Here’s an imaginary patient – we’ll call her Ruthie. She’s 70 years old, suffers from a chronic kidney ailment and is under treatment by a specialist – a very expensive specialist. Because he’s one of very few doctors with experience in treating her specific illness, he has hundreds of patients which means that he has to deal with each one in the most time-efficient way possible. A consultation with this doctor comes to 20 minutes or less, and it involves a 90 minute drive to reach his clinic.
Another complication is unpredictability – her condition is sometime better, sometimes worse. Her children nag her constantly to move into an oldies home with 24-hour care providers … but Ruthie doesn’t want to go. Her life and career have not prepared her to accept any limitation to her independence.
A few years ago, Ruthie’s problem would have been very difficult to solve. But not anymore!
Now she’s can test her kidney function at home at any time with two different methods – blood pressure and weight – and, using an app on her phone, send the results to a monitoring center. Her local pharmacy (located just around the corner from her house) is a key link in this process. Her pharmacist not only fills her prescription but keeps an eye on the test results and alerts both Ruthie and her doctor when the numbers go out of range. Close monitoring also allows her doctor to fine tune treatment to exactly match Ruthie’s treatment needs.
Outcome: Ruthie is stress-free in her own home, she is proactively controlling her condition, lessening the chance of emergency situations and making economical and best use of occasional visits to her doctor. She has been empowered by a technology and a system called Remote Patient Monitoring.
Remote Patient Monitoring (RPM) is not new; it was first used 60 years ago when cardiologists started transmitting EKGs over telephone wires. Use expanded slowly in the initial decades … and then exploded in 2020 and 2021 when the covid pandemic kept people at home and hospital capacity was stretched to breaking point. The need for RPM was undeniable, the effectiveness of RPM was demonstrated and the CMS quickly changed its rules to encourage RPM use. This included waiving cost sharing and relaxing requirements for billing. [CMS stands for Centers of Medicare/Medicaid, an agency of the federal government that administers the Medicare program and works in partnership with state governments to administer Medicaid, the Children’s Health Insurance Program and health insurance portability standards.]
Companies such as Apple and Ionic have been quick off the block too … 37 firms introduced new RPM products during the past two years. You never thought of that watch you wear while jogging as an RPM device? It can be. It counts your steps, records your heart-rate and blood pressure, creates colorful graphs that analyze your performance and you can transmit the data.
Devices small enough to strap on your wrist or carry in your pocket now measure many physical parameters, including blood sugar, oxygen level, stress level, how much and how well you sleep. There are even devices that monitor the well-being of a baby in the womb.
SIMI PHARMACY stocks a wide variety of devices that monitor and transmit data on health parameters. You can get monitors for blood pressure, smart scales, medical alert devices and many more.
Covid has been a major factor in the expansion of RPM but not the only factor. Here’s the key statistic: In 2020, about 16.9 per cent of the American population was 65 years old or over; by 2050 the number will climb to 22 per cent. People are living longer. The longer we live, the more healthcare we need. People over 80 account for 24 percent of Medicare beneficiaries, but 33 percent of Medicare spending. Average Medicare spending per person doubles between the ages of 70 and 96 – mainly on account of cardio or respiratory problems, diabetes and dementia. These four categories account for nearly 90 per cent of U.S. healthcare costs. Anything that eases strain on the entire healthcare system and allows people to have a better quality of life is welcome.
To help hospitals cope with covid, the CMS created the Hospitals Without Walls program in 2020. It worked so well, that hospitals are not only sticking to it, they are going beyond, expanding into diagnostics like echocardiograms and X-rays, to treatments such as oxygen therapy and intravenous fluids, and services too. Services includes pharmacy and nursing. RPM makes it possible to send patients back to their homes within a day of undergoing surgery; their recovery is tracked by RPM. In fact, remote watch is kept over all kinds of patients. For example, RPM works well for diseases as different as Type 2 diabetes and Alzheimer’s.
Clearly, the hospital-at-home concept benefits health services – they can do more with less. There’s another big plus point – one not so obvious to those of us living in full-service Ventura County. Imagine a family living somewhere on the backside of the Mojave Desert. The wife is expecting, something goes wrong. Even with remote patient monitoring, this is still a dangerous situation but at least signals coming in to a monitoring center are going to ring an alarm bell the second her condition starts slipping. This means no guessing about whether her condition is serious or not. It means more time to reach the nearest hospital, which means better chance of saving mother and child.
This discussion of RPM has been general so far. Where does SIMI PHARMACY come in? CMS now allows doctors, hospitals and care facilities to partner with pharmacists to monitor RPM data, educate patients in use of RPM devices and even to provide some types of medical intervention. The way it works is that a doctor refers a patient to an RPM program.
The pharmacy enrolls the patient, gets the RPM device, sets it up for the patient, explains how to use it correctly, receives and interprets the readings. The pharmacy follows the doctor’s instructions about when to report and contacts the doctor whenever needed.
Pharmacists are ideally placed to perform this role. For one thing, the average person sees a pharmacist must more frequently than he or she sees a doctor. People go to pharmacies that are close to their homes. Pharmacists are visible and trusted within the community. An RPM system involves many health-care professionals – doctors, IT specialists, insurance administrators – but it is the pharmacist who is in the “people-facing” role.
SIMI PHARMACY
is just at the very beginning of this new phase
but we know that it is going to expand rapidly.
WE ARE ALWAYS HAPPY TO SEE YOU IN PERSON,
but if that’s not possible, then we will be just as happy to see
your DIGITALLY TRANSMITTED DATA via RPM.