The following is a guest article by Dr. Joshua Liu, MD, Co-founder/CEO of SeamlessMD.
Over 10 years ago, I went down the rabbithole of preventing readmissions. I learned about “superusers” – the 5% of patients who represent 50% of healthcare costs. Like many providers, I thought: if we could monitor these patients, could we prevent readmissions?
RPM 1.0: Monitoring the Top 5%, High-Risk Patients
For decades, our healthcare system lacked the incentives or means to do so. However, the emergence of value-based care, mobile technology and cloud computing paved the way for a vibrant Remote Patient Monitoring (RPM) market. Adoption of RPM became mainstream in 2020 as COVID-19 forced stragglers to get on board.
Today, traditional RPM includes patients receiving a tablet and wireless devices for daily biometric monitoring (e.g., weight scale, blood pressure cuff). A healthcare team gets alerted for abnormal readings and intervenes earlier. For these top 5% of patients (e.g., hospitalized for exacerbation of complex chronic disease), the results have been incredible: health care organizations report higher patient satisfaction, reduced readmissions, and lower costs. This success begged the question of whether digital care could benefit the other 95% of patients.
Rise of the Digital Savvy, Healthcare Consumer
The pandemic has woken health systems to the realization that it’s no longer patients, but rather digital-savvy, Healthcare Consumers that we care for. Today, it’s well-beyond just the high-risk, top 5% of patients who want and expect digital care as part of the healthcare they receive. The 2019 Accenture Digital Health Consumer Survey showed that 53% of patients are more likely to use a provider who offers remote monitoring, and the 2020 Survey found 57% of consumers are open to being remotely monitored. Health systems now require Digital Transformation strategies for the other 95% of patient journeys: from low to high risk, and across surgery, oncology, and maternity care.
No longer is it only the 95-year-old with heart failure and COPD who needs digital care. Now, it’s also the 70-year-old patient who had cardiac surgery and wants to send a photo of his surgical incision to avoid traveling hours to the hospital. It’s the 65-year-old with a knee replacement surgery who wants to use her tablet to self-monitor her knee pain and watch physiotherapy videos. It’s the 30-year-old woman who wants pregnancy instructions on her smartphone and her mood and blood pressure monitored after her delivery.
Providers and administrators want this too. It’s the cardiac surgery nurse who wants patients to get digital reminders before surgery to stop blood thinners on time. It’s the orthopedic surgeon who wants to track his patient’s knee pain and long-term quality of life scores. It’s the Women’s Health executive who wants to grow market share by offering a differentiated experience to digital savvy young women.
RPM 2.0: Emergence of Digital Care Journeys to reach 100% of Patients
However, traditional RPM alone cannot fulfill this big vision – it is too costly and labor intensive to deliver at scale to tens of thousands of patients in a health system. It is also not clinically necessary – most patient journeys do not need continuous biometric monitoring but would benefit more from better adherence with care plans and broader symptom tracking (e.g., pain level). Moreover, while traditional RPM focuses on short, acute episodes (30 days post-discharge), most patient journeys need longer engagement (e.g., 12+ months for cancer care).
Meeting the Digital needs for the other 95% of patient care journeys has led to the recent rise of App-based RPM solutions, more commonly known as “Digital Care Journeys”, which can be easily scaled across surgery, oncology, maternity care, and other service lines. This involves health systems engaging patients with personalized digital care journeys via the patient’s own smartphone, tablet, or desktop computer to send surgery or condition-specific reminders, deliver pre- and post-care education and monitor symptoms. Patients can self-monitor via automated workflows (e.g., receive automated guidance on how to manage constipation post-surgery) and providers can get alerts and dashboards to monitor patient progress remotely (e.g., pain, incision photos).
Digital Care Journeys are critical to a Digital Front Door Strategy
Today, savvy health system leaders have recognized that their Digital Front Door strategy must satisfy consumers who increasingly expect digital experiences across their care journeys. This means a Digital Front Door strategy must now go beyond patient awareness and acquisition, but also engage patients throughout care delivery. In fact, a 2021 report from Deloitte’s Center for Health Solutions and the Scottsdale Institute surveyed technology leaders at 25 leading health systems and found the top two goals for Digital Transformation to be both better consumer satisfaction and engagement (92%) and improved patient outcomes (56%).
Take for example the University of Alabama at Birmingham (UAB) Health System, which launched their Digital Care Journey strategy in 2017, initially focused on a digital patient engagement platform to engage and monitor patients from pre-surgery preparation through post-surgery recovery, including Cardiac, Thoracic, Colorectal and Gynecology Oncology surgery. UAB has produced astonishing results with this initiative, including a 94.7% patient adoption rate, reductions in hospital length of stay by up to 2 days, and decreased costs by upwards of $8,100 per patient.
Or Baystate Health, whose Digital Care Journey program has helped its Cardiac Surgery program reduce readmissions by 72%, discharge to skilled nursing facilities by 60% and length of stay by 0.9 days. Perhaps the biggest impact has been on the consumer experience: for instance, Baystate Health’s Director of Digital has described how by chance he bumped into a veteran patient at a shopping mall who raved about how important Baystate’s digital care journey experience was in supporting his recovery after cardiac surgery.
RPM 1.0 showed our healthcare system what was possible when you combined the best of digital technology with care delivery. With RPM 2.0, or Digital Care Journeys, we will see leading health systems apply these principles at scale to ensure every consumer has a high quality, digitally supported healthcare journey – no matter their age, risk level or condition.
About Dr. Joshua Liu
Dr. Joshua Liu is a physician turned co-founder/CEO of SeamlessMD – a Digital Care Journey platform used by health systems to engage, monitor, and stay connected with patients across healthcare journeys. Joshua has also served as Chair of the Joule Innovation Council for the Canadian Medical Association and on the Advisory Group to the Office of the Chief Health Innovation Strategist for the Ontario Ministry of Health. A Digital Health thought leader, Joshua frequently speaks at conferences hosted by Epic, Forbes, TEDx and many others. Joshua has been named Digital Health Executive of the Year and holds a MD from the University of Toronto.
