By John Whitman, faculty member at the Wharton MBA Health Care Management Program specializing in senior car services | CMT Contributor
Historically, our health care system has not made it easy for physicians to provide in-depth comprehensive care services for high-risk patients. Reimbursement (or lack thereof) has often been a significant barrier especially for high-risk patients with multiple chronic conditions. While many associate chronic diseases predominantly in the senior population, the Centers for Disease Control estimates that more than 133 million Americans, or 45 percent of the total population, have at least one chronic condition.
The US Health Care System is aggressively moving in the right direction to address this and other significant issues by encouraging providers to take advantage of the effectiveness and low cost of utilizing technology. Medicare clearly recognizes the ability of technology to help reduce unnecessary and avoidable emergency room visits and hospitalizations and is willing to pay for effective technological solutions. That means that physicians have an opportunity to embrace these technological advances and not only provide better care for their patients, but also increase their revenue as well.
The reality is clear: the number of high-risk patients with diabetes, CHF, COPD, heart and other chronic conditions continues to rise and they are living longer than ever before. Monitoring these high-risk patients on a monthly basis through traditional office visits is no longer adequate to assure their safety.
Through amazing advances in technology over recent years, high-risk patients can now be monitored in real-time and their physician can be alerted immediately upon their readings falling outside their clinician’s patient specific guidelines. These alerts serve as an “early warning system” allowing the physician to provide medical intervention and resolve an issue before it escalates to a true medical crisis requiring an emergency room visit, hospitalization or worse.
I recently reviewed the Link+ Program created and powered by a company called LiveCare in New York City. This progressive company has created the first smart two-way real-time audio/video pendant that qualifies as a Personal Emergency Response System (PERS). This pendant connects by Bluetooth with Remote Patient Monitoring Devices. The combination of the pendant and the remote monitoring devices is called the “Link+Program” and is a Smart FDA Cleared Hub/Gateway that links to FDA approved devices to help monitor hypertension, diabetes, obesity, SPO2 with heart rate, and temperature to yield a very complete picture of a person’s overall well-being.
Linking the two-way audio/video pendant with the remote monitoring devices by Bluetooth and then having the pendant transmit that information to the remote monitoring platform is brilliant. It eliminates the need for a patient to use a smartphone, tablet or laptop to connect vital readings to the remote monitoring platform. In addition, because the process is totally automatic, it eliminates the potential for intentional or non-intentional incorrect recording of information. Furthermore, internet connection is not required because the pendant can transmit the information independently without internet access in the patient’s home. If an individual’s readings for a specific chronic condition go above or below the range established by the physician, it will trigger an alert. The physician can immediately review not only the reading that triggered the alarm, but the patient’s readings for as long as they have been using the system through an easy to read graph showing any positive or negative trends.
Another advantage of the pendant is the LiveCare Family App which allows a family member with an IOS device to easily communicate with Live Chat voice and video conferencing, Live Text to send pictures and text messages This increased capability of communication between the senior and his/her family can help prevent the many of the well know negative risks associated with social isolation. In addition, the Pendant can be used to locate any one wearing the pendant via HIPAA Cloud Based server while also providing a fall detection service. Last week I had the pleasure of interviewing Dr. Erik Ilyayev, an Associate Professor at Touro College of Medicine. Dr. Ilyayev also has a medical home practice and he and his staff of nurse practitioners visit medically isolated seniors in their homes in New York City. Dr. Ilyayev called the LiveCare Program a “Game Changer” because of the daily monitoring it offers for his high-risk patients and the support it provides for clinicians allowing them to provide even better care of their patients.
He provided multiple examples where the LiveCare Program recognized serious changes in a patient’s medical condition while at home. Without the early alert and the corresponding medical intervention, many of these cases would likely have escalated to a true medical crisis.
One specific example he offered was an 86-year-old woman with a history of high blood pressure that was normally controlled by medications. She takes her blood pressure twice a day with a simple cuff device and her readings are immediately Blue toothed to the pendant. The pendant immediately sends the readings to the remote monitoring platform. If the readings fall outside the requirements established by her physician on a patient by patient basis, an alert is sent to the physician. A few weeks ago, Dr. Ilyayev received an alert on this patient because her blood pressure was significantly elevated. He immediately went on his tablet and was able to view not only the reading that generated the alert, but 30 days of data in a simple, easy to read graph. “I was able to see a full month of readings and not just an individual reading at a moment in time.” He called the patient on the pendant and had a meaningful face to face interchange. Based on his findings he adjusted her medication in response to her immediate medical need. The patient continued taking her blood pressure twice a day and he was able to continue monitoring her progress. As she improved, he was able to again change her medications as needed… something he would never have been able to do with the traditional office visit model but very doable with the remote monitoring program in place.
Bottom line: not only does this program provide additional protection for high-risk patients; it allows clinicians to do a better job taking care of them while generating additional revenue for the physician practice. In most states, the two-way audio/video pendant is paid for by Medicaid as a PERS unit. The monthly billing potential for the physician depends on the number of remote monitoring devices recommended by the physician. For example, a senior with the Pendant and one remote monitoring device will be able to generate approximately $50 or more a month of net revenue for the physician. For a senior with two remote monitoring devices plus the pendant, the net monthly revenue for the physician would likely be $125 or more.
I recently had the pleasure of meeting the management team of LiveCare and seeing and holding the pendant and remote monitoring devices in my hand. Peri Avitan, the CEO and Founder of LiveCare was appropriately proud of the program his company has created and its ability to help improve care for high-risk patients while at the same time helping physician practices generate significantly more and well-deserved revenue.Peri offered to have his Director of Business Development, Eric Ditkowsky run a free, no cost evaluation for any physician practice interested in learning more about the program. Based onseveral practice specific statistics, Eric will be able to generate an estimate of the level of addedreimbursement available by offering the pendant and remote monitoring devices to those highriskpatients within a given practice.
Bottom line, not only does this program provide additional protection for high-risk patients, it also allows clinicians to do a better job caring for them while generating additional revenue for the practice. Better care, better revenue…yes, I would call that a “Game Changer!”
You can see more details about the Program at LiveCare’s website: www.LiveCareUSA.com or call (800) 993-4233
About the Author
Mr. John Whitman is a faculty member at the Wharton MBA Health Care Management Program specializing in senior car services. John is the founder and Executive Director of The TRECS Institute and for the past five years he has been aggressively evaluating the ability of telemedicine and remote monitoring to improve care for high risk seniors, reduce costs for our health care system and improve revenue opportunities for those providers utilizing telemedicine and remote monitoring services.