Navigating Tools vs. Change Management in Remote Patient Monitoring: A Strategic Approach

Oncology Practices Embrace Remote Monitoring to expand Advanced Therapy Access

Reston, Virginia – As cutting-edge cancer treatments like CAR T-cell and bispecific therapies become more prevalent, community oncology practices are increasingly turning to remote therapeutic monitoring (RTM) to ensure safe and cost-effective delivery. The shift comes as these therapies, while groundbreaking, require intensive monitoring that traditionally has been confined to larger hospital systems.

The Rise of Remote Monitoring in Cancer care

The need for consistent patient tracking between oncology appointments isn’t new. Evidence consistently demonstrates that proactively gathering symptom reports from patients allows medical teams to intervene early, preventing serious complications and reducing emergency room visits. The advent of new therapies is intensifying this need, pushing practices to explore innovative care models.

At a recent Community Oncology Alliance (COA) Payer Exchange Summit, leaders discussed the potential of RTM to bridge the gap, offering a viable path for community practices to offer these advanced treatments. Experts highlighted that successful implementation requires not only technological infrastructure but also a strategic approach to billing and workflow integration.

Navigating Reimbursement challenges

Texas Oncology,a large community practice,has been utilizing electronic patient-reported outcomes (ePROs) for nearly a decade,collecting data from over 100,000 patients. They are now piloting RTM specifically around bispecific therapies. However, converting this long-standing data collection into a billable service has been a recent advancement.

Jeff Hunnicutt, CEO of Highlands Oncology, emphasized the financial hurdles faced by many practices. While demonstrating improved outcomes and cost savings to payers is frequently enough possible, securing consistent reimbursement has been a persistent challenge. Medicare has expanded coverage for certain remote monitoring services in recent years, but navigating the specific programs can be complex.

“Sometiems payers are intrigued by the data, but actually getting reimbursed is a different story,” Hunnicutt noted.

Monitoring Type	Data Collected	Reimbursement Pathways (CMS)
Remote Patient Monitoring (RPM)	Physiological data (heart rate, blood pressure)	Chronic Care Management (CCM), Principal Care management (PCM)
Remote Therapeutic Monitoring (RTM)	Non-physiological data (symptoms, functional status)	Specific RTM codes established in 2022

Did You Know? The Oncology Care Model (OCM) ended in June 2022, prompting practices to seek alternative revenue streams – RTM has emerged as a key replacement for many.

Improving Patient Care Through Proactive Monitoring

Dr. Annette Fontaine of New Mexico Cancer Center utilizes remote monitoring for nutritional support and functional status evaluations. A significant barrier she’s encountered is cost-sharing for patients without supplemental insurance. Many patients initially embrace the technology (like Fitbits and scales), but discontinue use when faced with monthly bills.

Dr.Debra Patt of Texas Oncology shared an example of how ePROs enable her to proactively manage side effects. For patients undergoing treatment with CDK4/6 inhibitors, which can cause gastrointestinal issues, her triage nurse alerts her to reported symptoms, allowing for timely dose adjustments.

Beyond technology, access to reliable internet remains a challenge, particularly in rural areas. This digital divide can limit the reach and effectiveness of remote monitoring programs, underscoring the need for equitable access to broadband infrastructure.

Pro Tip: Gain staff buy-in from the outset of implementing a new remote monitoring programme. Present it as a collaborative effort, not a top-down mandate.

Implementation and the Path Forward

Panelists agreed that while selecting the right tools is important, the biggest challenge lies in implementation and change management. Successful integration requires careful planning, staff training, and a robust infrastructure for order entry, patient enrollment, and revenue cycle management.

Hunnicutt stated that Highlands Oncology was able to recoup revenue lost after the OCM ended using CCM and RTM, and this allowed them to reinstate positions that were previously cut. He emphasized that RTM does not need to be a profit center, but a means to reinvest in patient care.

“So that, to me, that’s the ROI thing,” Hunnicutt said. “I didn’t mean to make a whole lot of money on RTM, but if you can make us whole and allow us to be able to do that for our patients, then that’s all it is.”

Looking Ahead: The Future of Remote Monitoring in Oncology

The integration of remote therapeutic monitoring into oncology care is poised for continued growth. As technology evolves and reimbursement policies become clearer, more practices are expected to adopt these programs, expanding access to advanced therapies and improving patient outcomes. The focus will likely shift towards more elegant data analytics and personalized interventions,driven by the wealth of facts collected through remote monitoring.

Frequently Asked Questions

• What is remote therapeutic monitoring? RTM involves monitoring patients remotely for non-physiological data, such as symptoms and functional status, to guide treatment decisions.
• Why is RTM important in oncology? It allows for proactive management of side effects, improved patient engagement, and expanded access to advanced therapies.
• What are the biggest challenges to implementing RTM? Reimbursement complexities, patient cost-sharing, and limited internet access are key hurdles.
• How can practices successfully implement RTM? Careful planning, staff training, and a robust infrastructure for data management are crucial.
• What role does Medicare play in RTM reimbursement? Medicare has created specific billing codes for RTM services, but navigating these requirements can be complex.

Is your practice considering implementing remote therapeutic monitoring? Share your thoughts and experiences in the comments below!

How can organizations proactively address clinician concerns about workflow disruptions when implementing RPM?

Teh Rise of Remote Patient Monitoring (RPM) & Its Challenges

Remote Patient Monitoring (RPM) is rapidly transforming healthcare,offering benefits like improved patient outcomes,reduced hospital readmissions,and enhanced access to care. Though, accomplished RPM implementation isn’t solely about adopting the latest telehealth technology or RPM devices. It’s a complex interplay between selecting the right tools and effectively managing the organizational and behavioral changes required for adoption. Manny organizations stumble,investing heavily in remote monitoring solutions only to see limited uptake and disappointing results. This is often due to underestimating the change management component.

Understanding the Core Difference: Tools vs. Change

* Tools (Technology): these encompass the hardware and software used for RPM – wearable sensors, connected medical devices (like blood pressure cuffs and glucometers), patient portals, data analytics platforms, and telehealth platforms. Thay enable the collection and transmission of patient data. Focusing solely on tools leads to a “build it and they will come” mentality, which rarely works.

* Change Management: This focuses on the people side of RPM implementation. It addresses how clinicians integrate RPM into their workflows, how patients adopt new technologies and behaviors, and how the association adapts its processes to support RPM. Effective change management minimizes resistance, maximizes adoption, and ensures the technology delivers its intended value. Key elements include stakeholder engagement, training programs, and interaction strategies.

Key areas Where Change Management Outweighs Tool Selection

Several critical areas demand a strong change management focus, frequently enough exceeding the importance of the specific tool chosen:

* Workflow Integration: Simply adding RPM data to an already overloaded clinician’s dashboard isn’t helpful. Change management ensures workflows are redesigned to efficiently incorporate RPM data, flagging actionable insights and minimizing alert fatigue. This requires understanding current workflows, identifying bottlenecks, and collaboratively designing new processes. Consider clinical decision support systems (CDSS) integration.

* Clinician Buy-In: Resistance from clinicians is a major barrier to RPM success. change management strategies should involve clinicians early in the process, soliciting their feedback on tool selection and workflow design. Highlighting the benefits of RPM for them – reduced workload, improved patient care, and enhanced professional satisfaction – is crucial. physician champions can be invaluable.

* Patient Engagement & Adherence: Patients need to understand why they’re using RPM, how to use the devices correctly, and what to do with the data.Change management includes developing patient education materials, providing ongoing support, and addressing concerns about privacy and security. Patient activation measures (PAM) can help tailor engagement strategies.

* Data Security & Privacy: Implementing robust HIPAA compliant solutions is essential,but equally important is educating staff and patients about data security protocols. Change management ensures everyone understands their role in protecting patient details. Regular security awareness training is vital.

A Strategic Approach: Prioritizing Change Management

Here’s a phased approach to prioritize change management alongside tool implementation:

1. Assessment & Planning (Months -3 to -1):

* Conduct a thorough needs assessment to identify current challenges and opportunities.

* Define clear goals and objectives for RPM.

* Identify key stakeholders and their potential concerns.

* Develop a comprehensive change management plan.

2. Pilot Programme (Month 0-3):

* Implement RPM with a small group of patients and clinicians.

* Gather feedback on both the tools and the workflows.

* Refine the change management plan based on pilot results.

3. Phased Rollout (Month 3-6):

* Gradually expand RPM to larger patient populations and clinical teams.

* Provide ongoing training and support.

* Monitor key metrics (patient engagement, clinician adoption, clinical outcomes).

4. Continuous Advancement (month 6+):

* Regularly evaluate the effectiveness of RPM.

* Identify areas for improvement and make adjustments as needed.

* Stay up-to-date on the latest RPM technologies and best practices.

Benefits of a Change Management-Focused RPM Strategy

* Increased Adoption Rates: Clinicians and patients are more likely to embrace RPM when they understand its value and are properly supported.

* **Improved Patient Outcomes