Before remote patient monitoring, UPMC did not have easy access to patients at home and was relying on visiting nurses to get data, which didn't happen every day. Moreover, home-based patients could not access UPMC care on their own time – the providers would call them or visit them primarily based on its schedule.
With this in mind, the Pittsburgh health system wanted to address, through one integrated platform, a spectrum of diseases – from the sickest of the sick, all the way to light-touch, post-discharge smoking cessation programs.
With the remote monitoring program, the health system is setting the stage for population-based care across payer and provider models.
To aid with its effort, UPMC turned to remote monitoring and telehealth vendor Vivify. There are the two main technologies: a tablet with or without peripherals and a patient's own mobile phone. The Vivify platform provides the call center portal, equipment monitoring, reporting features, EHR integration and equipment delivery.
Caregivers log in to the Vivify portal and monitor alerts, bio-parameters and patient survey question responses to triage and guide virtual care. They also do live video visits with patients. Their documentation in Vivify flows back into UPMC electronic health records.
"Patients simply open a box, then turn on a tablet or respond to a text message to access remote patient monitoring," said Andrew Watson, MD, medical director of UPMC Telemedicine. "The process has been streamlined to make it simple for them. Care is provided through survey questions, educational videos, scales, BP cuffs and pulse oximeters, and live video visits."
During the one-and-a-half years of remote patient monitoring at UPMC, the provider organization is seeing a statistically significant decrease in observation status utilization for congestive heart failure patients, Watson said.
The health system has a large and growing number of anecdotal and documented cases of avoided emergency room utilization, filling critical prescriptions for sick patients, and finding patients who were critically ill at home and who didn't answer the remote patient monitoring requests, he explained. Further, Medicare members who enroll in Vivify are 76 percent less likely to be readmitted to the hospital.
"The transition to the remote patient monitoring technology was almost seamless; we educate the patients and call them to introduce them while admitted or at home," Watson said. "Patient satisfaction in over 1,500 patients remains over 90 percent. And compliance likewise is over 90 percent over the same time period."
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