Automating and integrating RPM boosts blood pressure care for Prisma Health

Prisma Health is the largest healthcare provider organization in South Carolina. The company had encountered a problem in collecting biometric data from patients and managing their clinical needs: fragmentation.

THE PROBLEM

The logistical challenge of distributing remote patient monitoring equipment to patients within the initial focus of approximately 50 physician practices proved overwhelming, given the organization’s internal resources alone.

“From the patient’s perspective, imagine being responsible for recording blood pressure readings multiple times a day, and then having to remember to take that information with you to the doctor’s visit,” said Angela Orsky, senior vice president of value-based care and clinical integration at Prisma Health. “It is understandable that this process would lead to gaps in data collection, especially for patients with visual impairments or difficulties with reading and writing.

“Despite efforts to educate patients about when to contact their doctor, it was common for them to overlook contact if their measurements were abnormal,” she continued. “For physicians, the sense of fragmentation in the process only increased as they tried to make sense of multiple measurements, spread across different documents, to determine appropriate medical interventions, including medication adjustments.”

PROPOSAL

Prisma Health sought help from supplier HealthSnap.

“The solution wasn’t just about the technology; it was a well-defined program that focused on logistics, patient engagement and full electronic health record integration for an optimized physician workflow,” Orsky explains. “The value of a program where the provider manages patient care, coordinates equipment delivery, and ensures proper operation addresses the coordination challenges facing our healthcare system.

“Patient engagement is equally important to the success of the program,” she continued. “The convenience for both patients and physicians, where patients take their measurements with home equipment and the data is immediately integrated into their health record, is a game changer.”

If patients forget their measurements, care managers intervene with reminders and monitor alerts, calling patients and escalating abnormal results in collaboration with the physician’s office. This comprehensive program provides Prisma Health with a faster time-to-market system that is scalable compared to building all components of a program in-house, Orsky added.

MEETING THE CHALLENGE

The first rollout started in primary education healthcare practices, targeting patients who met billable chronic diagnosis criteria for remote patient monitoring and/or chronic care management and who had visited their primary care physician within the past twelve months.

“In preparation for the rollout, we worked closely with a large internal medicine practice to establish standard workflows and live Epic EHR interfaces for several functions including outbound orders, outbound discharge management, inbound flowchart, inbound notes, loading interface, and outbound notes,” Orsky explained. “Educational sessions have been held for physicians to familiarize them with these workflows within Epic, including the process of reviewing charges before submitting them for billing.”

The integration also includes a summary of biometric measurements over time, allowing physicians to more accurately assess and treat the patient’s clinical status.

RESULTS

Clinical results showed that 82% of patients experienced reduced blood pressure (n=757 with at least 30 days of monitoring). Patients with severe hypertension saw a decrease from baseline in systolic blood pressure from 152.31 to 92.74, while diastolic blood pressure decreased from 133.63 to 82.23 after 90 days of participation in the program.

At baseline, 279 patients were classified as having stage 2 hypertension, which decreased to 74 patients after an average of 124 days of treatment with the program.

ADVICE FOR OTHERS

“Without exception, the value proposition requires a comprehensive program,” Orsky said. “While advances in technology and ease of coordination to deploy equipment are critical components of a… A robust remote patient monitoring program, integration with the EHR, and close clinical supervision in collaboration with the treating physician should not be overlooked.

“Despite significant planning and the identification of robust technology, achieving scale and timeliness of interventions to significantly improve clinical outcomes was not feasible without a full interface to our EHR,” she concluded. “Working with a vendor or company that is willing and able to support the integration should be a primary consideration.”

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