The ‘unbillable’ lightness of health

Holyoke’s remote patient monitoring system, which reduced emergency room visits among 94 percent of its participants, gained a spotlight recently in Colorado Springs at the 2022 Annual Rural Health Conference. Of all rural clinics in Colorado, Family Practice of Holyoke is the one location to use this system – and it has for two years.

“We operate it at no cost to our patients,” said Jayden Miracle, clinic manager. “We offer this basically as a community benefit. If we’re able to bill for the service, then we’ll bill insurance, but I would say probably...”

“Ninety-nine-point-nine percent is unbillable,” chimed in Tamara Laws, population health nurse, causing Miracle to laugh.

With equipment including biometric performance monitors, tablets, smart watches, and Bluetooth scales and blood pressure cuffs, the system allows patients to report any suspicious symptoms or data to a public health nurse, who then can advise patients and upload the information to the hospital’s electronic record. Family Practice acquired this equipment – 50 sets in all – using a $65,000 grant from the state’s Office of eHealth and Innovation. The grant, awarded in 2020, helped the clinic care for their patients remotely during the coronavirus pandemic.

Because Family Practice is designated as a rural health clinic, Miracle said, its payment model doesn’t allow them to bill Medicaid for remote patient monitoring. Medicare, she said, also is limited. Commercial insurances are “hit or miss.”

“But the reason we do it is we know the health benefits and we’ve seen our numbers improve,” she said. “We care about our patients and want their health to improve.”

Speaking at the Rural Health Conference in The Antlers, A Wyndham Hotel the morning of Oct. 21, Miracle and Laws relayed through a PowerPoint presentation the aforementioned reduction in emergency room visits – occuring over a year – and more: Hypertension numbers improved by 3.9 percent and 83.3 percent of patients with hypertension could control the disease. They also noted improvements in blood sugar management, noting one patient with diabetes who – through daily electronic monitoring – secured “a lower, more managed hemoglobin A1C result.”

A second patient mentioned in their PowerPoint, feeling ill, had managed to track their heart rhythm with a biometric monitor. When the rhythm proved abnormal, the patient contacted a population health nurse, who advised them to seek emergency treatment. Thanks to remote monitoring, they stated in the presentation, “the patient’s life was saved as a heart attack was identified” early.

Forty-two Holyoke residents currently use remote patient monitoring. The amount of training necessary for the system, Laws said, “depends on the person.” While older people may have some difficulty initially, she continued, “most of them get it down and they like it.” She, herself, was surprised by how fun the process became.

“When I come in with [the equipment], they’re my toys,” she said. “I get to introduce people to them, so it’s not as scary. Some people don’t do well with data, and helping demystify that for them has been very helpful.”

Following their presentation, representatives from rural health clinics asked Miracle and Laws for their contact information, seeking to establish remote patient monitoring systems of their own. What’s holding them back, Miracle said, is “the upfront costs.”

“There are a lot of companies out there that you have to pay monthly subscriptions to; obviously, if you can’t bill for the service, you can’t pay the monthly subscriptions for the equipment,” Miracle said. “We have been fortunate enough to secure grant funding and I’m always looking for other grant opportunities; it’s kind of a niche of mine.”

Whether one is sick or not, Miracle said, they are welcome to call Family Practice at 970-854-2500 and schedule an appointment to see if they should be enrolled in the monitoring system. Equipment, she added, is always available.