• Effy Healthcare

Turning RPM Data into Action – and Revenue

When integrated into clinical workflows, remote patient monitoring (RPM) technologies have the potential to improve patient outcomes and the bottom line. The challenge is creating proactive systems that alert providers immediately when data indicates results outside of normal limits.

Statistics indicate that healthcare’s long resistance to digital integration may be over, and the industry may be ready to fully embrace RPM technology. According to researchers, the global RPM “market is projected to be worth over $1.7 billion by 2027, up nearly 128%” from current levels.


The US RPM market is expected to grow almost 30% by 2024, with 11.2% of the population using RPM tools. Such an explosion in use is not difficult to imagine when you see commercials for glucose monitors or walk down the devices aisle in your pharmacy to find blood pressure monitors that report results to your physician’s office.


RPMs collect data and send it to the provider's electronic health system, where providers manually access it. Unfortunately, access alone does not improve a patient’s health. The data needs to become time-sensitive and actionable to influence health outcomes effectively.


The trick is bringing RPM data into the clinical workflow


Health Economist Jane Sarasohn-Kahn recently told Healthcare IT News that bringing virtual care into an episode of care workflow is the “tricky” challenge that must be overcome to realize the full potential of virtual care. She points out that “providers need to optimally leverage virtual tools such as… blood pressure cuffs to provide data to health coaches, who then work remotely with home-based patients to achieve desired outcomes.”


Effy meets the challenge of converting RPM data into immediate action


As Sarasohn-Kahn highlights, the primary challenge is the proactive monitoring of RPM data to find the variations that signal action is needed. The ideal solution would be a system that pulls information into the clinical workflow, allowing clinicians to be notified immediately of anomalies requiring attention. Effy Healthcare Business Assurance technology is the proven approach to solving the “tricky” challenge of converting data into actionable information.


Effy’s efficiency platform continuously monitors data in real-time and triggers alarms when the data falls outside of established thresholds. Warnings can be immediately sent into clinician workflows, presenting the opportunity to work with patients promptly to resolve the health issue.


The Effy Healthcare solution is layered on top of all existing technology, covering multiple medical systems and locations, and ensures the delivery of time-sensitive notifications despite non-integrated platforms.


The opportunity for RPM reimbursement

Medicare has been paying RPM CPTs since 2018


RPM CPTs include
  • 99454 (device set-up)

  • 99457 (first 20 minutes of monitoring/patient communication)

  • 99458 (each additional 20 minutes)

  • 99091 (data interpretation)

As technology evolves, prospects for fee-for-service reimbursement will grow. More difficult to calculate, but equally as important, is the effect RPM will have on organizations that increasingly rely on value-based care (VBC) models.


RPM can mitigate value-based care risk


Comprehensive RPM programs may allow organizations to take on more risk within VBC systems. The opportunity an integrated and responsive RPM program provides can significantly mitigate risk, which leads to higher payments. In addition, health monitoring empowered with proactive interventions can create a safety net to catch and potentially correct conditions before they become acute and require hospital care or expensive procedures that affect VBC compensation.


Effy Healthcare Business Assurance and Intelligent Automation technology use real-time data and actionable analytics to identify critical changes and issue instant notifications into workflows whenever customized thresholds are met. The flexibility of Effy Healthcare Business Assurance makes it a valuable tool anywhere your organization uses data – from clinical departments to revenue cycle management, to IT – to optimize operations.


Interested in learning how Effy Healthcare can optimize your RPM operations?

Contact us today!