Mayo Clinic RPM Model Improves Outcomes For Acute COVID-19 Treatment

Remote patient monitoring (RPM) programs are safe and feasible, and they yield positive health outcomes for acute COVID-19 treatment, according to a Mayo Clinic study.

The midwestern health system expanded its multi-state RPM program during the pandemic to treat infected patients at home, employing a strategy that many healthcare organizations have been using to reduce hospital congestion and give patients a chance to recover at home instead of in a hospital ward.

The original program helps patients with chronic care management for conditions like congestive heart failure and chronic obstructive pulmonary disease, but experts from the Mayo Clinic Center for Digital Health worked with COVID-19 physicians to adapt the RPM program to support COVID-19 patients. 

The team implemented the RPM program at Mayo Clinic campuses in Arizona, Florida, and Minnesota, with the help of hospital and ambulatory care staff. A total of 7,074 patients across 41 states participated in one of two RPM models, depending on their risk factors, between March and November 2020.

Both RPM programs produced high patient engagement levels, low hospitalization rates, and low 30-day mortality rates. 

Out of the 2,314 patients who used the low-intensity RPM model, 80 percent had at least one day of engagement with the interactive platform, and task compliance was rated at 61.6 percent. Nearly 80 percent of the 4,760 high-intensity RPM patients engaged with the equipment for at least one day, with a 72.5 percent compliance rate.

Only 9.4 percent of all patients were admitted to the hospital within 30 days of enrollment or discharge, and the average length of stay was three days for low-intensity patients and 6.4 days for high-intensity patients, the study noted.

The 30-day mortality rate was 0.4 percent, with 27 total deaths, all of whom were patients with high risk factors. In addition, less than 20 percent of all patients experienced symptoms that required nurses to defer care to a COVID-19 physician. 

The study results are promising for expanding RPM reimbursement. 

“We further believe the results of this study support the 2021 expansion of the Centers for Medicare and Medicaid’s (CMS) final rule to reimburse for qualifying remote patient monitoring program services for acute condition management,” Tufia Haddad, MD, medical director for the Mayo Clinic’s COVID-19 RPM program, stated in a press release.

“These were major barriers to telehealth and virtual care adoption prior to the pandemic, and these study results may help inform other needed healthcare policy changes to sustain adoption of this technology beyond the COVID-19 pandemic.”

The study prioritized several factors that led to its success, including incorporating different languages to accommodate patients’ native tongues, distributing the RPM program across the country to encompass a wide range of diverse patients, and providing two different RPM models depending on the patient’s risk factor.

Patients with low risk for severe illness received the low-intensity RPM model, which included a pulse oximeter and a thermometer. Using the Mayo Clinic mobile app, accessible through a smartphone or tablet, patients reported their vitals and symptoms twice a day and viewed educational content.

Clinical assistants monitored patient progress and reached out if patients did not complete the required tasks. Registered nurses tracked the patients’ responses and acted accordingly, sometimes providing the patient with additional information to self-manage their symptoms or alerting a care team if there were health concerns.

When the patients’ symptoms reflected recovery, they could end their isolation and exit the RPM program. 

The high-intensity RPM model for high-risk patients essentially operated in the same way, though patients received additional tools and technology, as physicians expected more severe symptoms.

These patients received a cellular-enabled tablet with RPM software and Bluetooth-enabled blood pressure cuffs and monitors, pulse oximeters, thermometers, and scales to passively record vitals, the study explained. 

High-risk patients would then complete the same tasks as the low-risk patients, with clinicians and nurses monitoring their progress through the Mayo Clinic app.