Remote Monitoring Lacks Support for Clinical Analytics: Report

Accountable care organizations lack confidence in the clinical and financial benefits of remote-monitoring technology, a Spyglass study found.

Although 55 percent of accountable care organizations have deployed remote patient-monitoring (RPM) technology, many doubt how these systems can help their clinical systems and bottom line, revealed a new report by Spyglass Consulting Group.

Of health care organizations interviewed, 71 percent were uncertain about integrating RPM technology with clinical care workflows and systems, including electronic health records (EHRs), according to the Spyglass study, "Trends in Remote Patient Monitoring 2013," released on July 8.

Under the Affordable Care Act, health care organizations gain value-based financial incentives to manage chronic conditions such as congestive heart failure, diabetes and asthma as well as coordinate care based on positive health outcomes. RPM technology could help doctors monitor patients' conditions, but the physicians are unsure how efficient they'll be as far as clinical and financial efficacy.

"We need to determine the efficacy across the continuum of care because the patient is seeing many different providers," Gregg Malkary, managing director for Spyglass, told eWEEK. "From a financial perspective, we don't understand the true cost of care of remote monitoring because we've never done it."

Doctors often don't follow up with patients in between visits to discuss data from remote-monitoring devices, Malkary said. "Why would a doctor monitor if they're not going to get compensated?" he asked.

Of health care providers Spyglass interviewed, 81 percent said that under the traditional fee-for-service model, they would have no incentive to monitor or coordinate the care of chronically ill patients. In addition, more than 50 percent of organizations interviewed were unsure if RPM technology could be clinically effective and if they could bring a positive return on investment.

RPM offers health providers the potential to avoid stiff penalties for excessive readmissions of Medicare patients, said the Spyglass report, for which the firm interviewed home health agencies, hospitals, multi-hospital delivery systems, government agencies and health insurers over a two-month period beginning in March.

RPM, or telehealth equipment, used by hospitals interviewed included Honeywell's HomMed, which 48 percent of respondents had deployed in their health care organizations.

In addition, 14 percent of respondents were using an RPM platform from Robert Bosch Healthcare Systems and 14 percent chose a remote-monitoring product from Philips Healthcare, which announced on March 6 at the Healthcare Management and Systems Society's conference (HIMSS13) that its IntelliSpace eCareManager 3.9 platform now incorporates Vidyo's VidyoRouter. The Vidyo device enables a health provider's telemetry devices to operate across a broader range of networks.

Products by companies such as Robert Bosch and Philips are end-to-end enterprise platforms compared with consumer health tracking devices by companies like Fitbit and Jawbone, which acquired BodyMedia in April. Many of the consumer devices, which often are developed as wristbands, lack integration with clinical systems, according to Malkary.

"Health care providers haven't figured out how [to] leverage consumer technology to support them from an IT perspective," he said. "There's a huge potential because of the advances in technology. We need to provide support for physicians to use the devices."

The Spyglass survey also found that 58 percent of organizations were concerned that RPM technology fails to support clinical analytics and decision support tools. These tools provide the potential to turn patient data into insight that can provide treatment based on real evidence, Malkary noted.

Under "evidence-based medicine," medical tests would be performed if evidence from analytics shows it produces positive outcomes, according to Malkary. "Analytics will allow us to make more intelligent care decisions based on clinical evidence," he said.

"Everything is going to be based on outcomes going forward," he added. "We know there is a definite disruptive shift going on in the health care industry today. We absolutely need tools like remote monitoring."

More time will be needed to integrate remote monitoring into clinical systems, however. "It will take us some time to figure it out," Malkary said. "It's not a question of if but when."