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How to build a regulated remote patient monitoring product that clinicians and patients will actually use

Kaushal VyasGeneral Manager, PI Digital

With the COVID-19 pandemic shining a light on the benefits of telehealth, there has never been a better time to be in remote patient monitoring (RPM). But if you’re going to be successful, you need to win over your two main users: patients and clinicians.

Remote patient monitoring – where clinicians can monitor patient data collected outside of clinical settings – has been slowly growing in popularity over the past few years, particularly in the U.S. There are several reasons for this, including advances in miniaturization, improved cloud infrastructure and security, changes to reimbursement in the U.S., and growing evidence that it improves patient outcomes1,2,3,4. However, adoption of new technology in healthcare tends to be slow, and widespread acceptance and adoption of RPM technology still looked some way off.

That all changed when the COVID-19 pandemic hit. Suddenly, social distancing and staying at home became essential, especially for anyone with pre-existing health problems. Health systems had to adapt. Fast. In countries such as the U.S. and Australia, telehealth services were quickly expanded to limit the interactions, and thus risk, for both patients and healthcare workers. Doctors, hospitals, patients and governments became willing, even eager, to embrace remote, home-based care for non-critical patients. The pandemic might just be the catalyst needed to push remote patient monitoring from emerging technology to core service5.

But while the time is right for change, you still need to persuade your two primary user groups – clinicians and patients – to use your product effectively. Below are some key factors you need to consider to maximize engagement and adoption of your remote monitoring product.

Focus on patient outcomes

Your patient needs to be at the heart of everything you do. After all, your whole purpose is to improve their health outcomes. There are multiple studies1,2,3,4 that show remote patient monitoring leads to better patient outcomes, in particular through reduced hospital admittance and improved adherence to medication. To be clear, I’m talking about regulated digital medical devices with clinically validated sensors and software that clinicians can use to make decisions about a patient’s health.

But no matter how well your product works, it won’t be of any benefit if your patient does not use it effectively. You should not assume that because patients have an illness, they will be proactive about their own care. There are many reasons they may not use your product properly, including discomfort with technology or physical or mental issues associated with their conditions. To be successful, you need to do everything you can to encourage them to use your product.

Make it easy to use

The key to getting patients to engage at home is to make it easy for them. This means easy-to-use technology that seamlessly fits into their daily routine. To achieve this, you need to have a deep understanding of your target patient cohort/s. This includes considerations such as age, cultural background, and familiarity with technology. Are they very young or very old, meaning a family member may be responsible for their care? Pay close attention to environmental factors and how your product will fit into your patients’ daily lives. For example, we are working on an at-home test for a client that needs to be conducted first thing in the morning. We need to take into account that it’s likely to be dark and our patients will still be sleepy. This means keeping everything as simple as possible and building in reminders so users don’t accidentally forget.

You need to be able to empathize with your patients and walk in their shoes. I’ve seen many good ideas let down by a bad user experience because the developer didn’t have a proper understanding of their customer. At PI, we use a mix of techniques including voice-of-customer research (think interviews, focus groups), user journey mapping (where you map out each step of a user’s interactions with your product) and co-creation sessions to understand user behaviour. Once you have a have a deep understanding of your patient users, you can develop your product to suit their needs and maximize engagement. This could include a simple, large text user interface suitable for older people, seamless Bluetooth communication between your device and app to prevent any manual entry mistakes, visual cues to show when a test has been successfully completed, or other contemporary design patterns.

Part of making it easy to use is also making it easy to keep using. Your product should be designed to help keep patients motivated and prevent forgetfulness. This could be through built-in prompts to remind them to take their medication or do their test, or even a visual or audio alert on the device itself. Visual progress trackers and gamification techniques like rewards or congratulatory messages have the power to activate patients and help make them accountable for their health6. Or perhaps you can avoid the problem altogether by using a small wearable device that automatically detects and transmits biometric data, so patients don’t actually need to take any action for the product to work.

Bottom line, a good user experience – which includes the device and the associated app – is essential to maximize patient engagement with your product.

Consider patients’ bigger health picture

If you are going to improve your patients’ health outcomes, you need to consider their health holistically. Regulated remote patient monitoring technology is often targeted at patients with chronic diseases, and those people tend to have multiple health issues. For example, studies show a person with Type 2 diabetes has a more than 97% chance of having at least one co-morbidity and a more than 88% chance of more than two, most commonly hypertension or obesity7. Software that can track a range of related diseases is more valuable as it allows clinicians (and patients) to see the whole picture.

So how do you do this? If you are already in the market, you might like to consider looking for other technology you can acquire to wrap into your platform. If you are early in your development process, your best move might be partnering with more established players to integrate your device into their platform. This will make your service much, much more valuable for healthcare providers and patients, as it will give a more holistic view of their health. To continue with the diabetes example, if you had created a product to track insulin usage, it’s likely your patients would also benefit from an exercise tracker, food diary and blood pressure monitor. You may like to consider partnering with other companies to integrate these technologies into your diabetes management platform.

Service design for clinics

Clinicians are not only key remote patient monitoring users, they are also key decision-makers or decision-influencers for whether a clinic or hospital buys your product. Like most people, clinicians can be resistant to change. You need to be prepared to educate them about how your product will improve their patients’ health and help their clinic or hospital. Other than being able to demonstrate how your product can help patient outcomes, in my experience, there are three key challenges you need to overcome if you are to persuade clinicians to prescribe your solution: workflow disruption, security concerns and financial incentives.

Tailor your product to fit clinical workflow

How your remote patient monitoring product fits with your customers’ workflow could be the deciding factor for whether they choose your product, or a competitor’s (or stick with the status quo). Clinicians are busy people who generally don’t want to have to spend a lot of time working out how to integrate a new system into their workflow. Investing time to research each of your key customer groups will help you understand their workflow, what is working well and what are the key pain points. This will help you identify opportunities for your product to not just integrate with your customers’ workflow but make it more efficient. Be aware that what works for one customer group (e.g. a physician’s office), may not work for another (e.g. a hospital). You’ll need to be able to adapt your system or focus on use cases that have the most commercial potential.

Ensure your product meets security and privacy regulations

Healthcare providers and systems are understandably cautious when it comes to security and patient privacy. Indeed, security concerns have been one of the barriers to telehealth adoption10. The cloud is the backbone of any remote monitoring play, so you and your customers need to be confident that their information will be kept securely and in compliance with HIPAA (Health Insurance Portability and Accountability Act). Once you’ve designed a security and privacy-compliant solution, it is equally important to ensure your platform remains compliant through changes and iterations.

Ensure your market is incentivized

In many countries, including the U.S. and Australia, clinicians are incentivised through reimbursement – either by the public health system or insurers. In the U.S., the Centers for Medicare and Medicare Services (CMS) – the largest health payer in the country – has added several reimbursement codes over the past few years8. This has made remote patient monitoring financially beneficial for doctors, while allowing them to provide better care for patients. Unfortunately, other parts of the world, including Australia, are not so progressive. While the COVID-19 pandemic saw telehealth temporarily added to Australia’s Medicare Benefits Scheme9, this was primarily for phone and video conferencing. However, this was a big step in the right direction, and there are positive signs that efforts by vendors and organizations such as ANDHealth may be successful in getting Medicare to recognize and reimburse digital health initiatives. In the meantime, you’d be well advised to target markets that have clear incentives in place.

Summary

The time is right for remote monitoring to finally take off, particularly in the U.S. where reimbursement is available. To be successful you need to develop a regulated product that will tangibly improve patient health outcomes by providing actionable insights and a holistic view of their health. It also needs to be easy-to-use for both patients and clinicians, easily integrating with their daily routine or workflow. Finally, any remote monitoring software must meet all the security and privacy requirements of the industry. Get these factors right and you’ll be well placed to take on this growing healthcare segment.

Learn how PI Digital can help you create a remote patient monitoring product that your patients and practitioners will love. Get in touch.

References

  1. Sharp B, Buckley C. 2018. Remote Patient Monitoring 2018: High Potential in a Shifting Landscape. Klas Research.
  2. Cassgnol D. 2019. CTA Survey Finds High Demand for Remote Patient Monitoring Devices. Consumer Technology Association.
  3. Steventon A, Bardsley M. 2012. Jun, [2020-04-10]. The impact of telehealth on use of hospital care and mortality. The Nuffield Trust. 
  4. Celler B, Varnfield M, Sparks R, Li J, Nepal S, Jang-Jaccard J, McBride S, Jayasena R. 2016. [2020-04-10]. Home monitoring of chronic disease for aged care. Australian e-Health Research Centre (AEHRC) CSIRO.
  5. Mosnaim G. S., Stempel H., Van Sickle D., & Stempel D. A. 2020. The Adoption and Implementation of Digital Health Care in the Post-COVID-19 Era. The journal of allergy and clinical immunology. In practice, 8(8), 2484–2486.
  6. Boosting patient empowerment and motivational pull: Achieving the next level in a gamified health environment. 2015. Monitor Deloitte.
  7. Iglay K, Hannachi H, Howie P.J, Xu J, Li X, Engel S, Moore L & Rajpathak S. Prevalence and co-prevalence of comorbidities among patients with type 2 diabetes mellitus. Current Medical Research and Opinion, 32:7, 1243-1252.
  8. Holland, T, M. 2020. The new rules for remote patient monitoring reimbursement. Samsung Insights.
  9. Providing health care remotely during COVID-19. 2020. Australian Government, Department of Health
  10. Fisk M., Livingstone A., & Pit S. W. 2020. Telehealth in the Context of COVID-19: Changing Perspectives in Australia, the United Kingdom, and the United States. Journal of medical Internet research, 22(6), e19264.
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Kaushal Vyas General Manager, PI Digital

Kaushal is the General Manager of PI Digital. He draws on his extensive strategy experience to partner with clients to understand their strategy, identify opportunities for digital innovation, develop practical roadmaps and deliver successful solutions to the market.

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