Page 19 Telehealth and Remote Patient Monitoring RPM for Long Termand Post Acute Care A Primer and Provider Selection Guide 2013

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Finally, active and timely response on the part of advice; and (e) repetition of this cycle at appropriate
health care professionals are important and an intervals. These “complete loop” interventions were
expected component of the telehealth intervention. effective across a wide range of medical conditions,
Such active/proactive interventions and timely re- monitoring and communication technologies,
sponses, in turn, lead to higher patient satisfaction geographical areas, and patients’ socioeconomic
rates. For example, one study reported that rapid status. 31
electronic messaging turnaround and replies by
physicians increased patient satisfaction (the aver- Financial incentives for physicians to review data
age turnaround time was 48 hours in this study). and engage in telehealth interventions may be key
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In fact, the VA’s telehealth program demonstrated a to delivering the expected benefits of telehealth
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high, 86%, patient satisfaction score. and RPM. As discussed above, physician’s respon-
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siveness and proactive interventions can lead to
higher patient satisfaction, and tying physicians’
5.4 Physician Engagement Key to financial incentives to patient satisfaction through
Success the Consumer Assessment of Healthcare Providers
and Systems (CAHPS) and similar measures is
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Engaging physicians and health care providers as one way to ensure physician engagement. The abil-
partners in care beyond the formal interactions ity of group practice physicians to negotiate with
with the health care system (office and hospital hospitals and insurance companies are becoming
visits) is vital to improving health outcomes for intimately tied with CAHPS outcomes. Initial stud-
patients. Telehealth and RPM technology can play a ies seem to suggest that physicians who spend more
significant role in increasing such engagement, and time with their patients and are able to effectively
consequently, the patient’s and family’s satisfaction communicate and answer all patient questions tend
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with care. However, telehealth and RPM may not to have better CAHPS scores. There may be an
deliver the anticipated benefits unless physicians opportunity to study how certain technologies can
and health care providers are involved. In fact, the affect physicians’ and health care providers’ CAHPS
most important and consistent finding of a review outcomes.
of 74 studies that reported the effect of interactive Additionally, the accountable, person-centered, and
consumer health IT on health outcomes or health quality-driven managed care era is driving health
care process measures, was that systems were ef- care providers to focus more on patient outcomes
fective when they provided a complete feedback and satisfaction. Physician-led Accountable Care
loop. The review revealed that such a feedback Organizations (ACOs) tend to focus their cost-sav-
loop included (a) monitoring and transmission ing efforts on keeping patients out of the hospital
of patient status; (b) interpretation of this data by as much as possible. Conversely, hospital-led ACOs
comparison with previously established individual often attempt to reduce the costs involved with
treatment goals or published guidelines; (c) adjust- hospitalizations and hospital readmissions. In both
ment of medications, diet, or information according scenarios, telehealth and RPM can play a role in the
to patient status; (d) timely communication back ACO model. CAHPS is one of the quality measures
to the patient with tailored recommendations or

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