The healthcare shift that could save lives and reduce hospital overcrowding | Viewpoint

In the complicated medical system, it can be easy to miss quiet but significant steps forward. Recently, one took place. A group that the medical community knows well, but most Americans do not, made a change that could transform healthcare for millions of people. It could finally bring the power of the clinic into people’s living rooms.

It boils down to this: More people are likely to have, or soon get, insurance coverage for remote patient monitoring (RPM) -- an array of tools that collect healthcare data from home and send it to their doctors.

The shift is seismic. For too long, the most sophisticated tools in medicine have been locked behind hospital doors, forcing a “waiting room culture” on patients. Now, many people will be able to access similar tools without sacrificing a day of work or traveling hours to medical facilities for all kinds of routine testing.

But it’s about more than convenience. With this kind of access, people will be much more likely to discover potential problems early on, before symptoms become so bad that they rush to a hospital. By moving care to the home, we can reduce hospital overcrowding.

The Department of Veterans Affairs reports that members of its RPM program have a 41% reduction in hospital admissions, and those who are admitted see a 70% reduction in the length of stay. To help more patients achieve these kinds of results, insurers and healthcare practices must act quickly.

Last year, the CPT Editorial Panel added new codes for digital health, AI and more. Few people outside of our industry are aware that public and private insurance programs use this guidance in making decisions. When the panel adds new codes, it signals to these programs that they should begin covering these things. But it’s not automatic.

The changes include expanded coverage of certain medical-grade RPM tools that provide clinically accurate data doctors need to make life-saving decisions. Crucially, the changes also include coverage for shorter periods of use -- and that's a sea change. A patient might only need to track certain healthcare data for a limited time, such as while recovering from an infection or surgery.

Medicare has already moved to expand this kind of coverage. “These additions give providers the flexibility they've long requested,” an article in Physicians Practice explains. “Clinicians can now bill for fewer monthly vital readings and shorter management time. For patients, this means RPM programs can finally match clinical reality.”

We must not let the burden of this transition lie on the patient. Individuals shouldn’t have to discover which tools are now covered. Leaders must step up, enact changes and inform patients about these new possibilities. That's how coverage becomes care.

My work focuses on humanity’s biggest killer, heart disease. The vast majority of heart disease and stroke are preventable. Some doctors place that figure as high as 90%. Many people only begin preventative steps after discovering their heart health is in danger. So early diagnosis is essential.

But early checkups are often out of reach, including for people in "healthcare deserts" and underserved communities. Nearly half of all U.S. counties, and 86% of rural counties, do not have a single cardiologist.

When patients can simply use a medical-grade tool at home to gather heart health data, send it off to doctors, and get feedback through telehealth, they’re more likely to act. And as they start to make lifestyle changes, they can track their improvements, recognize setbacks, and get updated advice more frequently, which creates a powerful cycle of empowerment.

The same thing goes for other forms of RPM -- whether people are tracking blood pressure, glucose, oxygen levels, or more. For many years, healthcare providers have talked about the importance of giving people “tools” to take their health into their own hands. Now, the medical system can do so literally. We must maximize this opportunity as quickly as possible to ensure that every American, regardless of zip code, has access to life-saving care from home.

Priya Abani is CEO of AliveCor.