Ochsner Health Takes Remote Patient Monitoring to a National Level

While many healthcare providers are just now getting into the remote patient monitoring arena, Ochsner Health has scaled its platform to a national level, and is now monitoring more than 20,000 people in health plans across the country.

And still, says Julie Henry chief operating officer for the New Orleans-based health system’s digital medicine department, “we’re learning lessons each and every day.”

That’s one of the guiding principles behind a connected health service that is seeing immense growth in the wake of the coronavirus pandemic, which has pushed many health systems to shift healthcare services from the hospital to the home. It’s a work in progress for everyone, from those deploying the technology to those paying for it. And there isn’t a hospital, clinic or practice out there that isn’t learning something new.

Ochsner, which has a long history of adopting innovative telehealth and mHealth technologies, launched its first RPM program in 2015, focusing on hypertension. The health system added diabetes in 2017, and more recently has developed protocols for cholesterol and COPD management. Other programs, addressing conditions like asthma and musculoskeletal medicine, will come eventually.

Henry says the health system has its own RPM strategy, built on the idea that the platform supplements the work of the primary care provider or specialist. It’s a three-tiered process. The first tier involves data collection through iHealth devices, with data automatically integrated into the Epic electronic medical record platform. That’s the backbone of pretty much every RPM program.

The next two tiers take the program a step further. The second tier, Henry says, adds health and wellness coaching, to “really personalize the patient’s journey.” This goes beyond analyzing the data for clinical outcomes, and is designed to help the patient develop a healthier lifestyle and take more control over his or her care management.

The third tier, meanwhile, loops in a healthcare provider, usually a pharmacist, to handle medication management. This adds an extra layer of support for patients, something not yet seen on a regular basis in RPM programs.

“It’s vitally important that we have a member of the care team that has those insights,” Henry says. Too often medication management is an overlooked part of the care plan, leading to gaps in care that dilute the effectiveness of treatment.

There’s also technical support and a newly added chatbot, as well as a 40-question survey administered prior to the program to identify any social determinants of health that may affect care coordination or management.

“You really need to have all these insights to help shape the patient’s care coordination,” says Henry, who anticipates adding behavioral health support at some point in the future. Some 40 percent of outside factors that influence healthcare, she points out, are behavioral.

While Ochsner launched this platform to treat its own patients, one of the enduring values of telehealth is its marketability, especially for health systems with the reputation and reach. Networks like Ochsner, Nemours, the Mayo Clinic, the Cleveland Clinic and UPMC can reach out far beyond their base, scaling up to treat patients in other states.

It’s not an easy task, says Henry.

“We have to put together a program that allows us to manage the business in a sustainable way,” she says. And to do that, “we had to assemble a village” that includes management, clinicians, tech support, coders and programmers, billing and legal experts, all working together to make sure each program is targeting the right patients and using the right parameters.

Ochsner is now marketing its RPM services to health plans and businesses around the country, charging a per-month per-member subscription fee. Henry says they’ve proven that the platform offers a 3:1 return for diabetes management and a 4:1 return for hypertension management, and they’re working on algorithms that would clarify ROI for other conditions.

The health system now has a dedicated digital medicine sales team that’s marketing the services across the country. They’d seen triple-digit growth even before COVID-19 turned the spotlight on telehealth.

That said, the margin for ROI is still evolving. The Centers for Medicare & Medicaid Services only started reimbursing for some RPM services in 2019, and private payers and Medicaid programs often follow the lead set by Medicare.

The federal government has stepped up to push telehealth and RPM along. Several emergency waivers were authorized during the pandemic to boost access to and coverage of virtual care services, and Congress is under increasing pressure to establish a long-term policy that keep many of those freedoms in place after the public health emergency concludes. The Federal Communications Commission has also stepped in, with efforts like the Connected Care Pilot Program and COVID-19 Telehealth Program, both aimed at helping organizations establish the broadband infrastructure to expand telehealth and RPM services.

Ochsner has benefitted from that. The health system was one of the first six in the nation to receive funding from the COVID-19 Telehealth Program in April 2020, and has been using the $1 million to purchase telemedicine technology, including devices for RPM programs.

That’s because many people who would most benefit from RPM don’t have the resources to use it – some can’t even afford the co-pays or the $40 to cover the mHealth devices. This includes the Medicare and Medicaid populations, a high percentage of which are living with one or more chronic conditions.

Recognizing those challenges, Ochsner is getting creative. The health system partnered with Louisiana’s Medicaid program last year to subsidize an RPM pilot program in selected communities. Henry says the goal is to use the data gleaned from the past year to prove the value of the program, and to show the state that it should be investing in this type of service.

“This has really amplified our role in digital medicine,” says Henry. “We are starting to prove” the RPM belongs in any conversation that focuses on improved clinical outcomes and better care.