The success of your Remote Patient Monitoring (RPM) program is tied to whether your patients actually take their measurements as prescribed. We call this Patient Compliance. Getting a daily or 2x daily or other regular measurement produces better results for everyone as follows:
- Better Health Outcomes: Multiple studies have shown that if you can get a patient to regularly measure a specific item like blood pressure daily they will improve their overall health status. In addition, the care team will have richer data on which to base ongoing support to help the patient to achieve their best health.
- Increased Reimbursements: If your patients don't take measurements on 16 days each month/30 days -- you can't bill for 99454 -- which is ~$65 per month. So, the more patients that at a MINIMUM are taking a measurement on at least one out of every two days, the more you can bill 99454. As a result, the more financially viable your RPM program will be. For more on RPM billing see this article.
- Decreased Patient and Overall Care Costs: The more regularly the patient is providing measurements, the more likely they and their care team will be able to work together to identify a dangerous trend and intervene before an event that requires the emergency room, ambulance ride, hospitalization, or other high-cost incident.
So, high RPM Patient Compliance is directly tied to the success of your RPM program on all levels. In our experience working with more than 100 patient groups and tens of thousands of RPM patients, you can expect the "rule of thirds" in terms of compliance.
* 1/3 are eager to never miss a measurement, and do at least one measurement per day with no reminders or prompting.
* 1/3 might miss a couple days here and there, but will do five or six measurements per week WITH automated tech-enabled tools, reminders, and prompting.
* 1/3 are going to default towards "non-compliant" -- BUT can do three or four measurements per week WITH automated tech-enabled tools, reminders, prompting and other best practices we will outline below.
As you see, you might get 30 to 40 percent compliance with low human effort and limited technological capability. However, if you want to optimize your results -- you CAN get to 80 to 90 percent average monthly compliance by doing the following 7 things:
- Send Immediate Automated Nudges: Your RPM program should be supported by a full-featured technology system. This system should be capable of sending the patient an automated text and/or email message to the patient immediately after their measurement is overdue. This kind of automated "nudge" is incredibly powerful and efficient.
- Notify Care Team: Your RPM program should ensure the Care Team is getting "compliance alerts" that can be layered so you are proactively notified when several days have gone by since the last measurement from the patient. This way if one day goes by we can rely on the automated "nudge" -- but if three or more days go by our Care Team will get involved.
- Make It Personal -- With Video: Your RPM program should ensure the Care Team can easily call, text, or email the patient. These channels can be used to reach out to the patient to inquire as to why measurements are not coming through, and identify the root cause and potentially solve it. Or perhaps the patient just knowing that someone is going to be getting after them will help. To make a difference, use video so the Care Team can send an on-demand text or email for a real-time video session with the patient. This level of support and 1:1 human communication will improve patient compliance.
- Give Automated Immediate Positive Feedback: Your RPM program should be capable of delivering a patient an immediate text and/or email with a confirming "pat on the back / we got your message / thank you". This will help enforce the positive habit loop. The care team can follow up later, too, but the automated "nice work" message is a powerful tool. Of course, we make it possible for your or your patients to disable these so they don't cross the line towards "annoying".
- Show Them Progress: Provide the patient immediate access to their ongoing trends and results. Cellular/LTE devices are great for ease of use -- but don't necessarily provide an ongoing view of the measurement trends for the patient. These can be motivating -- your RPM system should have an OPTIONAL patient-facing web portal and mobile application where patients can view all of their historical measurements and trends. This is especially powerful when the patient is making positive progress towards lowering blood pressure, weight, glucose, and so on.
- Engage Local Team: Your RPM program should allow the spouse, children, parents, friends, other caregivers to join the patient "support community" so they can see and know the status of every measurement. These individuals can serve as an extended "care team" keeping the patient on track and providing reminders, support, and encouragement.
- Send a Paper Letter: Typically as a last resort, we have seen success sending an official Compliance Request Letter. Typically this is originating on letterhead from the provider office asking the patient to comply with the RPM program. The benefits of the program will be highlighted, the same benefits the patient originally acknowledged as part of their agreement to participate. This letter, or a follow-up letter, may also confirm for the patient that their participation in the RPM program will be terminated if they don't restart their ongoing measurements.
Many of these best practices rely on the Sentinel Effect and Hawthorne Effect. That is, the tendency for human performance to improve when it is being observed and/or evaluated. Simply put, your patients are more likely to take their measurements on time if they know the care team is watching, and cares about the patient’s behavior. So, your RPM solution must be capable of making sure the patients know that what they do or do not do is being observed. This will drive higher compliance, and as a result better outcomes across the board as noted. At 1bios, we ensure your RPM program will be able to utilize these best practices and more.
For more information on what to look for in software features and functionality in a full featured RPM, CCM and other virtual care programs system, check out our other articles, or download our e-book.