Is RPM the answer for an aging population?

While many providers are still struggling to manage the chaos of data management  which the COVID-19 pandemic exacerbated and helped highlight, other providers are looking forward towards major trends that will affect interoperability and data transparency. An entire generation of individuals continue to  move towards dependency on healthcare services, especially remote patient monitoring (RPM) technologies. Due to shifts in cultural and technological forces, we can expect to see an increase in RPM services and the need for providers to invest in technologies that integrate data across a multitude of platforms. 

According to the US Census, in 2010, there were only 40 million Americans that were aged 65 years old or older, however, there were nearly 163 million that made up the age categories that are now  35 to 74 years old . With over 50% of the population moving towards requiring increased care due to age, that means we can continue to expect to see healthcare costs within these age groups rise. 

The Centers for Medicare and Medicaid Services (CMS) split personal health care (PHC) spending into five age groups from 2002 to 2014. During that 12-year period, spending for those aged 85+ saw a 94% increase, with the only other highest spending category those aged 45-64 which saw an 96% increase. 

A cultural push 

Are the cultural values of baby boomers and Gen X  pushing healthcare services towards more remote patient monitoring services? 

At the largest age category, baby boomers (born between 1946-1964), present an interesting challenge for the next decade. This generation in particular is based on the American Dream, one that looks to enjoy established comforts – this includes independence and being able to come and go as they please.  This would suggest that aging citizens will prefer the freedom and flexibility offered through  technological advances , such as remote monitoring for their healthcare. 

Likewise, the millennial generation (1981-1996), is smaller than the generation before it, but arguably more tech savvy and will want  to find innovative ways to manage the aging population. The millennial generation is one that is comfortable with wearable technology. Take, for example, the Apple Watch. Launched in 2016, the Apple Watch has helped in the paradigm shift towards acceptance of remote monitoring. Given these preferences, one may argue that generationally there is a move towards trading security for the usability and convenience virtual devices and services  presents. 

What is remote patient monitoring? 

Remote patient monitoring uses health and medical technologies to collect patient  data and send it between providers and patients. These solutions allow patients to manage and  collect their own data, maintaining autonomy,  while providing remote consistent oversight by clinical staff, medical professionals, family, or others. 

As a result of the COVID-19  public health emergency, health insurers were  forced to pay for virtual  services they previously would have rejected, such as telehealth and remote monitoring. As a result, there has been an enormous increase in the uses and studies behind remote monitoring in many areas of healthcare.

The opportunities RPM provides

When data is appropriately shared and aggregated with clinicians the possibilities for the patient journey, public health management, and disease management, are endless. 

RPM allows healthcare providers the ability to follow patients across the entire continuum of care. From the first call into the office, to back home again,  RPM helps  individuals receive less invasive measures of care, while communicating relevant information between health professionals. This allows providers to make treatment decisions based on near real-time data. 

But doing so has not been easy, particularly during the COVID-19 pandemic which  highlighted major problems in public health data management, including the lack of interoperability within the healthcare sector and the field, leading to lapses in communication and questions of accuracy. Although RPM offers great benefits, if providers do not have the proper integration and the ability to leverage the data they are collecting, RPM will fail. 

As many payers mandate that patients only use medical devices for RPM, the need to be able to incorporate medical device data into data infrastructure, while securing that patient data, presents an added integration challenge. 

New  opportunity presents integration challenges 

With increased focus  on interoperability and  provider-to-provider integrations,  there is an additional shift towards patient-centered information access and sharing . With this shift, protecting patient data is going to be one of the largest concerns for the public, clinicians, and other medical stakeholders.  Healthcare provider offices currently have many EHR systems that contain siloed data -- posing a huge challenge in accessibility, transparency, and actionability of patient data. Access to patient-centered information is paving the way to include clinical and contextual data that provides healthcare professionals with a holistic viewpoint, such as personal device monitoring data, lifestyle behavior, and social determinants of health (SDOH) . 

Adding to the list of challenges is data sharing agreements, complex patient matching algorithms, procedures, and governance, all issues that arise when dealing with data exchange between two entities involved.

A solution for providers  

CYBX integrates data seamlessly between legacy and modern business systems to promote internal interoperability,  leveraging our Unified Healthcare Data Fabric (UHDF).

Integrating with a variety of interfaces, such as JDBC, API, HL7, etc, CYBX takes data processing, evaluates data quality, and normalizes data across multiple sources, in near real-time, without ever changing the location of that data. This data is then consumable by a variety of external systems such as analytics, QHINs, regulatory reporting, and business intelligence systems. This provides actionable and insightful data to clinicians, minimizing focus on compliance, and increasing real-time access to integrated patient data, regardless of where the data is stored. 

CYBX is currently partnering with leaders in healthcare remote patient monitoring (RPM), such as eCare21, who offers a secure, cloud based solution to patients with chronic conditions to remotely communicate with providers. The combination of user-friendly and adaptable functionality for the patient and the extended care team with an open, flexible and HIPAA compliant integration framework will lead to a much faster and wider adoption of RPM.

What comes next? 

As the aging population is moving towards adopting  virtual services which are reliant on RPM technologies, there will need to be quick and effective changes made to support adoption. One of these changes in the continual evolution of regulatory pronouncements, particularly as it relates to interoperability between health IT developers of certified health IT, health information networks, health information exchanges, or health care providers. 

On April 5th, 2021 a Final Rule issued by the Office of the National Coordinator for Health Information Technology (ONC)  went into effect, starting what will be a series of regulatory changes working towards increasing patient access and  transparency through provider interoperability. Information blocking will no longer be tolerated as a practice when it is likely to interfere with access, exchange, or the use of electronic health information (EHI).   

ONC Timeline

*To note, from April 5th, 2021 to October 5th, 2022, the EHI definition is limited to the EHI identified by the data elements represented in the USCDI*  

ONC Timeline through 2023 for healthcare interoperability standards. All information collected from the Office of the National Coordinator for Health Information Technology.

These changes  over the next two years are only the beginning of changes that need to happen that will require preparation, especially as more aging populations enter the healthcare system. The adoption of RPM technology may be more appealing to physicians if better regulatory incentives are to be offered for adopting these technologies. 

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