4 Lessons learned and key advantages to building RTM and RPM solutions
Remote therapeutic monitoring (RTM) and remote patient monitoring (RPM) are poised to transform the field of digital health in the coming years, thanks to new CPT codes that let clinicians get reimbursed for prescribing these solutions, among other market forces.
The power of these solutions lies in their ability to both motivate patients to adhere to treatment protocol and track that adherence to generate a rich source of valuable health data – two features that, together, create a closed feedback loop.
As we’ve mentioned elsewhere, the data that RTM and RPM solutions generate will have a transformative impact on the healthcare industry, giving clinicians the ability to track the success rate of various treatment plans for people with various physiological characteristics and ultimately prescribe treatments with much greater confidence in their likely outcomes.
In this piece, I’ll dive into why that’s true, examining key lessons from our past work developing RTM and RPM solutions and the advantages of those solutions that work uncovered.
Lesson 1: RTM and RPM solutions must work for patients AND clinicians
Anyone looking to develop an RTM or RPM solution that enjoys high adoption has to cater to two key stakeholders:
- The end-user or patient: You have to demonstrate to this group that the solution is helping them so that they use it.
- The clinician or prescribing member: You have to convince this group that yours is the correct solution to use in a competitive space.
The key to convincing both parties is to create feedback loops that inspire adherence.
Let’s look at an example.
In our work with medical device developer Theragen, our goal was to help improve adherence with ActiStim-S, a noninvasive therapeutic that delivers electrical signals to help stimulate bone growth after vertebrae fusion surgery.
In talking to clinicians and patients, we learned two critical pieces of information:
First, that movement is key to recovery from surgery.
Second, when patients are in post-op pain, they’re more likely to be still.
Finally, we discovered that patients have a very short-term memory for pain, meaning it’s hard for them to assess their current pain relative to their past pain.
That’s a big problem for a population that only interacts with their surgeons at multi-week intervals after surgery. Without any way to track daily pain levels, it’s almost impossible for the clinician to measure the success of the surgery during the recovery phase and therefore to know what steps to recommend to advance a patient’s recovery.
RTM and RPM solutions have a significant advantage in scenarios like this because they enable data tracking over time.
The solution we developed for Theragen (an app to accompany the therapeutic device) taps into this advantage in three key ways:
- It prompts users to keep a pain diary. This lets them see how their symptoms improve over time, which helps motivate them to stick with the treatment.
- It tracks step-counting data from the pedometer Theragen built into its device. This lets patients observe how their movement correlates with pain.
- It makes data shareable with clinicians. Today, patients’ pain diaries, step counts, and device usage are downloadable via PDF for clinicians, who can use this information to track a patient’s progress in recovery and guide their next-step recommendations. In the future, we’re considering a patient portal that would give clinicians a real-time view of patient data.
This leads directly into the second big lesson.
Lesson 2: Data is an essential ingredient to success
There are a few ways to look at the success of an RTM solution like what we built for Theragen:
- Success for the individual patient: is the solution helping them stick with their recovery protocol and leading to better health outcomes?
- Success for the solution itself: does it improve adherence in a way that’s demonstrable to clinicians and repeatable for other patients?
- Population-level success: can we demonstrate to enough people that the solution improves outcomes for a given group so that it becomes widely adopted, thus improving outcomes for nearly everyone in that group (and often lowering healthcare costs)?
All three of these require data. To be successful, RTM solutions must make it easy to gather data on an ongoing basis.
More than that, though, RTM solutions should make data visible and understandable to both physicians and patients. It’s one thing for a surgeon to tell you to be sure to move around as much as possible; it’s quite another to see that the days with the highest step counts consistently have the lowest pain ratings.
That can lead to the kind of ah-ha moment that makes the difference between a patient adhering to surgery recovery protocol and not.
In our work with Theragen, we found that the RTM component of its product offers a considerable advantage over similar products in that it is easier to use, inspires movement by tracking steps, and leads to better adherence.
Data visibility isn’t the only thing that inspires adherence, though.
Lesson 3: Emotions affect adherence
One of the most fascinating and important takeaways from our user research is that the way people feel about their condition affects the likelihood of adhering to a treatment plan.
This is especially true for conditions that have social stigma, like overactive bladder (OAB). People with OAB often feel so embarrassed about their symptoms that they never bring them up, even with their doctor.
As you can imagine, that makes OAB really hard to treat.
Because even if a person does talk to their doctor and gets a treatment plan (keep a diary, take medicine, do physical therapy), their adherence has a huge psychological component.
RTM solutions have the potential to address that psychological component to maximize adherence and improve outcomes.
For example, in our work with Renalis to develop an app that delivers behavioral therapy to treat OAB, we focused on finding ways to reward patients for engaging with the app and on removing the stigma around the condition.
One use case: When a user reports a leak, the app might offer statistics to show how common such leaks are or share other users’ stories to communicate that the user is not alone.
This is a huge advantage of RTM solutions. Because patients access them from devices that they carry in their pockets or purses, the experience of using them is incredibly intimate. And just as we get small hits of dopamine from seeing someone like our posts on social media, RTM solutions can deliver positive feelings by rewarding users for inputting data and reinforcing that their symptoms are normal and that they’re making progress.
This capability is especially important when patients have limited access to healthcare providers.
Lesson 4: Many patients don’t have access to specialists
A recent McKinsey report projected that RTM and RPM solutions could save anywhere from $1.5 to $3 trillion in global healthcare costs by 2030.
That’s a staggering number, but it starts to come into focus when you consider that most people with OAB, for example, don’t live within four hours of a specialist who can diagnose and treat the condition. Others may be closer but physically unable to visit. And others still may be able to visit a doctor for an assessment but not have access to care again until they’ve reached the point of needing surgery.
For anyone with limited access to treatment, symptoms often continue to get worse and worse, affecting their lives in bigger and bigger ways. If and when they are able get treatment, they typically require more expensive, more invasive procedures (like surgery) than they would have if they’d had access to care sooner.
RTM solutions help solve this. They can be downloaded by anyone with a smart device and an internet connection. And they don’t just deliver care every few weeks or months, as a specialist would. They can provide prompts, reminders, and reinforcements that improve patient adherence to treatment protocol on an ongoing basis, which can keep patients out of doctor’s offices, and even out of operating rooms.
A major opportunity to improve health outcomes
Digital health is at an inflection point.
With widespread mobile device ownership and internet access, plus CMS support for RTM and RPM reimbursement, the potential to transform people’s lives and our healthcare system is tremendous.
When healthcare and digital health companies build solutions that are easy and enjoyable for patients to use, that capture data on an ongoing basis, and that make data accessible to physicians, they’re helping to realize that potential.
If you have a vision for improving health outcomes, we’d love to help you make it a reality. Get in touch, and we can help you figure out where to start.
Published by TXI Healthcare in Digital Health