Connected Health: C-suite 'cautiously optimistic' on ROI with remote monitoring

BOSTON—Remote patient monitoring has been around for a long time but tends to be in the early stages for most organizations, said Khinlei Myint-U, MBA, corporate manager of product development and communications for the Center for Connected Health (CCH) in Boston. Myint-U was part of a panel discussion at the 9^th Annual Connected Health Symposium on Oct. 25.

Those organizations that want to grow their remote monitoring program need tools to determine how to change from research to a larger scale operation. A larger operation affects all aspects, from the cost structure to implementation to staffing, making the ability to measure return on investment (ROI) so important.

To that end, Myint-U is one of the team members working on the ROI Tool for Remote Patient Monitoring at the CCH in Boston. The team’s goal was “to create a valuation tool that can become a decision-making tool. We also want to allow people to think about levels of their program, input and output and how that can change ROI."

Implementation is very different for different organizations, said Myint-U. Those different implementations can include differences in technologies, ways of thinking about interventions, how to involve physicians and care coordinators and incentivizing patients. That’s why the tool had to be very flexible.

“There are hundreds of ways people are doing this,” said Kamal Jethwani, MD, MPH, corporate manager of research and innovation for CCH. There are many vendors plus various ways of buying and selling the technology and service. With that in mind, “we tried to make it flexible enough so that every single construction can fit in. At the same time, a new user won’t get bogged down by complexity.” He compared the tool to Turbotax for remote patient monitoring ROI.

Users begin with an enrollment screen which asks about the total number of remote monitoring patients are expected in any given year and concurrent patients at any one time which “helps evaluate how much technology will be needed.”

The next screen is for human resources. When remote monitoring programs get funding for pilots, the principal investigator and research assistants launch the program, he said. With scalability the job roles expand. More staff will need to be hired and the tool helps program leaders “walk through the logic, such as this is what you’ll need if you have a goal of 5,000 patients.”

One of the most complicated screens is the one for technology since that comes in lots of shapes and complexity, he said. The tool lets users compare upfront investments, per patient rental costs and much more. There also is a cellular version for costs of landlines, hosting, licensing software and more. Inventory management covers the various ways the technology is delivered and refurbished for each patient.  

The tool includes program improvement, because the goal is not just to evaluate whether the program made money but also how to make it better, he said. Users can play around with the numbers, checking to see what happens if patient enrollment increases by 5 percent or if technology costs change by 20 percent. “The slider scale lets users see the change right there on the fly.”

Five organizations enrolled patients in remote monitoring for an average of six months and made two phone calls per week to the patients. Patient surveys were conducted because patient satisfaction was paramount and critical, said Lynn Redington, DrPH, MBA, senior program director for the Center for Technology and Aging. Patients were followed longitudinally which was important because “when we come back to the C-suite they say that’s soft core data. We have to quantify that. Patient care is paramount but reduction and stability of costs is equally paramount.”

Jeremy Rich, DPM, is principal manager of HealthCare Partners Institute based in Los Angeles, one of the five organizations to test the ROI tool. He said his organization’s patients feel very empowered with the remote monitoring. Meanwhile, the tool collects the data the C-suite is looking for. Hospitalizations were cut by almost half and outpatient visits went up. “Patients are more engaged in their health so they see the doctor more frequently. That’s music to my ears. I have cautious optimism.”