Wellstar Uses Remote Patient Monitoring to Create Partnerships With Patients

Hospitals and health systems are jumping onto the remote patient monitoring bandwagon these days to boost care management. At the Wellstar Health System, administrators are looking beyond the clinical benefits of RPM and focusing on partnerships.

“We keep the patient at the center,” says Sally Eckford, assistant vice president of virtual health at the Atlanta-based health system. “We always try to keep them in the middle of every decision we make. For us, RPM gives us a chance to create a new relationship.”

Wellstar launched its first telehealth program in 2015, with a telestroke platform. The health system has gradually expanded its virtual care palette since then, and saw an opportunity to launch RPM within the home health space for patients with congestive heart failure.

The benefits were quickly recognized. Patients were sent home with devices and connected with their care providers back at the hospital within 48 hours, far better than the typical two weeks it took to schedule a home health visit. And with continuous monitoring and access to care at any time, hospital readmissions dropped as well.

With the coronavirus pandemic, Wellstar learned how to adapt the RPM platform to a new population, quickly developing a program that sent pulse oximeters to those with COVOD-19 and monitored them for two to three weeks. Again, success, as none of the patients in that program were admitted back into the hospital.

With the pandemic moving into the rear-view mirror, Eckford said the health system sat down to map out a more robust RPM platform. They quickly identified those with hypertension as a population that would respond well to home-based monitoring, then delved into other chronic conditions and disease states, like COPD and diabetes.

With each new population, the health system made sure to bring in all the doctors, nurses and staff involved in the program to hash out every outcome they might see. An often overlooked part of the planning process, Eckford says, is taking into account all of the variables, and developing protocols for every situation. Overlook this, and you run the risk of having patients admitted back to the hospital for concerns that could have been addressed much earlier.

Another sticking point was making sure patients were ready for RPM.

“It’s not a scary process” to equip patients with devices at home and connect them to care providers in the health system, says Eckford. “But one thing you do learn quickly is that all patients are not tech-savvy, so you need to make the (process) super super simple. These people need to be comfortable.”

“Any time you create a new way to care for the patient, there’s always some concern,” she adds. “It just creates an angst.”

And that’s where Wellstar began thinking about RPM in terms of comfort and collaboration. Aside from helping them to learn how to use devices at home, Eckford says, the health system began seeing this as an opportunity to forge partnerships.

“When you couple the data with the patient relationship, you realize there’s a huge learning opportunity for us,” Eckford says. “It gives us an opportunity to adjust care … and to work with the patients on their own care.”

As the healthcare industry transitions away from COVID-19 triage and finds lessons to learn from how it used telehealth and RPM over the past year and a half, providers are realizing that patient engagement will play an important role in that transition. Connected health advocates have long said that these tools and platforms are designed to promote collaboration on care, and that providers need to learn how to get patients involved in care management so that they can take more control over their care. This is especially important at a time when many people are reluctant to return to the doctor’s office and are either leaning on telehealth to access care or ignoring healthcare altogether.

RPM programs offer providers an opportunity to create pathways of care that extend to the home, where providers and patients can work together on care management.

RPM “is an extension of care that we provide,” says Eckford. “Technically, it’s not hard to do. But there’s a lot more to it” than the technology. By creating relationships, the health system has an opportunity to guide care, promote health and wellness and help patients make better lifestyle choices.

One avenue for evolution may lie in the devices used in the home. Eckford says Wellstar currently supplies their own devices, but someday they might look to have the patients supply their own devices. That would open up the platform to consumer-facing mHealth technology, which is often much more popular (and stylish) but not always easy to trust or integrate into the patient record. A health system that can find a way to integrate consumer devices stands a good chance of boosting engagement, which in turn will lead to better clinical outcomes.

There are other opportunities for evolution. Some hospitals are testing out RPM with more complex patients in an acute hospital at home model, where remote monitoring is combined with in-person visits to care for patients at home who might otherwise be in the ICU. There are also some programs that meld RPM with mobile integrated health and community paramedicine concepts.

For Eckford and Wellstar, the evolution of RPM goes hand-in-hand with the idea that healthcare is becoming more patient-centric. Care is moving out of the hospital and into the home, she points out, because that’s where people want to access and receive care, and it’s where they’re more comfortable and more likely to heal faster. Providers need to become a partner in that process.

“There are huge opportunities here for us and for our patients,” she says.