This article is third in a series of articles addressing remote physiologic monitoring (RPM). In the first article, we discuss the benefits of RPM and provide a compiled fact sheet. In the second article, we outline items to consider when choosing an RPM vendor and technology. In this article, we provide a high-level overview of infrastructure considerations for RPM implementation as part of your chronic disease management efforts. For a more thorough stepwise guide, take a look at the American Medical Association’s (AMA) Digital Health Implementation – Remote Patient Monitoring Playbook, which outlines a comprehensive 12-step process.
Identify Your Goals
As noted in our second article, the first and most important consideration in this process is to identify your goals for implementing an RPM program. Think about the needs of your patient panel(s) and which chronic diseases you want to address. Articulate for your staff what you think an RPM program will help you accomplish. For example, one systematic review from the Community Preventive Services Task Force found the addition of self-measured blood pressure (SMBP) monitoring was effective in decreasing patients’ systolic and diastolic blood pressure measurements. Additional resources related to Self-Measured Blood Pressure Monitoring can be found on the Million Hearts website.
Vendor and Technology Selection
Think about which technology and vendor are the best fit for your practice based on your needs and available resources. Review our Top Tips for Selecting Your Remote Patient Monitoring (RPM) Technology and Vendor article.
Before implementing a new RPM technology, be sure to work with staff to clearly outline your existing workflows for chronic disease management and identify how the workflow will need to be adapted to include this technology. Think about how team roles and responsibilities will shift to accommodate new processes. For example, who will be responsible for training patients to use this technology and how will data be recorded?
Be sure to test new processes and seek feedback from staff, care teams and patients before you roll out your new RPM program to your entire clinic or organization. For example, you might choose to test the technology with a small subset of your patients with a dual diagnosis of diabetes and hypertension. You may need to iterate the workflow a few times and conduct additional training before fully launching the program. Check out our adapted version of the Plan-Do-Study-Act (PDSA) Worksheet to aid in your testing process.
Communication, Communication, Communication!
Develop clear written communication standards and pathways for IT, vendors, clinicians, billing staff, care teams, patients, families etc. Communication will be critical throughout your implementation process to reduce the risk of surprises and quickly resolve any issues that crop up.
Think about when your practice is most busy and whether you have any other big projects underway. There may not ever be a "good time" to launch a new program but there may be some exceptionally busy times to avoid.
Regular Evaluation and Maintenance
Schedule regular checkpoints to review your data and qualitative feedback to determine if your RPM program is meeting your identified goals. If your goals have shifted, determine whether you need to modify the program to accommodate those new goals.
Share Your Story
Congratulations! You’ve successfully launched RPM to support your chronic disease management efforts. Let us know what elements of your process were most successful and how you overcame any barriers. Your success stories can help the next practice. Watch our Remote Physiologic Monitoring Services recording where two clinic managers share their experiences.