Remote Patient Monitoring

Reduce the cost of Care? Here is the low-hanging fruit.

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Here is where the money is.

According to the CDC, 90% of the nation's $3.8 trillion per year healthcare costs can be attributed to people with chronic disease and mental health conditions, and that a recent Partnership to Fight Chronic Disease publication determined that treatment of the seven most common chronic diseases, coupled with productivity losses, will cost the U.S. economy $2 trillion dollars annually - $8,000 per person by 2030. The same analysis that reductions in unhealth behaviors could save 1,100,000 lives per year.

How much of these costs are borne by your patients and your organization?

Two cost centers related to people with chronic disease are frequent Emergency Department visits and hospital readmissions. An H-CUP Statistical Brief published in 2021 revealed the following: "Across all expected payers in 2018, there were 3.8 million readmissions, of which Medicare accounted for 60.3 percent (2.3 million) and Medicaid accounted for 19.0 percent (721,300). The overall readmission rate was 14.0 per 100 index admissions, with Medicare stays having the highest readmission rate (16.9 percent) and privately insured stays having the lowest readmission rate (8.7 percent). The average readmission cost was $15,200, ranging from $10,900 for self-pay/no charge stays to $16,400 for privately insured stays." Not factored are the amounts that went unpaid and ultimately were written off as losses. Below are the diagnosis associated with the readmissions..


Related to frequent ED users, In a 2020 report published in the National Library of Medicine titled "Persistent frequent emergency department users with chronic conditions reported: As background, "Frequent emergency department users are patients cumulating at least four visits per year. Few studies have focused on persistent frequent users, who maintain their frequent user status for multiple consecutive years. This study targets an adult population with chronic conditions, and its aims are: 1) to estimate the prevalence of persistent frequent ED use; 2) to identify factors associated with persistent frequent ED use (frequent use for three consecutive years) and compare their importance with those associated with occasional frequent ED use (frequent use during the year following the index date); and 3) to compare characteristics of “persistent frequent users” to “occasional frequent users” and to “users other than persistent frequent users.

Among frequent users, a subgroup of persistent users keeps on visiting EDs frequently over a multiple-year period. Definitions of persistent frequent ED use vary in the number of visits per year (from more than three visits to more than five visits per year) and in the considered period (from a two-year period to a five-year period). Although their prevalence ranges from 1 to 20%, they can account for more than 60% of the total visit volume. Factors associated with persistent frequent use are physical disorders, mental health disorders, substance abuse, previous number of ED visits, and being a frequent ED user the previous year. Many studies have examined frequent ED use, but few have explored persistent frequent ED use. Besides, few studies have explored persistent frequent use considering chronic conditions.

In the United States, an emergency room visit costs $2,200 on average, according to the most prominent insurance carrier in the U.S., UnitedHealthcare.

Frequent ED Users

“A billion here, a billion there, and pretty soon you're talking real money." Senator Everett McKinley Dirksen

For years, as the scenario described above increased to the level of today, healthcare organizations could do little to reverse the tide. Options for effective management of chronic disease patients improved somewhat with the advent of electronic health records because more data was available. On the other hand, for the most part, patients were still required to self-manage coordination of their complex care-delivery. Their results are most obvious in the outcomes presented above.

In many instances, ED visits and readmissions are preventable with timely remediation to deteriorating conditions through medication management and other therapeutics. Remote patient monitoring could have identified a worsening of conditions before the need for emergency treatment and/or hospitalization. Not every monitoring solution is adequate for patients with complex healthcare requirements. What is needed is the ability to monitor multiple conditions and deliver the data real-time. Data analysis must occur simultaneously. Data trends are often more important than specific data points in time. Then, the information must be well-communicated and visible to be acted on. False-positive alerts must be held to a minimal level to assure a lack of alert fatigue.

Intersect on FHIR™ was developed with the architecture needed to deliver on each of these requirements. It's unique feature set combined with ease of seamless integration with on-premises EHR systems enables provider organizations to effectively take on the scourge of frequent ED visits and expensive readmissions - all while markedly improving patient outcomes and quality of life. It couldn't happen soon enough.


FHIRhose is the name of our new blog where we will post information about Intersect on FHIR and other topics relevant to remote patient monitoring and difital healthcare platforms. We hope you find it interesting and informative. Check back regularly for new content.

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