At a recent PrepMD Webinar a panel discussion was held to share best practices to address the common challenges on cardiac device remote monitoring programs. The panel discussion was led by Rob Lerman, MD, CMO, along with three CCDS-certificated leaders from the PrepMD Clinic Solutions Team.
Kent Seckinger, CCDS, PrepMD 4+years, cardiac device space for 20 years, working split half between the device industry for manufacturers and the other half working for a large device clinic.
Brianne Terrell, RN, CCDS, PrepMD 1 year, device clinic for about 10 years working in support of device implantation, patient consultation, perioperative device management, in-clinic follow up, and remote monitoring.
Janet Cedric, CCDS, worked at Prepmd 4.5+ years and in the cardiac space for about 24 years. I’ve managed and started up device clinics.
Q: Based on your years working in cardiac device clinics, can you share any advice or tips on how clinics handle the staffing requirements needed to run their remote monitoring programs?
Brianne: I worked in a clinic of all registered nurses and our responsibilities made for very fragmented days. We were all responsible for seeing device clinic patients in person and handling remote monitoring patients. Obviously, the patients seen in person seemed to always get the most priority. During and after COVID, we ended up having to send many of our nurses to work from home and what we found was we were able to work more efficiently when we had dedicated staff for remote monitoring. So it was really one of those aha moments.
Janet: I’ve been fortunate enough that the clinics that I worked in had dedicated staff who were well-trained and supported, so they were all very capable of being able to recognize and manage the complex issues of cardiac devices and remote monitoring. Some clinics I’ve been in touch with decided that due to COVID staff changes and shortages they needed to move to a third party vendor to manage their remote monitoring.
Kent: As a clinic increases in patient size, so do the remote transmissions and there comes a balancing point where a limited staff, or in some cases one individual, is responsible for in-person and remote care of device patients. Having a dedicated staff for remote monitoring clearly helps as a clinic grows in size and allows the clinic to manage and improve efficiencies. The best situation to start to improve a device clinic is to be able to have that right mix of in-clinic staff versus dedicated remote staff.
Q: What would you say most clinics feel are the biggest challenges faced with running an effective and efficient remote monitoring program?
Kent: Many of the biggest efficiencies any clinic should achieve is centered around patient education. Too often a patient is sent home after device implantation with a transmitter without any education around the device, the transmitter and the importance of remote monitoring. Spending some dedicated time at the first post-op follow up visit which can take a good 30- 40 minutes is crucial. Taking time to educate the patient and the family is so crucial. This patient communication and education should clearly explain the benefits of remote monitoring and how this will ultimately make the patient’s life safer and easier by reducing unnecessary in-office visits and hospitalizations. It also helps to explain the billing associated with remote monitoring so they are not surprised or confused. This patient communication will help reduce a lot of that hidden workload and burden on the clinic staff, including unnecessary patient-initiated transmissions or connectivity issues.
Brianne: I find that looking back 10 years ago versus today the remote monitoring population and requirements of any clinic has just exploded and these clinics are feeling the pressure of managing it all. It’s rare that we talk to a clinic that does not feel the need to have more hands on deck to manage their remote monitoring. I would say the biggest challenge most clinics face is the huge remote monitoring workload burden and figuring out the best workflow for their individual clinic.
Janet: I’d say the biggest challenge remote monitoring clinics face is not having the appropriate dedicated staff. We see a lot of benefit from clinics hiring dedicated administrative staff to help with remote monitoring. Especially when the software is integrated with EMR, there are a lot of backend tasks that can be crucial to making things more efficient. There are many times when the remote monitoring staff will need to talk to the in-clinic staff. If you have a dedicated staff for remote monitoring they will be able to identify any patient care problems earlier and get that patient into be seen by a clinician sooner and ultimately providing improved patient care.
Q:Based on your experience, do you have some advice or tips that you can recommend to those trying to start up or improve their remote monitoring program?
Brianne: The value of a dedicated staff for remote monitoring cannot be underestimated, in addition to the importance of a thorough communication process to educate patients about remote monitoring and ensure their monitors are connected and transmitting.
Kent: If you really want to reduce your clinic workload, it’s really coming down to educating that patient from the start. The result will be fewer patients with disconnected monitors and fewer calls from disgruntled patients who don’t understand the remote monitoring billing. This patient communication is a really crucial step and sets the stage to reduce a lot of that overload, which allows clinics to operate at a much higher efficiency level.
If you are a clinic manager with questions or need help with the management of your cardiac device remote monitoring responsibilities, contact the PrepMD Clinic Solutions Team.