Report Cites Success of VA's COVID-19 Remote Patient Monitoring Program

A new report finds that the Department of Veterans Affairs used remote patient monitoring to provide care for more than 23,500 veterans during the height of the pandemic, interacting with thousands of patients on a daily level and greatly reducing hospitalizations.

The study, conducted by members of the VA’s Office of Connected Care and published this month in Telehealth and Medicine Today, says the department was able to treat so many veterans at home and at such a successful rate largely because it has been running a strong RPM platform for almost two decades. The VA pivoted quickly to address veterans diagnosed with COVID-19, researchers said, and was able to keep the hospitalization rate for those in the program at about 4 percent.

“The success of this effort demonstrates the importance of having infrastructure in place and framing it in a way that provides flexibility and allows it to be scaled up in times of greater need,” the research team concluded.

The Remote Patient Monitoring-Home Telehealth (RPM-HT) program was launched by the VA’s Office of Connected Care in July 2003, assigning 110 care coordinators to manage roughly 1,500 veterans with acute and/or chronic conditions who qualified for home-based care. That program now encompasses more than 2,800 care coordinators managing more than 75,000 veterans in more than 20 standardized programs, including hypertension, heart failure, diabetes, chronic obstructive pulmonary disease and even depression.

“Based on the initial assessment and specific Veteran need, Care Coordinators determine the best technology to assign and provide to the Veterans,” the report states. “Two contracted vendors provide these technologies, which include a video hub device (a physical unit with a screen), interactive voice response (IVR) (using phone voice and keypad responses), a web browser, a tablet, and apps. In addition, a wide range of peripheral devices collect and transmit data by wired, Bluetooth, or manual entry. The technologies are ordered, distributed, and refurbished through a centralized process.”

The program allows care providers to not only capture daily biometric data, but provide health and wellness resources and support.

“Although these innovative technologies are important, providing the information needed to monitor large panels of Veterans, the heart of the program is the personal connection of the Veterans with their assigned Care Coordinator and the intensive case management provided,” the researchers noted. “This results in reduced hospital admissions and bed days of care, improved clinical outcomes, and a high level of patient satisfaction for home telehealth patients.”

That process was put to the test in 2020, when the coronavirus pandemic took hold. According to the study, the VA’s Office of Connected Care, recognizing the virus’ threat to veterans, modified the RPM-HT program to address COVID-19 and bumped up the program to include more care coordination, frequent communications and a thorough protocol for identifying patients at risk, assigning the right technology and monitoring them as needed.

According to the study, the VA saw surges in veterans diagnosed with COVID-19 in April and July of 2020, as well as during the winter of 2020-21, when the agency twice surpassed 2,000 daily admissions into the program. Throughout those surges, the VA maintained and even increased its satisfaction rate for the program, which regularly stands at about 90 percent.

The program’s success bodes well for its continued growth, especially as a majority of the nation’s veterans become older and more in need of care management – and as VA healthcare providers look to shift more care out of hospitals and long-term care facilities and into the home.