Most healthcare professionals are aware of the benefits of remote patient monitoring (RPM), from reducing readmissions to lowering costs. However, barriers can arise when you’re attempting to implement a new RPM program into a healthcare organization. Clinicians and care teams are wary of additions to an already heavy workload, and administrators have questions about how the program will generate revenue. 

The solution to these problems is simple: integrating the workflow of the RPM program into the Electronic Medical Record (EMR). This helps reduce extra work for your teams while making it easy to document and bill patient treatment. It also helps increase buy-in from clinicians, since all of the workflow processes are managed in a system they’re already using.  

Case Study: Novant Health 

One prominent healthcare organization that applied this strategy successfully is Novant Health, an integrated system of physician practices, hospitals, and outpatient centers headquartered in Winston-Salem, North Carolina. Novant’s overall goal was to build RPM programs that were sustainable, beneficial to both patients and providers, and highly scalable.  

In 2021, Novant Health developed a pilot of the program through a partnership with the Bariatric Solutions group. By adjusting key aspects of the program to fit other use cases, the program soon expanded into other service lines, including the Heart & Vascular Institute and Women & Children’s Institute. 

Knowing that many patients have obstacles to seeking in-person care—including lack of transportation, inability to take time off work, and a preference for virtual care developed during the pandemic—Novant Health’s Digital Health & Engagement team sought a scalable solution that allowed patients to receive care at home. After careful evaluation,  Novant chose the HRS Remote Patient Monitoring Platform due to several key factors: 

  1. The benefit of allowing the patient’s family caregivers to participate in the care journey—especially after seeing the importance of this during the COVID-19 pandemic. 
  2. The robust educational resources provided by HRS that help patients learn how to better manage their health. 
  3. The ability of the HRS system to integrate with Novant’s Epic EMR to quickly reflect clinical documentation in patient medical records.  

Streamlining the Billing Process 

Novant also wanted to ensure that the billing process wouldn’t add extra work, and investigated the CPT codes that could be applicable to the program. To bill for any RPM service, it was imperative that the documentation reflected the patient-transmitted vitals, the clinical monitoring notes and the time spent providing the service. Eventually, workloads were built around these CPT code requirements: 

RPM CPT Codes

CPT Code

Description

Billable Frequency

99453​

Initial set up and patient education​

Once per episode​

99454​

Supply of devices and collection, transmission, and summary of services​

Once per 30 days​

99457

First 20 minutes of remote physiologic monitoring by clinical staff/MD/QHCP​

Once per calendar month​

99458​

For an additional 20 minutes of remote physiologic monitoring by clinical staff/MD/QHCP​

Multiple per calendar month​

By making the process start and end in the EMR, Novant ensured a smooth workflow—and success for the overall programs. 

How the Novant Health Integration Works 

Integrating the RPM programs with the Epic EMR is a four-step process: 

  1. Enrollment. When a provider identifies a patient to be enrolled in the RPM program, an order is placed in Epic referring the patient.  
  2. Epic Integration. The provider signs the order initiating the connection between Epic and HRS. The Epic system sends the patient’s name, date of birth and medical record number to the HRS portal creating the patient profile. 
  3. Patient monitoring. When the patient begins sending data remotely using the HRS platform, the information is monitored in ClinicianConnect. All newly transmitted vitals, any clinical notes and the time spent for patient encounters are sent into the patient’s Epic chart. 
  4. Accessible patient information. The documentation is then easily available to the care team reviewing the patient’s medical record without requiring additional login to the HRS portal. 

High Praise from Clinicians 

Novant Health clinicians were very pleased with the results of the programs, from the ease of implementation to the excellent patient outcomes.  

“EMR integration is crucial to an effective RPM program on multiple levels,” said Dr. David Voellinger of Novant Health Bariatric Solutions. “Patient care is more efficient by allowing RPM data to be viewed within the EMR for seamless record review documentation, and orders. Communication is more efficient by integrated messaging between provider, RPM staff and practice staff. Patient education is more successful by adding EMR resources to existing RPM education. Lastly, referrals for RPM program becomes routine as the provider simply enters referrals for RPM like any other referral.”  

Dr. Jaleema Speaks of Novant Health WomanCare Winston-Salem also shared positive comments. “Completing an EMR integration allows the clinician’s process of enrolling a patient into the program to be completed with ease,” she said. “Our remote patient monitoring program allows for patients to be engaged with their healthcare outside of the clinic. As a provider, I am pleased to have a reliable tool to enhance patient care that incorporates educational materials and provides patient access to the care team. Having the documentation reflected in the patient’s Epic chart provides the clinician ability to make decisions on the patient’s care and determine appropriate timeframes for following up in the office. Our patients are recognizing the benefits and reporting satisfaction with the RPM program’s ease of use.“ 

Creating Satisfied Patients and Outstanding Results 

The RPM programs at Novant Health have been well received by patients, as evidenced by these patient satisfaction scores. RPM patients agreed that: 

  • 95% “The RPM program makes me feel supported by my healthcare team.” 
  • 98% “I would recommend the RPM program to a family member or friend.” 
  • 95% “I am more involved in my care while using the RPM system.” 
  • 98% “Being in the RPM program helps you feel more comfortable managing your health.” 

The different service lines offering the RPM program also experienced significant wins: 

  • 4.08% Average weight loss for bariatric RPM patients prior to bariatric surgery 
  • 3.98% Average BMI reduction while enrolled in RPM prior to bariatric surgery 
  • 7.8% Reduction of 30-day readmissions for RPM cardiac rehab patients compared to current state readmissions for non-participating patients 
  • 95% Available RPM OB/GYN patient Capacity reached within the first three months of the program 

Without question, integrating the RPM programs with Novant Health’s existing EMR system helped to increase buy-in from clinicians, speed implementation, and create positive outcomes for patients. Going forward, the lessons learned could help expand the programs to other departments with patients who could greatly benefit from remote patient monitoring.