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Improving Patient Use of At-Home Testing and Medical Device Management

January 20, 2022
Posted in Feature Articles

The COVID-19 pandemic has led to the explosion of new devices and technologies that enable the delivery of care to the home and they have the potential to improve patient lives and outcomes. While medical devices, diagnostics, and remote patient monitoring tools can significantly increase quality of life, improve health outcomes, and reduce the burden on the healthcare system, they also bring challenges for patients that must be addressed to ensure success.  

Barriers to At-Home Testing and Device Utilization

Barriers for these at-home tools are common and can be a serious impediment to their use. They can include limited health literacy, complicated instructions, specific delivery parameters, unknown reimbursement indications, prolonged utilization, device maintenance, and integration of data with care provider systems. Any of these barriers can prevent the successful evaluation, deployment, and sustained use of a medical device.  

Patient Engagement Technologies Can Help

Patients who need to use medical devices including simple blood pressure monitors, moderately complex continuous positive airway pressure (CPAP) machines, and life saving devices like left ventricular assist devices (LVADs) will almost always benefit from added support, but that can be time consuming and labor intensive when done manually by the care team. Automated patient communication technology can make a substantial difference for patients and relieve a significant burden for care team and device manufacturers.  

Barrier 1: Accurate and Efficient At-Home Testing

At-home testing is a common first step to determine if a patient could benefit from a medical device or therapy, but it’s often not successfully completed for a variety of reasons that can be alleviated with patient engagement technology. 

Obtaining insurance authorization. When a test or device is indicated, but needs to be pre-authorized by insurance, patient engagement technology can be deployed to initiate the request or empower the patient with the information they need to obtain authorization.

Acquiring the equipment. Technology is an excellent way to automate logistics and delivery of equipment for testing. Devices must often be set up and packaged in preparation for testing, but when patients skip their pick-up appointments, staff waste a lot of time returning the equipment to stock and trying to reschedule with the patient. Tests and devices that are shipped to patients are subject to failed deliveries if items are temperature sensitive or require delivery signature. In some cases, a low rate of return for tests and equipment also creates a financial burden on companies. And all these challenges delay patient care. Patient engagement technology can automatically deliver prompts and reminders to ensure the successful delivery and return of at-home testing equipment. 

Optimal test results. At-home testing must be accurately executed to optimize efficacy and usefulness, which can be difficult for a patient who is not familiar with technology or medical devices. Patient engagement software can provide step by step instructions, troubleshooting, and tips to ensure the test is successfully administered. 

Virginia Mason leveraged patient engagement technology to support at-home sleep apnea testing, recognizing that the path to diagnosis and treatment of obstructive sleep apnea was fraught with challenges. To address this issue, they deployed several automated communication pathways to promote home medical equipment (HME) appointment attendance, deliver educational messages and videos, provide encouragement and coaching, and support troubleshooting for home sleep apnea teat (HSAT) completion and CPAP compliance. This approach has resulted in significant reductions in no shows and increased compliance. Download a case study to learn more. 

Barrier 2: Delivery and Set-Up

Once testing is successfully completed and a medical device is indicated, a digital patient engagement tool can automate the logistics of delivering the device, set-up, and utilization. 

Arrange delivery. Using a simple form, you can identify the best time to deliver the device, which ensures timely delivery and creates a seamless experience for the patient.  

Guidance for set-up and utilization. Many devices can be difficult to set up and may require some configuration. In addition, there may be an array of features that can help create an excellent patient experience and ensure the patient receives the maximum benefit possible. Step-by-step guidance from day one will provide patients with the information they need to begin using the device, promote proper maintenance, and reduce phone calls from patients by proactively answering questions. 

Facilitate device return if needed. In some cases, a device may no longer be needed but they are often not returned, resulting in lost revenue and waste. With digital messaging, returns can be easily facilitated, from shipping instructions to logistic assistance. 

Barrier 3: Successful Long-Term Use and Adherence

Even when patients can significantly benefit from a medical device, use, management, and long-term adherence can still be challenging. Automating a digital communication pathway is an effective and efficient way to deliver personalized pre-education, coaching, and ongoing support.  

Pre-education. Digitally deliver valuable information to make sure patients know what to expect, what supplies they will need, or physical arrangements they should plan on making before the device is delivered. 

Coaching and support. Patients may face barriers over time like fatigue and frustration. Providing periodic encouragement, tips, and reminders can help patients stay engaged, maximize the features and benefits of their device, and adhere to the treatment regimen. 

Maintenance guidance. Many devices require maintenance and consumables which can be overwhelming to patients managing a chronic illness. Use engagement technology to provide ongoing support and prompts to order consumables like replacement tubing, parts, and test strips. 

The DOCS, Nevada’s only American Diabetes Association Certified Center and a designated “Center of Excellence” for Medtronic, a manufacturer of insulin technology, recognized the need for added support to ensure patients can initiate and sustain use of an insulin pump, and reduce the number of phone calls they were receiving. They created a patient communication pathway that is carefully designed to proactively address known barriers and challenges for the device. The pathway helped them achieve successful device adherence and significantly fewer phone calls from these patients. It also decreases calls to the manufacturer’s help center as patients have the information they need at their fingertips. To learn more, read a Q&A with endocrinologist Dr. Ashish Dewan. 

Conclusion

Providing digital, proactive support during testing, delivery, and long-term utilization improves the patient experience and clinical outcomes, while preventing revenue loss from non-adherence and devices left unreturned. Using automated care pathways that are designed to support each patient journey optimizes patient success with testing and device set-up, adherence to treatment protocols, device return upon discontinuation, and an increase in case manager productivity.

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