How Remote Patient Engagement Solutions Reduce Readmissions

“Clinicians often perceive these initiatives as additive work that doesn’t seem to provide immediately obvious benefits to patient care. Executives tend to emphasize how important patient flow is to the organization’s efficiency and finances. But that doesn’t address clinician concerns, and they struggle to fully invest in these initiatives.” -Nursing Executive, Advisory Board¹

Digital Patient Engagement: How to Address Challenges in Adoption

Misalignment and miscommunication of strategies lead to challenges among healthcare professionals and their team culture. A reluctance to adopt new technologies may have consequences, such as reduced patient response times, physicians being alerted or notified when they’re not on call, or non-urgent messages being delivered in the middle of the night when they should be held until normal business hours. If used well, however, these remote patient engagement tools can drive a variety of positive patient outcomes.

Medical directors, managers, and hospital leaders may grapple with physician resistance to digital patient engagement platforms. Their hesitancy might include the following questions: 

• How can medical practitioners engage and connect with patients outside of brick-and-mortar facilities? 
• Will remote patient engagement solutions actually improve value-based care outcomes and reduce patient readmission rates, or is this another technology fad? 
• Can virtual visits and updated monitoring systems be turned into billable hours?

A plethora of new virtual patient technologies are being introduced in the marketplace. Hospital and clinical healthcare administrators are looking for ways to reduce patient readmissions and eliminate wasted costs. Yet, providers may see these new technologies as an added burden to their daily, in-person patient engagement workflows. Swamped with increasing demands and pay-to-perform incentives, patients may get lost in the shuffle, especially those who require chronic care management or specialty visits.

Both patients and providers may have a lack of awareness when it comes to ehealth engagement technology.² Let’s look at a brief history and understanding of patient engagement, and how you can walk away knowing what strategies you should consider implementing for your medical organization.

What is Remote Patient Engagement in Healthcare?

Remote Patient Engagement Defined
Remote Patient Monitoring (RPM) is a broadly defined term which includes a range of digital tools that track a patient’s health. The information is sent back to healthcare professionals or caregivers to determine effective treatments. A few tech examples include heart monitoring devices, glucose meters, surveillance monitors, and digital reporting logs.³ 

Remote patient engagement is the use of these tools and devices to communicate and follow up with patients in a secure, timely manner. These medical bands and devices are commonly used by physicians and practitioners to monitor chronic conditions and post-surgery assessments. Dieticians, therapists, and wellness coaches use these tools for preventive, proactive, and rehabilitative health plans.

Patient Engagement Before 2020
About 60 years ago, some of the first remote telemedicine technologies were developed by NASA to track the health of astronauts.⁴ As telehealth technology expanded, private companies and the government invested money and research into different healthcare delivery methods. Enter the Health Insurance Portability and Accountability Act (HIPAA) in 1996 and the Affordable Care Act (ACT) in 2010, which allowed more coverage for patients with chronic conditions. This opened the door for accessible and reimbursable patient visits that utilize remote patient monitoring and telehealth technology.

Patient Engagement After 2020
The consumerization of healthcare has accelerated, but the trend was in motion well before the COVID-19 pandemic. This fueled demand for healthcare organizations and providers to communicate more frequently with their patients and families. Sharing healthcare information digitally can accelerate speed to care, and 77% of patients are willing to do so if it positively impacts their care.⁵

In a recent interview, PerfectServe Chief Medical Officer Dr. Rodrigo Martínez shared that patient engagement technology adoption is a main need for healthcare organizations to stay relevant over the next decade:

Patient Engagement Digital Platforms

The types of digital platforms that facilitate patient engagement vary widely. Some offer niche-specific chronic care and treatment, like Health Recovery Solutions, which tracks biometric activity, such as blood pressure and oxygen levels. Amazon has even joined the game with their Halo Band, which measures movement and sleep tracking. According to one study, 69% of respondents use smartwatches for chronic care management.⁶

List of Common Patient Engagement Devices

Like Gene Roddenberry’s tricorder in Star Trek, new medical devices are developed every year. One company invented DxtER™, a device designed “to prove the concept that illnesses can be diagnosed and monitored in the comfort of one’s own home by consumers without any medical training.”⁷ It was created to diagnose up to 34 different health conditions. While it’s not fully launched in the consumer marketplace, healthcare organizations and trained practitioners do use similar medical patient engagement devices.

Medical devices typically go hand-in-hand with a digital monitoring system for patient care, and for physician and nurse communication. Common devices used for patient engagement may include:

• Wearable bands (Smartwatches, Fitbit, etc.)
• Glucometer
• Pulse oximeter
• Electrocardiograph
• Blood pressure cuff
• Digital scale
• Smartphones
• Tablets or Laptops
• DxTer Tricorder (Yes, inspired by Star Trek.)

Knowing these tools are available is one thing. Applying them in a way that enables patients to communicate with a physician or nurse is another. So how can a healthcare organization use patient engagement strategies to their full advantage?

Patient Engagement Strategies: Reach Patients Before They Get Readmitted

According to CMS, the Hospital Readmissions Reduction Program (HRRP) “encourages hospitals to improve communication and care coordination to better engage patients and caregivers in discharge plans and, in turn, reduce avoidable readmissions.”⁸ With 6 in 10 adults in the U.S. having been diagnosed with a chronic disease, patient engagement tools and workflows will remain a priority for healthcare organizations.⁹ An awareness of these needs, combined with actionable foresight, may reduce these readmission events.

Do You Have a Patient Engagement Strategy?

Create a plan to measure your patient outcomes, not just quick, transactional clinic visits. Identify which remote patient engagement solution is best for your providers—something that is easy to train and implement. Being proactive versus reactive with these tools could boost physician, nurse, and patient morale. 

What are the common goals your healthcare organization wants to achieve? Knowing this information can act as a filter for your patient engagement strategy plans.

Patient Engagement Example for a Chronic-Condition Specialty Practice

If you are a specialty practice, build common message templates related to your patient’s frequent needs, which, when delivered to the patient, allow them to respond and transition to a remote video visit initiated by the right on-call provider. Here is one example for a 65-year-old patient with a recent kidney disease diagnosis and low GFR:

Physician’s Office: “Thank you for calling Green Valley Nephrology Clinic. Our hours are 9 AM through 5 PM Monday through Friday. If this is an emergency, please hang up and dial 911. Otherwise, press one to leave a message, press two to schedule an appointment, etc.”

Patient: (Presses one) “Hi Doc. This is George. I’m calling about my test results and the blood draw you did for my kidneys. I can’t remember my login to look at it, and I’m not good with computers. Do I need to go to the hospital? I’m peeing more than normal and I have some swelling in my legs and feet. Let me know.”

Physician’s Office: (Call routes to the on-call physician. Message alert pings Dr. Shaeffer, the on-call nephrologist. He decides to send a text message back through a secure, front-office number that masks his personal cell phone). 

Dr. Schaeffer: (Via text message) “Hi George. I received your message. Do you have a few minutes to hop on a video call? I will send you a link.”

Patient: “Yes, sure. Send me the link.”

Dr. Schaeffer: (Physician sends secure link.) “Here you go. [hyperlink]”

Patient: “Oh, there you are—got it. I see you now. Thanks for sending me the link. Wow, technology these days! So, do I need to go to the hospital?”

(Video conversation continues with patient and on-call specialist).

Scenarios like the conversion above may occur for any established, chronic-care patient and their physician. Let’s look at a few tips you could implement for your healthcare organization, so more patients like George can receive better care.

4 Ideas to Increase Patient Engagement

1. Send frequent—but not too frequent—text reminders that are beneficial for the patient. Some examples include appointment reminders, critical lab results, treatment reminders, and clinic feedback questions. Let them know you care by using automated touch-points which save time for both medical practitioners and the patient in day-to-day interactions.
2. When assessing chronic conditions, see if there is a way the patient can message you securely or log in to their health record to view the same data.
3. Communicate a plan for the office staff and medical practitioners so they know what messages and protocols have been set up. This includes things like lab results, inbound voicemails, and which messages are critical versus non-critical for patient healthcare outcomes. 
4. Coordinate schedules so all patients know at least one on-call practitioner can answer their questions. Updates to these schedules can be automated from the provider or administrative staff through a simple app, without chasing down a Google calendar or paper spreadsheet at the office.

For more ideas on how medical groups are using patient engagement strategies, see a demo of PerfectServe’s solutions for your medical practice or hospital.

¹Nursing Executive Center. (2020). Engaging Frontline Staff in Patient Flow: Two tactics to engage clinicians’ hearts and minds [White paper]. Advisory Board. https://advisory-prod.azureedge.net/-/media/project/advisoryboard/shared/research/nec/success-pages/2020/engaging-frontline-staff-in-patient-flow.pdf

²Safi, S. Thiessen, T. Schmailzl, K. (2018). Acceptance and Resistance of New Digital Technologies in Medicine: Qualitative Study. JMIR Publications, 7(12). https://doi.org/10.2196/11072

³Delvecchio, A. (n.d.). remote patient monitoring (RPM). SearchHealthIT. https://searchhealthit.techtarget.com/definition/remote-patient-monitoring-RPM

⁴Gruessner, V. (2015, November 9). The History of Remote Monitoring, Telemedicine Technology In recent years, healthcare reforms and federal legislation has pushed forward the spread of telemedicine technology and other technological advancements. mHealthIntelligence. https://mhealthintelligence.com/news/the-history-of-remote-monitoring-telemedicine-technology 

⁵(2021, June 15). New Data from HIMSS Shows Rapid Digital Health Adoption Necessitates Personalized Patient Technology. HIMSS. https://www.himss.org/news/new-data-himss-shows-rapid-digital-health-adoption-necessitates-personalized-patient

⁶Neslon, H. (2021, January 22). Condition-Specific mHealth Devices Best in Chronic Care Management. mHealthIntelligence xtelligent Healthcare Media. https://mhealthintelligence.com/news/condition-specific-mhealth-devices-best-in-chronic-care-management

⁷DxtER™ A New Kind of Consumer Medical Device. Basil Leaf Technologies. https://www.basilleaftech.com/dxter/

⁸(2021, December 1). Hospital Readmissions Reduction Program (HRRP). CMS.gov. Centers for Medicare & Medicaid Services. https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/Readmissions-Reduction-Program

⁹(2022, January 24). Chronic Diseases in America. Centers for Disease Control and Prevention. https://www.cdc.gov/chronicdisease/resources/infographic/chronic-diseases.htm