Measuring the ROI of Remote Patient Monitoring

Kulmeet Singh

Kulmeet Singh, the chief executive officer of Albuquerque, N.M.-based Twistle, believes in putting the patient at the heart of the healthcare journey.

That’s why his 10-year-old company has invested in automated patient communication software that can offer personalized, step-by-step guidance to improve outcomes, safety and satisfaction, keeping patients engaged, on track and supported every step of the way.

“A care plan is often a handout that can range from a single page to the size of a book, and we are turning that information into turn by turn guidance for the patient through messaging in an automated way,” he says. “In the event that a patient asks a question that the automation hasn’t anticipated, the care team gets alerted to take over from the automation and continue supporting the patient.”

Remote patient monitoring was already a growth area before the pandemic, with one estimate published in late 2019 predicting a $16 billion surge by 2023. The need to keep patients safe for the past year—and away from hospitals and waiting rooms—has only increased interest.

But one stumbling block has been demonstrating the value of such systems, so that health systems or payers would be willing to invest.

To address this, Singh and his Twistle team have developed a quantifiable and reliable way to measure return on investment (ROI), using years of data on the impact of reducing readmission rates, average length of stay, no shows/same day cancellations, emergency department (ED) bounce back visits, and phone call volume.

For example, clinical leaders at ChristianaCare, a network of private, non-profit hospitals in the MidAtlantic states, were looking to improve early detection of postpartum hypertension by overcoming low attendance for follow-up office visits, so they deployed Twistle’s remote patient monitoring platform to engage new mothers after discharge. Patients were prompted to report their blood pressure reading and answer a short survey.

“The program has successfully reduced postpartum hypertension-related readmissions and eliminated long-standing racial disparity,” Singh says. Although only 30 percent of patients attended in-person postpartum office visits, the remote monitoring program drove 91 percent of new mothers to submit at least one blood pressure reading—a 203 percent increase in hypertension screening, and decreased 30-day readmissions by 55 percent.

Another successful case study involved Washington-based Providence St. Joseph, which collaborated with Twistle to build digital care plans for total hip replacement and total knee replacement surgeries. These care plans were designed to automatically deliver the right information to patients at the right time, including education, reminders, surveys, checklists, and messages from their care team. Patients enrolled in the Twistle pathway experienced a 44 percent reduction in hospital readmissions, a reduction in surgical complications and the length of stay was reduced by 15 percent.

Twistle offers hospital leaders the peace of mind that the patient engagement solutions they adopt will generate the promised return on clinical, financial and operational outcomes.

“Measuring ROI is very difficult, especially since health systems are straddling fee-for-service and value-based care business models,” Singh says. “The same value that Twistle might bring in a value-based care context may not deliver value in ROI in a fee-for-service context and vice-versa. We generally take a patient-first approach to arrive at a good outcome, independent of what the business model is. If you don’t have a patient enrolled and engaged in an ROI tool, there’s no opportunity to influence ROI. Patient satisfaction, leads to additional revenue.”