September 2022
We’re Piloting a Remote Patient Monitoring Program To Improve Health Outcomes
Blue Cross and Blue Shield of Illinois (BCBSIL) is piloting a remote patient monitoring program that uses state of the art technology to monitor physiologic data trends for select patients following discharge. Three Illinois hospitals are participating so far, two in Chicago and one in Springfield. The program is available to some of our commercial non-HMO, Illinois Medicaid, and Medicare Advantage PPO members.
How does the program work?
Upon discharge, eligible members receive a remote patient monitoring kit, which includes a wearable biosensor and other components. During the first 24-48 hours after discharge, physiological data for normalization (such as heart and respiratory rate, temperature and physical activity) is collected.
A baseline physiological profile is established using cloud-based analytics, and continuous monitoring populates a cloud-based dashboard. BCBSIL care coordinators periodically monitor dashboard trend indicators, which may predict declines in health status. The care coordinators respond to key changes in physiological data – which provide opportunities for intervention – over a 30-day period.
BCBSIL case managers may engage the member’s physician or specialist for a virtual or in-person visit to evaluate and adjust treatment regimens, where appropriate. Working in conjunction with the member’s health care team, BCBSIL case managers offer education and support to graduate the member out of the monitoring program.
Member Success Story
Pilot results to date have shown that remote patient monitoring can be effective in supporting improving patient outcomes and avoiding hospital readmissions. Here’s an example of one member’s experience:
- A 35-year-old female patient was discharged in stable condition with a congestive heart failure diagnosis.
- During the monitoring period, several trend alerts triggered signaling changes in activity level, respiratory rate, and other parameters
- BCBSIL care coordinators contacted the patient for interpersonal engagement.
- A discussion with the patient revealed that she hadn’t filled her prescription and ran out of Lasix.
- BCBSIL care coordinators contacted the member’s physician and arranged for auto-shipment of her medications.
- The member’s physician increased Lasix for one dose, then had the patient return to her original dose.
- BCBSIL care coordinators followed up with educational resources to reinforce the importance of diet restrictions and medication adherence.
- The patient was successfully managed at home without an additional M.D. or ER visit, and without the need for hospitalization.
What’s next?
This program creates the opportunity to evaluate the clinical/medical benefits of remote patient monitoring on specific diagnoses to yield decreases in hospitalizations, readmissions, ER visits, and poor health outcomes related to delays in care interventions.
BCBSIL will be contacting additional hospitals to participate. based on their interest in innovative approaches to post-discharge patient management and their volume of BCBSIL members.
More information may be published as the remote patient monitoring program is expanded. Continue to watch the Blue Review for updates on BCBSIL programs and initiatives.
The above material is for informational purposes only and is not intended to be a substitute for the independent medical judgment of a physician. The fact that a service or treatment is described in this material is not a guarantee that the service or treatment is a covered benefit and members should refer to their certificate of coverage for more details, including benefits, limitations and exclusions. Physicians and other health care providers are encouraged to use their own best medical judgment based upon all available information and the condition of the patient in determining the best course of treatment. Regardless of benefits, the final decision about any service or treatment is between the member and their health care provider.