BayCare Health System looks to expand remote patient monitoring

The BayCare Health System has utilized remote patient monitoring for years.

Dr. Chris Bucciarelli of BayCare Health System says he's encouraged by the results of a pilot program to expand remote patient monitoring.

In fact, the Florida health system first began remote monitoring in 2007. But BayCare is expanding its use of remote patient monitoring, and is looking to help more patients with chronic conditions have a better quality of life and stay out of the hospital.

BayCare has been engaged in a pilot program with Cadence, a health technology company that offers remote patient monitoring services. Dr. Chris Bucciarelli, BayCare’s vice president of ambulatory services and chief medical officer, says the project is ongoing but the early results have been encouraging. He hopes the program will enable the system to do much more with remote patient monitoring.

In an interview with Chief Healthcare Executive®, Bucciarelli says BayCare’s desire to do more with remote patient monitoring reflects the changes in the healthcare industry and the goal of meeting patients’ needs.

“It's with medicine as a whole,” Bucciarelli says. “It's moving more and more to ambulatory, and we need to figure out ways to to really mitigate the risk and really do true population health and treat our patients as a whole, more effectively.”

He says the system wants to better utilize technology “to really have a positive impact on our patients and our community.

“That's where this is really stemming from, is really the demand and the need to really serve our patient population, serve our community, to be able to provide high quality care through creative and innovative ways,” Bucciarelli says.

• Read more: What hospitals should think about with remote patient monitoring

‘Very reassuring’

Working with Cadence, BayCare is engaged in a remote monitoring program with more than 300 patients. The program includes patients with heart failure, hypertension, and diabetes.

Cadence’s technology captures real-time data on patients, such as their weight, blood pressure and glucose levels. The patient’s primary care physician from BayCare and Cadence’s team get the data and can reach out if there are concerns. For a patient with heart failure, a sudden gain of several pounds could indicate the patient is retaining fluids and needs attention.

“This is a way to get that red flag right away, have corrective action done at home, and be able to mitigate,” Bucciarelli says. Or if needed, the physician may direct the patient to the clinic or the emergency department.

Bucciarelli says he likes to be cautious reviewing the results of the remote monitoring program, since the pilot project isn’t complete. But he says the early returns are promising.

“It is definitely too early to just start throwing out hard numbers, but we've already seen some reduction in total cost of care that seems to be significant,” Bucciarelli says.

So far, patients with diabetes in the remote monitoring program have been getting control of their glucose, and patients with heart disease have shown improvement. Bucciarelli says the system will continue to evaluate data but he likes what he’s seeing.

“We haven't seen anything negative by any means,” Bucciarelli says. “And really, they're trending the way we expect, and very similar to some other patient populations that have had impact with Cadence as well. So it's very reassuring.”

Eventually, BayCare hopes to expand the program to 500 patients, and he hopes to see the system monitor patients with different diseases in the program.

• Read more: Continuous glucose monitoring and health equity

Looking at new solutions

When asked about BayCare’s decision to expand remote patient monitoring, Bucciarelli describes it as a natural evolution.

“I'd say we're always looking at new and innovative ways to be able to deliver care,” he says.

“I think our global strategy over the last two years, frankly, has really had a little bit of a different focus,” Bucciarelli says. “And really, it is more focused on, I call it, where the puck is going in the future of medicine. And I think this serves that need, and is going in that direction.”

With Cadence, the system found a good partner with a strong algorithm that identifies patients that could potentially succeed in remote patient monitoring. Cadence works with primary care physicians and the BayCare doctors will make the final call on whether a patient should be enrolled in the program.

The remote patient monitoring program also meshes with the system’s desire to close disparities in care and make it easier for some patients to obtain care, he says.

“This allows us to have access points to maybe some of the other underserved areas that might not always be able to have certain types of access points or the ease of it,” he says. “And I think the bigger part is those people that can be more at risk also for having a bounce back or having to be admitted to the hospital just because they didn't have that management.”

“The goal is to have more access, period,” he adds. “And so we have to find technologies that allow us to do that. This, I think, is accomplishing that, or has the potential to be accomplishing that.”

Measuring success

While BayCare hopes to eventually expand the remote monitoring program, Bucciarelli says the system will continue to evaluate its success. He says the system will be looking at outcomes for patients and if they continue to have more success in managing their conditions.

The system will also weigh factors such as a reduction in readmissions, or if the program is also seeing shorter hospital stays for those who do need to return for additional care. In addition, BayCare will also determine if it’s lowering costs, both for the system and its patients.

“I think cost of care is another one, because that shows that we were able to keep them home,” Bucciarelli says. “They didn't have to go to the ED three times last week, they didn't have to be admitted that one time.”

Ultimately, Bucciarelli says he hopes the remote patient monitoring program will demonstrate “not only they're getting better care, but we're actually doing it at a cheaper cost, which is even better.”

The importance of communication

BayCare physicians and staff gave feedback in the development of the program, which has contributed to its success, Bucciarelli says.

For hospitals and health systems that are looking to develop or expand remote patient monitoring programs, he stresses the importance of “really good communication with the teams.”

“You can have the best algorithms and things in the world, right, but if you're not having good communication and understanding of that, then you can definitely have a downfall,” Bucciarelli says.

He also points to the importance of making sure that the workflow of clinicians is considered in developing remote patient monitoring programs. Providers should be able to find patient data quickly when they are notified of an alert on a patient.

“If it's a convoluted process where they would have to log into another program … then you're not going to have adoption, and it's not going to be able to have the highest impact possible,” he says.

Bucciarelli says he’s most excited about the possibility of helping patients have a better quality of life, and potentially lowering their healthcare costs with remote patient monitoring.

“Hopefully, we’re able to provide an enhanced experience that's going to have better outcomes at a more effective price point, if you will, or reduce that cost,” he says.