Higher Patient Engagement, Adherence, and Care Quality: One Practice’s RPM/CCM Experience

10

Questions for Christine Onstott,
Director of Operations at Cardiac Solutions,
an Arizona-based cardiology practice

Christine Onstott, AAS-N, BS,
is the Director of Operations
for Cardiac Solutions, a
comprehensive care practice
with three locations in Arizona’s
West Valley area and 22 board-certified cardiologists. The
practice, which continually
explores new approaches to
provide high quality care at lower
costs, recently partnered with MD
Revolution to implement RevUp, a
chronic care management (CCM)
and remote patient monitoring
(RPM) program.

Now, only 14 months since
implementing RevUp, Onstott
says the solution has increased
patient enrollment and
engagement in the practice’s RPM
and CCM programs (including
among the practice’s older
patients) and led to higher
patient adherence to treatment
plans and better outcomes,
without increasing the workload
of providers and staff. In fact,
she says, because of the solution,
providers and nursing staff are
experiencing a record low number
of alert escalations that require
their review.

In this Q&A, Onstott shares more
about the solution’s impact on
the practice and their patients.

What were your goals when you implemented MD Revolution’s RevUp solution?

We wanted to reach a larger percentage of
A
our patients, not just those with a history of
heart failure who come into the clinic regularly.
Population health management is important to us,
we wanted to reach patients with other chronic
disease states and provide them with quality care
in-between their already scheduled in-office visits
with their Cardiologists. Keeping a patient out of
the hospital is good for the patient, insurance
providers, and hospitals.

You mentioned that reaching more patients and engaging them was a key objective. How has the solution impacted that?

Once patients are enrolled, they see the benefits
A
of the program and see the value of constant
medical supervision. The patients I have personally
spoken to, including my parents, love the service.
The product is easy to use, and patients interact
with the RevUp application on a regular basis
which is amazing given our practice’s patient
median age of 80.

We’re encouraging our patients to engage in their
own care by using RevUp. In healthcare we often
tell patients what they need to do, but that doesn’t
mean they will follow through.

Can you provide an example of how the RevUp solution enhances patient access to your cardiologists?

Enhancing access for patients with hypertension is
a good example. These aren’t necessarily patients
with a history of heart failure, but simply those
with a condition that we can monitor remotely
with the use of blood pressure equipment. RevUp
helps monitor the patients pressures in-between
visits to the office and alerts us if there are
abnormal readings that would warrant a sooner
visit to the office.

Why did you select MD Revolution?

We looked at several companies, but eventually
A
heard about RevUp through our EMR partner, which
made integration easier, almost seamless. We also
wanted customization, which they were able to do,
and their easy-to-use interface was a no-brainer.

We knew that provider adoption would be a huge
aspect of program success. We can put anything
into place, but if our cardiologists aren’t referring
patients, our patients and our practice won’t
experience the benefits. Integration, however,
made adoption easier because we were able to
pull patient information directly out of the EMR,
including their CCM category, and even how to best
engage the individual patient, whether it be via
text, email, or phone call. The integration support
was essential in the adoption.

Your practice decided to deploy MD Revolution’s CCM and RPM solutions simultaneously. Why?

We have never looked at the product as two
A
separate solutions because we believe they work
together. The CCM component provides us with the
personal clinical touchpoints we want our patients
to experience, sort of like a concierge service, and
the RPM component allows us to monitor blood
pressure which is a health component that CCM
can review with the patient. They go hand-in-hand.

How quickly after implementation did you start experiencing the benefits of the solutions?

We meet with our RevUp partners monthly and
A
review patient enrollment, engagement and how
many alert diversions we were able to make. We
continue to perfect the services we are providing
by looking at patient outcomes and most recently,
working on how to track hospital readmissions.

Billing for CCM and RPM can be very confusing. How has the process been for your practice?

After answering some of the initial questions our
A
staff had – and after the MD Revolution team
helped patients learn how to use a blood pressure
cuff – we had much fewer headaches and more
accurate billing. That’s huge. Also, there are
differences between insurers and what they will
cover, and that must be explained to the patient
by our staff. Not every patient has the same copay;
there are many Medicare plans, which means the
copays fluctuate and must be communicated to
the patient.

What were some challenges you worked through with RevUp after implementation?

One of the biggest changes we were able to make
A
after implementation was the way we handled
our patient alerts at night and over the weekend.
These alerts are now handled by the RevUp team
in the same way our staff would take care of them
during the business day, taking the burden off
the on-call physician which was huge. Working
out those sorts of workflows simplified the
process and ensured that the patient received the
appropriate care quickly.

What lessons could other practices learn from your experience with a CCM/RPM solution?

Because implementation is so important, it’s
A
essential to bring physicians into the decision-making process.
The solution must be thoroughly
explained to the physicians, and staff needs to be
ready to evolve their workflows. It’s also important
to bring patients into the process by helping them
understand that your practice is HIPAA compliant
and not selling their information. We explain MD
Revolution’s relationship to Cardiac Solutions –
that they’re contractors we’re using – so there’s no
patient confusion on their integrity.

Identifying superusers throughout the practice
and other experts who can quickly answer
questions about the solution is also key. I have 198
employees, and we have over 500 patients come
through the doors daily. Recently we have added
a device representative in our offices Monday,
Wednesday, and Friday who is available to speak to
patients face-to-face and answer questions. We’ve
also identified superusers throughout the practice,
not just our individual offices, who spearhead the
CCM and RPM program and answer questions from
colleagues.

Overall, would you say the RevUp solution is helping you achieve your goals?

Yes! It is affecting our patients’ health in a very
A
positive way. They see us taking care of them with
these additional and frequent touchpoints, while
enabling us to have a handle on their wellbeing
even when they’re not here seeing us physically.
This is helping us provide our patients with high
quality, concierge-like care. It’s something that no
other cardiology practice provides.

MD Revolution delivers the solutions and
platforms to practices that want to improve
operational efficiencies and increase revenue
opportunities at scale. MD Revolution’s Care
Management platform RevUp is a service-model
software that integrates with EHRs to
support the management of remote patients
for practices and health systems with their
own dedicated care teams. MD Revolution
further supports virtual care initiatives with
RevUp programs, which cover patient services
that include care managers, clinicians, and
communication provided by RevUp.