Sweetwater Medical Associates is a single-clinic family practice and internal medicine facility in Sugar Land, Texas. It has five providers, as well as a staff team including eight medical assistants (MAs).

THE PROBLEM

Since the COVID-19 pandemic, Sweetwater has been perpetually short-staffed. The team always has seemed strapped for time, finding it challenging to monitor at-risk patients with hypertension and obesity to help manage their chronic conditions and look for signs of impending problems.

"We serve lots of patients with chronic conditions, including hundreds with hypertension and obesity, and it's crucial to get patient readings to better understand their condition," said Eric Navarette, practice manager at Sweetwater Medical Associates.

"Before we had remote patient monitoring with an AI-enabled virtual assistant, a patient would come to the office for a visit, where their blood pressure and/or weight was taken and recorded, or maybe they regularly tracked these metrics with a self-process – typically non-digital with pen and paper – at home, which then was shared at the visit or via telehealth," he continued.

Staff also that found many of the patients with these two chronic conditions also called the office often to check in or seek care. The incoming calls were voluminous.

"We knew there was a better way to manage these patients with RPM technology, so we set out to analyze the solutions available to us," Navarette explained. "The continuous flow of patient data can proactively alert providers of a complication, so they can quickly intervene and reduce the risk of a worsening event or escalation of care, such as a visit to the ER or a hospital stay."

PROPOSAL

100Plus, a Connect America company, offers an AI-assisted remote patient monitoring platform that enables healthcare providers to remotely monitor and manage their patients' health conditions.

"We reviewed three solutions and chose 100Plus because it was so comprehensive and included the AI-enabled virtual assistant, which nobody else had," Navarette noted. "As well, they offered significant support to analyze our patient population to determine who was best suited for the RPM program and to onboard them.

"We also are seeing enhanced clinical workflow efficiencies, especially fewer incoming calls to our MAs from patients. The RPM platform and our new clinical workflow have actually increased patient engagement, too."

Eric Navarette, Sweetwater Medical Associates

"An analysis was performed on our patient population with an automated proprietary tool that reviewed patient records for diagnosis codes associated with obesity and hypertension, as well as mapped reimbursement qualifications," he continued.

Then the vendor helped Sweetwater narrow the patient pool to those who had engaged the practice for an appointment within the last 12 months.

"The vendor team then began an outreach to gain consent from the patients to be included in the RPM program, which involved phone calls, emails and texts to eligible patients, explaining the purpose of the RPM program, how it works from the patient perspective and its benefits," Navarette explained.

"100Plus also handled the onboarding of patients," he added. "The appropriate connected devices were sent to enrolled patients, such as pulse oximeters to measure blood oxygen levels along with the blood pressure cuff, scale and glucometer. A significant portion of onboarding and patient communications was also done using the AI virtual assistant."

MARKETPLACE

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MEETING THE CHALLENGE

Sweetwater launched the RPM program in October 2021 with 100 patients and now has expanded the program to 240 patients.

"The readings are taken by patients in their home and automatically recorded within the provider portal, which can be viewed by providers, and the data can be shared with caregivers or family members, if the patient desires," Navarette noted.

"Providers and MAs regularly go into the portal to review the readings and to determine how the patient is doing or if they need changes in therapy and treatments," he continued. "Now patients can also access their readings on their smartphones through the recently launched new patient portal."

Checkup calls are made by MAs to the enrolled patients to discuss the results, when needed. So, essentially, it's the MAs on the frontline working with patients – the AI virtual assistant named Esper plays a crucial role, as well.

For patients, the virtual assistant engages with them. Many patients liken the virtual assistant to a person, offering nudges and/or accolades and delivering the perception of being supported, which can drive a sense of personal accountability.

By regularly measuring and personally seeing their key vital signs, Sweetwater staff believe this may also increase patient motivations to make healthier decisions in improving these biometrics.

The 100Plus RPM platform is not currently connected to Sweetwater's EHR, but that's in the plan for the future.

RESULTS

Sweetwater staff were thrilled with the RPM technology and saw impressive results in the first six months: Patients enrolled in the program achieved average systolic blood pressure reduction of 5.80 mmHg for those with hypertension and mean weight loss of 3.45 pounds for those with obesity.

"We also are seeing enhanced clinical workflow efficiencies, especially fewer incoming calls to our MAs from patients," Navarette reported. "The RPM platform and our new clinical workflow have actually increased patient engagement, too.

"One might think that's counterintuitive because we are using remote technology, but the efficiencies in taking the patient vitals, the near real-time flow of data and automatic recording of those readings in the patient portal are allowing our MAs to review the data and to reach out and engage patients armed with that data, whether it be a 'Good job' phone call to the patient or one that may require probing questions or changes in therapy or medications," he continued.

Either way, team members are reporting patient engagement has been enhanced overall, he added.

ADVICE FOR OTHERS

"Technology can be daunting," Navarette advised. "Look for technology partners that deliver a lot of support, such as the analysis stage to select patients in your patient panel who are well-suited for the RPM program, as well as the support to educate and onboard them – even supplying and distributing the connective care devices.

"The AI virtual assistant has been a game-changer, too, as this technology offloads a lot of tedious work for our small staff, streamlines our clinical workflow and enables enhanced patient engagement," he added.

Sweetwater sees technology as the future, and while it means changes, it's likely to result in change for the better, he reported.

"With AI-enabled RPM, we are streamlining our clinical workflow, improving our overhead and, most important, improving patient outcomes," Navarette concluded.

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