Digital health management and treatment for respiratory disorders are growing rapidly. New monitoring devices that use artificial intelligence (AI) appear often and are regularly approved by the FDA for clinical use.
These devices provide significant benefits to COPD and asthma patients. Far beyond the national average of 50% patient adherence to treatment protocols, these devices improve the adherence rate to 85-90%. Many patients report fewer exacerbations and reduced frequency of rescue medication use. These devices also reduce the number of hospitalizations and emergency department visits for pulmonary patients.
Often, health insurance covers all or part of the cost of digital health devices for patients. Medicare typically pays 80% of the cost of each device and supplies since they are considered Durable Medical Equipment.(For more information, please see our previous blog post, Reimbursement for Digital Health Solutions for COPD Patients.)
Nevertheless, clinical providers (especially solo practitioners and small to medium health care organizations) who consider launching a respiratory digital health program should be prepared to address specific challenges as well as take advantage of substantial opportunities.
The benefits to patients mentioned above bring several benefits to providers as well. For example, much higher rates of adherence to treatment protocols translates to fewer urgent in-person visits or visits to emergency departments. Better health of patients means fewer resources expended on staff and less time devoted by providers to individual care.
Remote patient monitoring (RPM), especially when conducted with “smart” AI devices, enables providers to analyze patient conditions in real time without having to wait for an in-person visit. Such immediate access to patient data affords better decision making, more rapid response to urgent situations, and fewer clinical errors.
Since most RPM devices can transmit (usually through a smartphone app) patient vital signs and other data to a patient’s electronic health record (EHR), providers can save staff time and eliminate data entry errors. Eliminating EHR clinical errors can reduce treatment errors and result in more reliable processing of claims by health insurance carriers. A win-win outcome for patients and providers.
When launching a respiratory digital health program, providers should prepare to address the following challenges. Indeed, thesec hallenges can be considered as a kind of checklist for launching such a program.
- All digital devices should be suitable for use by young children and elderly patients and their caregivers. Some devices are engineered especially for pediatric purposes.
- Training in the use of digital devices and accompanying software should be arranged for providers, other clinical staff, patients, and in-home caregivers. For providers, such training should include interpretation of reported data. This will likely be an important, ongoing feature of any respiratory digital health program and may incur additional cost and staff time.
- All providers and support staff should be trained to enter correct billing codes for digital monitoring and treatment of respiratory conditions. Doing so will ensure that health insurance carriers andMedicare/Medicaid will reimburse correctly for such services.
- Parameters indicating an urgent medical situation or changes in treatment can vary according to individual patient circumstances. Such customized parameters and instructions should be recorded in each patient’s EHR.
- Providers and clinical staff should be trainedto answer patients’ questions about the use of digital devices and software.
- Lack of technological infrastructure (high-speedInternet access, smartphones, etc.) might be encountered for some patients.
- All recommended devices and accompanying software should interface smoothly with the installed EHR system to ensure accurate data entry. It would be prudent to check with the EHR vendor and device manufacturers to make sure that a smooth interface will occur.
- Digital device vendors should ensure that transmission of data is HIPAA-compliant.
- Disparity of access to digital devices for financial reasons might present a challenge for some patients. Providers should consider devising a policy to address such situations.
- For pulmonary patients, it is helpful to use devices that can monitor environmental conditions in addition to patient vital signs and conditions.
- Tracking of outcomes—the effect on number of in-person and emergency department visits, frequency of use of rescue medications, number and frequency of exacerbations, degree of patient satisfaction, etc.—is necessary to evaluate the success of the program.
- Finally, the degree of competition among device developers and the rate at which new features are introduced make this a good time to add such a program to your telemedicine initiatives.
Launching a respiratory digital health program takes time and careful planning. If you see a significant number of pulmonary patients, however, the reward in improved patient care, time saved, and lower cost of treatment can be great. Such results may significantly improve net revenue over time.
Journal of Thoracic Disease:Digital healthfor COPD care: the current state of play (2019)
Mobihealthnews: Digital’s future in respiratory health, from clinical trials to remote care (2020)
Journal of Aerosol Medicine and Pulmonary Drug Delivery: Reflections on Digital Health Tools for Respiratory Applications (2020)
JMIR Formative Research: Passive Monitoring ofShort-Acting Beta-Agonist Use via Digital Platform in Patients With ChronicObstructive Pulmonary Disease: Quality Improvement Retrospective Analysis(2019)
American Journal of Therapeutics: Digital Health Technology and Telemedicine-Based Hospital and Home Programs in Pulmonary Medicine During the COVID-19 Pandemic (2021)
StartUp Health: The Future of Respiratory Care Has Arrived (2018)