Remote Patient Monitoring

[pod squad]

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Anyone have experience with Remote Patient Monitoring devices for DFU prevention etc? Specifically regarding reimbursement, are they worth incorporating into private practice? Have seen a few companies popping up lately...(Siren socks, Orpyx etc)

 

[Feli]

WTF? FTW?

 

[Pronation]

I use a system where when the patient sees a trail of pus and blood behind them then they come in to see me for amputation.

 

[heybrother]

 

[DYK343]

Ive heard of these. You can ding the patient thru your smartphone if theyre walking on the foot to let them know youre watching.
(or so im told - never used one).

 

[AttackNME]

Anyone have experience with Remote Patient Monitoring devices for DFU prevention etc? Specifically regarding reimbursement, are they worth incorporating into private practice? Have seen a few companies popping up lately...(Siren socks, Orpyx etc)

Nope. I feel like the patients that have the capacity to use it are the ones who won’t need it. The ones who are most vulnerable are those who won’t be able to use these things, nor would they be able to do anything about it if the alert finds something concerning.

 

[Pronation]

Ive heard of these. You can ding the patient thru your smartphone if theyre walking on the foot to let them know youre watching.
(or so im told - never used one).

Glad to see that the technology has trickled down from remote control underwear.

 

[DYK343]

Glad to see that the technology has trickled down from remote control underwear.

Please explain.

 

[Scrantonicity]

Ive heard of these. You can ding the patient thru your smartphone if theyre walking on the foot to let them know youre watching.
(or so im told - never used one).

What??? That's creepy. I think I'm good the way things are---listening to patients lie about their activities the last 2 weeks works for me.

 

[GreenHousePub]

The last thing I need is to be able to monitor patients when I'm not at work

 

[deleted285117]

The last thing I need is to be able to monitor patients when I'm not at work

Agree... If they don’t care enough about their own health to do what we tell them in the first place, a small accountability device aint gonna change anything.

 

[pod squad]

Agree with the tongue in cheek comments regarding the compliance of these patients. I'm more curious about it as an additional (albeit small) income stream. Codes 99453-99458 are able to billed for this every 30 days...

 

[heybrother]

Before you get $$ signs.
99453 can be billed once at the start.
99454 requires the patient to submit 16 days of data.
99457 is the 20 minutes of virtual interactive time with them.
99458 is the add on time code

Without doing the negative skeptical I think you need to sit down and ask yourself - how will this go wrong and explode. More so ask yourself - how will I efficiently implement this to not kill myself.

Perhaps Medicare covers the codes - will private insurance?
Will the patients pay?
Will they owe a copay?
Will you need to separate the billing onto 2 different days to ensure there's no 50% reduction
Will the patient owe a copay on 2 separate days?
Will the patient do 16 days worth of data so you can meet the list?
When the technology breaks will the patient expect you to fix their internet problem? I can't !!! this one enough. I tried doing telahealth during the pandemic. It sucked.
Ideally all of your patient monitoring would be accomplished on like ...1 day a week. What will you do when all different manner of people have their data coming in on different days.
Will Medicare/payors decide that if you are doing this then you shouldn't see the patient that month? ie. they'll pay this or pay a visit?
Remember that the hated 99212 is like $50ish bucks and can be accomplished potentially in 1-2 minutes.
Will neurotic people look at their own data (can they?) and be calling you saying please check my data, please, please you have to check it now.

Sometimes there's just something very straight forward about simply seeing a patient in the office. No internet. No phones. No texts. Just lay eyes and then move on.

 

[pod squad]

I've considered all these potential pitfalls and have my concerns for sure, just wondering if anyone has had any experience with it

 

[heybrother]

I've considered all these potential pitfalls and have my concerns for sure, just wondering if anyone has had any experience with it

Fair enough. I wonder do you take on any additional liability doing this.

"I thought the doc was watching me and would intervene if something bad happened"

 

[pod squad]

Most of these companies are set up so that you pay them a monthly fee per patient for the monitoring/logistics of the device. Talk about a great business model lol. They try to sell you on the profit margins (pretty slim) of insurance reimbursement after the monthly fee. That being said, it is essentially passive income granted the patient is compliant. Not sure how this would affect the medical liability and I doubt there's been any legal precedent to date regarding it. Something to think about for sure.

 

[dtrack22]

A practice I used to work for had a post about it on social media and that’s how I know it’s likely a poor financial decision and a bit of a scam…

 

[GreenHousePub]

A practice I used to work for had a post about it on social media and that’s how I know it’s likely a poor financial decision and a bit of a scam…

That's what gave it away to you? Not when you read that it was remote diabetic foot monitoring?