Patient Activation: The Secret to RPM Success

RPM, Remote Physiological Monitoring, is a proven, valuable telehealth solution that can greatly improve outcomes for patients with chronic diseases or prevent readmissions of patients recently discharged from the hospital.

A few weeks ago I outlined the 5 Reasons Why RPM Programs fail:

#5 Negative Financial ROI

#4 Lack of Clinician Buy In

#3 Cumbersome Technology

#2 Insufficient Monitoring Support

#1 Lack of Patient Engagement

In this final article of my series on RPM, I focus on the #1 reason why RPM programs fail, Lack of Patient Engagement, and am offering you below a collection of changes and improvements you can make to your RPM program to ensure its sustainable success.

Why Patient Engagement Matters

The answer to that should be obvious, but so often in healthcare our attention is drawn to quality measures, reimbursement rates, RVUs, process optimization or digital health solutions which makes it easy to lose sight of the patient.

Prior to launching my consulting firm, I spent 12 years at the Mayo Clinic in Rochester, Minnesota where the primary value is that “The needs of the patients come first.” At the Mayo Clinic that is not just an empty slogan or a plaque on a wall — it truly is a lived value for over 100 years when one of the Mayo Brothers said even more adamantly that “the needs of the patients are the only needs to be considered”.

So, yes, patient engagement matters, because ultimately the goal of RPM is to at least stabilize if not improve the patient’s health — and we can only do so if the patient cooperates, if they “follow” their care plan. Most commonly this involves taking their medication regularly – all of them and at the right dose and the right frequency.

Obviously if patients are not engaged, if they stop participating in the RPM program (i.e., stop taking their weight or blood pressure measurements), then the overall program will fall apart if that is the case for many patients.

Without the, ideally daily, vital sign measurements, there may be not enough data collection for reimbursement. With active participation in their care plan, the desired outcomes of RPM for that patient (e.g., a well-managed chronic condition or a prevention of a readmission) may not be achievable.

With a lack of participation by the patient, the expected revenue or cost avoidance (in the case of readmission prevention) is not there to offset the cost of the devices, the monthly platform fee, and the cost of the monitoring staff. This then leads to Reason #5, a negative financial ROI (which can be improved through other means, too).

Driving Toward Patient Engagement

To put it simply, there are three key conditions that must be in place to all but ensure patients’ engagement in their care:

(1) Great Technology: First off, the patient-facing monitoring devices must be easy to use. If they often fail, disconnect, or are otherwise cumbersome to use, patients eventually will not bother. In addition, devices that often fail can drive up support cost exponentially that can derail the ROI of an RPM program.

(2) Great Support: Patients value the human touch and many of them truly appreciate and value knowing that someone is “watching their data” and that someone is “waiting for them” to take their measurements, or otherwise they will get a call. Superb support with a warm customer service attitude will go a long way to make patients feel special.

In addition, all monitoring nurses I’ve talked to had numerous stories to tell how they just love to take the data as a take off point to turn the conversation into a teachable moment that would improve the patient’s participation in their care plan. Even in this day and age of AI and chat bots, without great support, true patient engagement is not sustainable.

(3) Emotional Enrollment: The most important aspect of patient engagement is often overlooked or underutilized by most RPM programs that I’ve studied. Most programs do have a good patient “onboarding” process, where the patient is trained on the mechanics of how to use the devices, how to take good measurements and how to transmit the data. In good programs patients are furthermore educated about the limitations of the program (i.e., the monitoring is not 24×7 and is not a substitute for initiating a 911 call) and the expectations with regards to the frequencies of measurements.

What many programs are missing, however, are conscious steps to ensure that the patient is also emotionally enrolled (and not just “logistically”). And this enrollment starts with the patient’s trusted clinician. For chronic care management this is the patient’s primary care doctor. For readmission prevention it’s the patient’s surgeon or hospitalist. In a conversation that takes no more than a minute or two, the clinician can compassionately outline how much value the patient stands to derive from actively and consistently participating in the program. How their participation can prevent miserable consequences such as ER visits, hospitalizations, or simply feeling sick.