to the COVID-19 pandemic.RPM Devices
Who can deliver RPM services?
Physicians and other qualified healthcare professionals (QHCPs) can provide and bill for RPM. Clinical staff can furnish and manage RPM under the general supervision of the billing provider.
Who can receive RPM services?
Any patient. With that said, a provider should only order/prescribe RPM if captured data is directly relevant to managing a patient’s condition(s) (i.e., medical necessity), with such justification documented in the medical record.
What are the benefits of using RPM?
RPM provides a wide range of benefits, including the following:
- Keeping people healthy
- Reducing the number of hospitalizations
- Reducing readmissions
- Reducing hospital lengths of stay
- Reducing patient, provider, and overall healthcare costs
- Permitting older and disabled individuals to remain at home longer and delay or avoid moving into skilled nursing facilities
What do providers need to deliver RPM services?
Since each RPM program is different, the steps to set up programs will vary. The amount of work that providers must complete will differ by RPM program, but these are the general steps for providers who choose to deliver RPM services with minimal external support:
- Speak with private payers to determine coverage (if considering non-Medicare patients)
- Consider who you will take as RPM patients (i.e., establish your patient base)
- Identify the condition(s) you will manage
- Select the device(s) you will use to provide RPM
- Set up an intake procedure to address matters such as initiating the patient care process, training patients on using the RPM device, installing the equipment in patients’ homes (if necessary), maintaining the devices, and responding to equipment problems
- Establish policies and procedures
- Train staff
- Market program
While this may seem like a lengthy list, a good RPM program vendor will perform many of these steps, thereby reducing the effort and management required from the provider and staff.
What do patients need to receive RPM services?
This will largely depend upon the RPM device and how data is transmitted from patient to provider. Some devices require patients to access one or more of the following: Wi-Fi; smartphone (in some instances, newer models); and personal computer. Other devices may only require the device itself. Such devices use cellular data to transmit information. Depending upon the design and/or complexity of the device, patients may need in-person or virtual assistance to set up and use the technology.
Where is data captured via RPM stored?
Where RPM data is stored will depend upon the device. Typically, data is captured and transmitted via a Wi-Fi or cellular network to a central data repository. Types of repositories include an electronic health record (EHR) system or personal health record. Older devices often stored the information on the device itself, which then required patients to convey the information to their providers. This type of workflow is no longer considered RPM by Medicare and the vast majority of other payers.
How is remote patient monitoring different from telehealth?
RPM is considered a specific subset of telehealth. One can use the phrase ‘telehealth’ to refer to RPM, but telehealth can also refer to many other types of remote healthcare services. RPM is the use of a device for interaction between providers and patients outside of the provider’s organization. Telehealth is the use of electronic information and telecommunications technologies to support long-distance clinical care, patient and professional health-related education, public health, and health administration.
Must patients provide consent to receive RPM services?
Yes, and providers must obtain and document consents in patients’ medical records. Medicare allows for informed verbal consent, but other payers may require written. Due to COVID-19, CMS temporarily modified the requirement that consent must be obtained prior to providing an initial RPM service. Practitioners can now obtain consent at the time services are provided and by individuals providing RPM services under contract to the ordering physician or qualified healthcare professional.
What rules and regulations do I need to follow when creating an RPM program?
Like any healthcare program, providers should follow HIPAA security and privacy regulations. Providers should ensure that their RPM devices and technology are compliant with FDA standards. Technology that meets FDA standards can help ensure quality control and assurance, data accuracy, and compliance. Finally, providers will want to ensure that their RPM programs follows the most current coding and billing rules.
How do I ensure my RPM program is HIPAA compliant?
This essentially boils down to carefully vetting RPM vendors and their devices. Vendors should build their devices so that patient data is encrypted when it is in transit — from patient to provider and vice versa — and when the device that stores the data is not in use.
What are the common types of RPM programs available to providers?
There are a variety of programs and vendors providers can choose from. Generally speaking, they can be broken down into two types: full-service programs and those requiring a self-managed approach. The following summarizes the essential differences between these programs:
- For a full-service program, a practice contracts with an RPM company to supply patients with devices. The practice can either hold a stock of the devices to distribute to patients or have the vendor ship devices directly to patients as the office enrolls them. Many full-service programs allow practices to lease the devices, eliminating upfront costs for each new patient. Devices are often cellular, which is simpler for patients to use. All they need to do is insert batteries into the devices and power them on. Some full-service programs offer technical support to patients. Monthly costs are a higher percentage of reimbursement, but the initial cost for each device is eliminated and staff time to manage the program is greatly reduced.
- For programs requiring a self-managed approach, practices maintain the supply of devices (typically Bluetooth) and contracts with an RPM software vendor to manage the data from those devices. This approach requires the practice to perform what amounts to providing ongoing technical support for patients, although this time does count towards the management codes and is therefore not billable. Taking a self-managed approach can prove cheaper in the long run, but practices will need to incur significant initial costs and allocate more office resources and staff time to the program.
