Implementing an Insourcing Model for Efficient Remote Monitoring
At the 2023 HRS meeting in New Orleans, ScottCare and 91 Life cohosted a Rhythm Theater panel discussion on the subject of “The State of Remote CIED Monitoring Today”. This is part 3 of a series of summaries of the presentations presented by the speakers.
Dr. Advay Bhatt presented a case study on how Valley Health System in Ridgewood, New Jersey, has developed a robust remote monitoring program to handle the overwhelming amount of data associated with this practice. By implementing an insourcing model and leveraging advanced technologies, they have successfully maintained control, scalability, and quality while providing comprehensive care. This summary will highlight their approach, focusing on connectivity, staffing models, data management, and continuous process improvement.
Optimal Structure for Remote Monitoring:
Valley Health System recognizes three primary options for remote monitoring: in-house, outsourcing, and insourcing. While each has its advantages and challenges, they advocate for the insourcing model, which combines the benefits of scalability, control, and quality. By merging their office staff, contractual monitoring labor services, and a data management platform, they achieve a balanced approach to remote monitoring.
Connectivity as a Priority:
Valley Health System operates a 24/7 remote monitoring service, emphasizing the importance of connectivity for optimal patient care. Ensuring patients are enrolled and educated at the time of implantation is a key component. Dedicated staff with well-defined responsibilities, redundancy layers, and uniform protocols for data review and alert management contribute to maintaining connectivity. Sharing data with referring physicians and engaging patients in their care further strengthens the connectivity aspect.
Scope of Valley Health System's Practice:
With a 500-bed community hospital and a medical group comprising over 400 providers, Valley Health System serves northern New Jersey and beyond. Their remote monitoring program involves six electrophysiologists, three office-based EP labs, one heart failure AP, four device technicians, and dedicated medical assistants. Collaborating with partners like ScottCare and 91 Life enables them to manage the increasing number of patients, billable transmissions, and maintain staffing ratios.
Continuous Process Improvement:
Automation plays a crucial role in streamlining workflows, such as billing, faxing, and EMR integration. Valley Health System continuously works with their office teams, ScottCare, and 91 Life to enhance protocols for alert escalation, vendor-specific technologies, and analytic validation. Their focus is on eliminating delays, identifying high-level alerts, and improving clinical and administrative care through resource allocation and technological advancements.
Improving Connectivity and Beyond:
Connectivity assessment for loop recorders, ICDs, and pacemakers can be challenging. Valley Health System developed an automated algorithm in collaboration with 91 Life to track connectivity based on the presence or absence of daily ECG snapshots. This approach enables them to monitor connectivity patterns, improve patient connectivity status, and enhance patient care. They are also exploring messaging and communication improvements, feedback systems, longitudinal patient management, and EMR integration.
Conclusion:
Dr. Advay Bhatt illustrated how by adopting an “insourcing” model and leveraging innovative technologies, Valley Health System has built a highly structured and efficient remote monitoring program. Their emphasis on connectivity, staffing optimization, data management, and continuous process improvement enables them to deliver excellent patient care while adapting to the evolving needs of the healthcare industry. Through collaboration and automation, they achieve cost-effective and quality-driven remote monitoring practices.
