Q: Can you tell us about your company and the challenges you are solving within the remote monitoring space?

A: Even before the COVID-19 pandemic, health systems faced numerous challenges. Burdensome EHRs contributed to clinician burnout, chronic disease rates were continuing to rise, there were inadequate funding mechanisms for many systems to move to more proactive, value-based care, and poor interoperability between EHRs and other systems limited flexibility to meet evolving care needs. COVID-19 further highlighted existing issues with clinician efficiency and patient care. Thankfully, broad government mandates in the past few years have made interoperability a reality and the pandemic catalyzed an expansion of funding for virtual tools that enable value-based care delivery, making 2022 the opportune time to adopt more robust, flexible, integrated care delivery platforms like Rimidi. 

The Rimidi platform was built as an enhancement to the EHR, not a replacement, and is designed to support quality improvement, workflow optimization and patient engagement objectives all within the existing EHR workflow. Rimidi is unique in that it brings remote patient monitoring, chronic care management, clinical decision support and patient-reported outcomes together in one highly composable platform.

Specifically, the Rimidi platform supports: Proactive management of patients with chronic conditions and other high-risk patient groups to avoid costly and dangerous complications and interventions; optimization of treatment decisions based on the intersection of patient data and evidence-based guidelines to drive personalized recommendations to get patients to goal more quickly; improved clinical efficiency within practices by driving workflow optimization in clinic and via virtual care delivery models; and incorporation of the social determinants of health and patient-reported outcomes into clinical practice.

Q: How does your company differentiate from other remote monitoring vendors?

A: Some key differentiators of Rimidi’s Cardiometabolic Management platform are tight integration with leading EHRs via SMART on FHIR, the breadth of the comorbid disease states we cover, our incorporations of patient-reported outcomes and social determinants of health measures and our clinical decision support engine. Rimidi’s CDS cards support almost any insight or intervention a client wants, including RPM data alerting and interventions, referral management, lab or medication recommendations, clinical trial identification and more. In addition, we are currently the only RPM platform that enables continuous glucose data visibility within the EHR by integrating with both leading CGM systems.

Q: What are some of the biggest changes your company has seen around how health systems are approaching remote monitoring since 2020?

A: We have been doing remote patient monitoring for 10 years–since long before there were even CPT codes available for reimbursement–because we see it as a better way to deliver care and achieve better outcomes for the highest risk patients. When the public health emergency allowed for more flexibility around RPM reimbursement, there was a flurry of interest. In some cases, practices were just looking for new revenue streams from reimbursement to stay afloat while in-person visits were limited. 

What we are seeing now is health systems starting to take a more long-term, strategic approach to remote patient monitoring. They are looking for solutions that won’t just get them reimbursed, but will integrate with their existing workflows and improve patient outcomes.They are examining who within the health system should manage RPM programs–is it an extension of primary care or set up for specific service lines? Can the existing chronic care management team do this? Do we have the in-house staff to manage this, or do we need third party care managers?

Q: What does an ideal client look like? How are health systems best organized for success in remote monitoring?

A: We work with a number of different provider groups, from small practices or federally-qualified health centers to large academic medical centers. Our client base also mirrors the split fee-for-service, value-based care market. We work with some providers who are entirely risk-bearing entities and have set up remote patient monitoring programs to improve how they manage chronic conditions. We work with other providers who still live in the fee-for-service world, have taken advantage of expanded funding mechanisms for RPM and are seeing the improvements in patient outcomes as a result. 

Clients who have the most success tend to start with a very specific problem, figure out how to set up a program, and expand into other use cases from there. For example, they may choose to start with Type 2 Diabetes and define the target RPM patient cohort as patients who had an A1C above 9 percent at their last screening. With a defined cohort, they can figure out how they want to enroll the patients (in-person or virtually), who manages the program, which platform features most support their triage, etc. 

Some of our most successful clients use a team of pharmacists to manage their RPM program, from patient enrollment to engagement throughout.

Q: What measurable outcomes have you seen from your clients who have prioritized remote monitoring?

A: We have seen measurable results across a number of different use-cases and provider types. A few examples: 

• As COVID-19 disrupted care across the US, many high-risk patients at Northeast Valley Health Corporation (NEVHC), a California  FQHC, were missing appointments and screenings, which led to poor hypertension control rates. After implementing the Rimidi platform within their NextGen EHR workflow, hypertension control rate went from 38 to 70 percent in the group of patients being remotely monitored for blood pressure.

• Serving an area with a high incidence of Type 2 Diabetes (T2D), Leon Medical Centers has many Medicare Advantage patients with elevated hemoglobin A1c levels and multiple cardiometabolic risks. They implemented Rimidi within their Epic EHR workflow and enrolled patients with A1Cs greater than 9 percent at their most recent screening. Since the program began, 88 percent of enrolled patients have been able to lower their A1Cs below 9 percent. 

• Boston Medical Center uses the Rimidi platform to monitor blood pressure in postpartum women who had high-risk pregnancies and are at greater risk of stroke. Monitoring those moms at home within BMC’s Epic EHR allows the nursing team to prioritize care and intervene early. In the client’s last analysis of the program, 94 percent of patients had blood pressure readings compared with 40 percent of women with conventional postpartum care.

• At Desert Oasis Healthcare, in addition to seeing clinical improvements including a 2.8 point improvement in A1C and a 30mg/dL improvement in LDL, the care team reports that they can serve three times as many patients with the Rimidi platform than without it.

Q: What major functional enhancements and/or product investments are you making in the near term to keep up with the evolution of remote monitoring?

A: Our product roadmap has always been driven by listening to our existing clients and the broader market and understanding their pain points. What we hear most often relates to their workflow. There are myriad new medical devices that could improve patient care, but gathering the data remains the responsibility of the patient or requires the clinician to log into a separate software system to access the data. 

As evangelists for SMART on FHIR and interoperability, we continue to add device integrations to our platform, along with adding and expanding EHR integrations so that clinicians can see remotely-generated data in their workflow alongside other pertinent patient data.

For example, Rimidi recently added Abbott’s FreeStyle Libre continuous glucose monitor to our suite of supported devices. This not only makes CGM data available to clinicians within their workflow, but also allows for clinical decision support to drive patient identification and intervention at the population level. On the EHR front, Rimidi is one of the only platforms with support for CDS hooks in production at multiple client sites within the Epic environment. This allows for even more native workflows for Epic users. Rimidi will expand this support to Cerner and other EHRs over the coming year. We will also add new digital therapeutics to our platforms, bringing those emerging technologies to the point of care.

Q: How is your company partnering with clients as reimbursements and use cases shift?

A: Rimidi’s client success team meets monthly with clients to understand their needs, both from a reimbursement and a clinical use-case perspective. We frequently engage in policy discussions, monitor changes to the physician fee schedule and build features within our platform to support new reimbursement pathways (i.e. tracking time spent on remote patient monitoring). In addition, we’re constantly talking to emerging medical device and digital therapeutic partners to build a pipeline of device integrations as new technology comes to market for specific clinical use-cases.

Q: What are the biggest opportunities health systems should be thinking about this year when it comes to remote monitoring?

A: Health systems should be thinking about how to integrate continuous glucose monitors into their clinical workflow as CGMs become more widely used by people living with diabetes. Another trend we have seen is health systems looking at how deferred care during the pandemic has impacted their quality metrics. For example, many providers have seen a dip in their population’s hypertension control due to missed screenings. Remotely monitoring blood pressure is a good way to improve hypertension control in the population.

Q: How do you see remote monitoring evolving in 2022 and beyond?

A: I expect to see RPM finally integrated into mainstream care delivery. This is no longer a novelty, but rather a part of the long-term vision for good patient care and improved quality measures. Defining the partners to support this, the staffing model within the health system and the clinical workflow is key.