Over the last several years, the use of telehealth and remote patient monitoring (RPM) has steadily grown. Specifically among home health care providers, telehealth and RPM has proven a useful tool to enhance patient engagement and education as well as to prevent adverse outcomes such symptom exacerbation, hospital readmissions, or mediation mismanagement. 

Home health agencies have leveraged telehealth and RPM to provide patients with educational resources, perform virtual visits, monitor patient vital signs, and more. Typically, telehealth programs have focused on a limited and standard set of patient populations such as CHF, COPD, hypertension, and diabetes. However, since the onset of COVID-19 the use of telehealth and RPM has increased substantially among home health and hospice agencies, health systems, and even payers. 

CMS & Healthcare Providers Respond to COVID 

In March 2020, at the onset of the pandemic, the Center for Medicare and Medicaid Services (CMS) acted swiftly to expand access to telehealth services by removing barriers faced by patients and providers. These actions include but are not limited to the waiver of originating site requirements, the expansion of qualified telehealth providers, and the expansion of eligible patients to receive telehealth services. 

Changes to prior restrictions had a profound and immediate impact on the adoption of telehealth and RPM. Prior to the announcement of a public health emergency, approximately 13,000 Medicare beneficiaries received telehealth services each week. In the last week of April alone, nearly 1.7 million Medicare beneficiaries received telehealth services. But who are these patients? And will this trend continue after COVID-19 subsides? 

The Growth of Telehealth During COVID

As CMS relaxed telehealth restrictions, healthcare providers across the country quickly responded to the COVID-19 pandemic with telehealth, recognizing the need to quickly identify sick patients and provide them with enhanced support and care. Whether a hospice provider, independent home health agency, or health system, HRS partners leveraged telehealth and RPM to maximize staffing resources, conserve PPE, and increase bed capacity. 

ProMedica Monitors COVID-positive Patients With Telehealth 

At ProMedica Home Health, all patients referred to home health were screened for COVID-19 symptoms and all positive patients were enrolled in the telehealth program for continued monitoring. Likewise, any COVID patient who was intubated or received oxygen during their hospitalization, was enrolled in ProMedica’s telehealth program to continue receiving 24/7 post-discharge. Once enrolled in telehealth, ProMedica’s COVID patients were assigned the COVID-confirmed care plan to enable clinicians, family caregivers, and the patients themselves to track their symptoms and recovery. 

Healthcare providers also recognized the need for new partnerships and programs in order to prevent community spread and protect vulnerable patient populations. At independent home health agencies, we saw new partnerships form between home health providers, hospitals, and universities, among others. 

SummitWest and CMU Partner to Screen University Students for the Virus

At Colorado Mesa University (CMU), located on the western slope of Colorado, the need to return college students to campus was met with fear and concern over exposure and community spread. To assist in identifying COVID cases and monitor symptoms, and triage patients, CMU partnered with SummitWest Care. Through the partnership and use of telehealth, CMU and SummitWest Care have controlled the spread of COVID-19, keeping students, faculty, and the broader community safe.


Telehealth Emerges as the Standard of Care

The establishment of new partnerships and the expansion of telehealth services specifically for the use of COVID-19 has been well documented. However, an arguably more impactful transition in healthcare and telehealth has been in the use of telehealth and RPM for non-COVID patients. As discussed above, prior to the COVID pandemic, the use of telehealth has been used primarily to monitor the recovery of chronic care patients including CHF, COPD and hypertension patients. However, during the COVID pandemic, healthcare providers have broadened eligibility for telehealth and remote patient monitoring. 

A key goal for many providers throughout the pandemic has been to increase bed utilization. One way we’ve seen providers accomplish that goal is by working across different departments and organizations to identify, enroll and monitor COVID-19 patients. Another critical element of increasing utilization has been to divert non-COVID patients from hospital, critical care, skilled nursing and other departments to receive care and recover at home, shortening their hospital stay and decreasing their risk of exposure. This resulted in an increase in the number of patients receiving telehealth care and expansion in the patient populations deemed eligible for care. Specifically, HRS partners saw a significant increase in the use of telehealth and RPM for oncology, pediatric, dialysis, and sepsis patients, to name a few. 

The Path Forward with Telehealth & RPM 

A rapid shift in protocol for health systems and other providers proved the efficacy of telehealth and RPM for a diverse set of patient populations and enhanced communication between providers. Health systems are now expanding upon their COVID protocols to embed telehealth and RPM in discharge planning moving forward, working with telehealth and EMR partners to develop predictive risk modeling tools. The aim of such tools is to evaluate patient demographics, SDoH, health status, vital signs, and other patient information to recommend patients be discharged and enrolled on telehealth and RPM for the remainder of their recovery. Beyond the COVID pandemic, these tools will further assist in increasing capacity and cost savings, as well as improving patient satisfaction and quality of care.