Camille Baxter:
Hello. Welcome to Healthcare Insider, a sponsored content podcast series from Modern Healthcare Custom Media. I'm your host, Camille Baxter. Today, we are speaking with Dr. Tahir Haque, a practicing physician and medical director for hospital at home at Biofourmis. His clinical and research work focuses on improving clinical care through innovative delivery and health equity initiatives. And Khurram Mir, senior manager at UCI Health, who leads multiple initiatives focused on delivering innovative care models using remote patient monitoring and hospital at home programs. Before we dive in, we'd like to thank the sponsor of this episode, Biofourmis.
Biofourmis, a global leader in providing advanced technology and clinical support for care at home and digital therapies. Biofourmis is this clinically validated platform powered by machine learning and advanced analytics, enables improved clinical outcomes, maximizes the effectiveness of high value drugs and lowers costs across the entire care continuum. Biofourmis is transforming patient health through personalized predictive care. Today, we are talking to Tahir and Khurram about how hospital at home and remote patient monitoring, also known as RPM, are viable solutions for healthcare systems as they look to solve for staffing shortages, hospital readmissions, and increased cost of care. Tahir, Khurram, thank you so much for being here today.
Dr. Tahir Haque:
It's a pleasure to be here and look forward to the discussion.
Khurram Mir:
Thank you so much for having me.
Camille Baxter:
Well, let's jump right in. Dr. Haque, the letters RPM cover a lot of ground these days. For the purposes of framing that term for today's discussion, how should we think about RPM?
Dr. Tahir Haque:
Remote patient monitoring is an umbrella term used to describe the gathering, monitoring, and most recently, interpreting of patient data outside of the traditional healthcare setting. This can include a variety of factors. I like to break it into buckets. The first is "where." The different settings could be the home, in the car, or even a person who's traveling. The next bucket is "what." So thinking across the acuity level, acute or more commonly termed as hospital at home, postacute, or even chronic or outpatient care. The third bucket is "when." When we're monitoring a patient, we look at continuity. Is this episodic monitoring or continuous monitoring? And the last is "how." How is the data collected and displayed to the clinician? For health systems that are considering remote patient monitoring solutions to tie into their different care models, it's important to identify the problem you are trying to solve, and then determine the correct entry point across the care continuum for your specific health system. This allows you to focus on one specific area, identify your pinpoints as you scale and grow before expanding to the different acuity levels.
Camille Baxter:
I really like the where, what, when, how buckets. It really helps us to better understand all that RPM encompasses. With RPM as the umbrella term over all remote care, what areas of the RPM care continuum is UCI Health currently focused on?
Khurram Mir:
Yeah. I loved what Tahir mentioned and how he differentiated the buckets, because you can easily confuse the word RPM and how it's utilized in a healthcare setting. When we first launched our first generation of RPM technology in January of 2021, our primary focus was to solve for bed capacity issue. That was the problem that we were trying to solve at that point. The capacity crisis wasn't new. It was exacerbated during the pandemic. So what we really wanted to do was create innovative models that allowed us to monitor patients on a post-acute basis. And if the patient was improving in the hospital, if the physician determined to fit the program's inclusion criteria and they could benefit from the program, then we offered this potential RPM program to them.
And during our journey, we quickly learn that if we really want to scale and go into the other buckets that Tahir mentioned, like acute inpatient at home or chronic care management models, we will need to start looking at a platform that can serve various different offerings. We don't want to go down the route of having point solutions. So we made a switch in November 2021, just very recently, to start building that infrastructure to help support those other care models, and acute inpatient is a framework that we have been developing internally. When given the approval, we would want to launch acute inpatient at home as well.
Camille Baxter:
Tahir, same question for you. Where has Brigham and Women's focus their efforts on the continuum of care?
Dr. Tahir Haque:
Similar to UCI, we've evaluated different areas across the care continuum. Brigham and Women's has been fortunate enough to grow their home hospital program since 2016. Over the past five or six years, we've seen that we started off with a small set of diagnoses in a limited patient volume to where we are now, comparable to an inpatient medical team. Our program has had multiple reasons for starting as well as its sustained growth. Like many other health systems, Brigham and Women's has a capacity issue. Being able to safely treat appropriate patients at home has allowed us to care for more patients, especially during the pandemic. More importantly, delivering the higher quality of care while utilizing fewer resources and improving patient satisfactions are also key drivers to maintaining and growing our hospital at home program.
Camille Baxter:
Khurram, let me stay with you for the next question. At the end of the day, hospitals are deploying these programs to improve patient care and patient experience. Can you think of a patient where your RPM program was able to improve the patient's experience and outcome by avoiding an admission or readmission?
Khurram Mir:
Yeah, absolutely. RPM has been a useful tool that has helped us understand more about the patient behavior, their adherence, and the compliance to the program. When we are creating our programs, patient centered approach is always at the heart of it. Patients at the center of our development efforts, and we are also looking at how do we really make this a seamless experience for our clinicians. Even with that, patients are anxious in the program. They have questions about the program. What we've been able to find that our remote command center has been able to answer a lot of those questions and address a lot of those requests. We've had early successes in the programs and we were able to divert patients from the hospital. In one such instance, we had an anxious patient who was ready to come back to the hospital. Our remote patient nurses were able to connect with the patient, and they had the foresight of connecting with our case management at the hospital and discuss what would be the best course.
Since we have a mobile urgent care... We were able to deploy mobile urgent care to the patient's home, so we're able to keep the patient into the home setting. What we are trying to do is we're trying to build that continuum of care. We don't want to cherry pick a platform. We want to create synergies between platforms. So we have RPM platform. We have mobile urgent care platforms. We want to create synergies that we can provide value to our patients and keep them outside of the hospitals because home is where our patients heal, and we want to keep that at the center of our development.
Camille Baxter:
Dr. Haque, some of the objectives around remote patient management are around tracking success and ROI. What are some of the metrics that Brigham and Women's chose to track? How is the program performed against the goal set?
Dr. Tahir Haque:
Like Khurram, I'm fortunate enough to work at a large academic medical center focused on improving care delivery and driving innovation. Brigham and Women's has published research regarding patient outcomes and resource utilization of our acute care at home program, including the first randomized control trial, looking at acutely ill patients treated at home. So I can highlight some of the major findings in that study. We showed a 38% reduction in cost of care, relative to traditional inpatients and a 70% reduction in readmissions compared to their traditional inpatient counterparts. Interestingly enough, the study also showed that patients treated at home had fewer diagnostic tests and specialty consults ordered compared to their traditional inpatient counterparts. Patients were also less sedentary and spent less time lying down compared to those who were hospitalized at a brick and mortar facility. And like Khurram touched on, in the pandemic, our hospital at home program managed to create capacity.
We published a study last summer, which showed that we created a capacity of 419 bed days over a 95-day bed period during the 2020 COVID surge. I touched on published outcomes earlier. One highlight that our program has improved the transition of care from the acute ambulatory settings, and like Khurram mentioned, really focused on joining this fragmented process. Most of all, patients and families are active participants in their care because they're able to take part in the decision making process, as well as the care delivery. And finally, being able to deliver care in the patient's home has a profound impact on the patient's perception of their disease, as well as the patient-provider relationship.
Camille Baxter:
There are so many aspects of a remote patient monitoring program, but Khurram, if you had to choose one function, software, hardware, or service to focus on, what is one that you feel is most critical for success?
Khurram Mir:
That's actually a tough one because we went through this journey twice. Like I mentioned, in January, then we did in November again. What we've learned through our learnings and trial and error is we're always looking for a platform that can serve multitude of care offerings. If I had to pick one thing, I would say it's the AI capabilities. With the growing demand of care at home, you want to be able to start identifying the signals amongst the noise and how do you really truly care for the patients that really need care at that particular moment versus the ones that are less acute or less chronic in nature that you can circle back to. So this is where we partner with Biofourmis. They have a biovitals index. This basically risk stratifies patients to the top that we really need to care for, and they help manage that population. AI being at the core of some of the things that we want to do at UCI Health, being able to reduce some of that workload off of our clinicians, help address some of that workforce burnout issues, and be able to really focus on patients that really need care at that time versus patients that maybe we can circle back to later in the day.
Camille Baxter:
Yeah, that really helps to give a framing and understanding to the importance of the AI. I love that, your statement, identifying the signals against the noise. Dr. Haque, last question for you. The program at Brigham is one of the more mature programs in the US. With your experience, what developments are you most excited about in the world of remote patient monitoring?
Dr. Tahir Haque:
From my clinical work, I've learned that it's important to be thoughtful about the end user of any solution, and that's the clinician, and more importantly, the patient. As Khurram touched on earlier, solutions that take data and then offer actionable insights from that data are definitely the future of remote patient monitoring. As remote patient monitoring and virtual care becomes mainstay, platforms that deliver a user-centric approach and address the fragmented and siloed solutions that exist before are the ones that excite me the most. And here, Khurram talked about the initiatives at UCI, make me believe that this is going to be the future of care.
Camille Baxter:
Khurram, how about you? What RPM developments are you most excited about?
Khurram Mir:
We've been on this journey now with Biofourmis since November. We're looking at other use cases. We're also looking at other offerings that we can do in the home setting. The possibilities are endless. You can do recovery at home. You can do infusions at home, and remote patient monitoring can be used into that space. We're evaluating all these options and thinking, holistically, how do we really do this from an overall strategy perspective.
Camille Baxter:
Well, Khurram and Tahir, thank you so much for your time today and helping us to better understand RPM and where it's going in the future.
Dr. Tahir Haque:
Thank you for having me.
Khurram Mir:
Thank you so much for having me.
Camille Baxter:
This has been a sponsored episode of Healthcare Insider, created in collaboration with Biofourmis. For more information about Biofourmis, please visit Biofourmis.com or email at [email protected]. Biofourmis, a global leader in providing advanced technology and clinical support for care at home and digital therapies. Biofourmis is clinically validated platform powered by machine learning and advanced analytics, enables improved clinical outcomes, maximizes the effectiveness of high value drugs and lowers costs across the entire care continuum. Biofourmis is transforming patient health through personalized predictive care. I'm your host, Camille Baxter. Look for more episodes of Healthcare Insider at modernhealthcare.com/podcasts or subscribe at Apple podcasts or your preferred podcatcher. Thanks for listening.
