Digital

Digital Health Implementation Playbook Step 7: Designing the Workflow

Overview

Document an updated workflow for remote patient monitoring (RPM). This will likely require changes to your current clinical protocols to ensure that you are efficiently managing your staff’s time amidst their new RPM responsibilities. Consider how to use your EHR to simplify communication and ensure staff members have access to resources and clinically relevant RPM data to execute and adapt patient care.

Quote

"You have to intimately understand and appreciate how a process works from the perspective of the patient, providers and caregivers and each operational stakeholder before you can improve or replace it.”

—Omid Toloui, Vice President of Digital Health, CareMore

Goals to accomplish

  • Engage the Implementation team (specifically, an IT representative) to provide input on workflow design
  • Document your existing workflow
  • Identify updated procedures necessary for RPM, such as patient identification, patient training, device management, data monitoring and analysis, interventions and billing
  • Define what data points are clinically relevant and protocols for how “clinically relevant data” will be identified and communicated to the appropriate care team members
  • Ensure bandwidth to perform new responsibilities (streamline procedures, automate, outsource, hire new staff)
  • Assign accountability for any new actions necessary for integration
  • Document a new workflow that incorporates necessary changes across departments
  • Engage your IT team and/or vendor to understand how to best integrate your workflow into your EHR
  • Develop resources to support and socialize the new workflow (written procedures for each department, patient tracking documentation, communication templates)
  • Collect staff feedback and iterate as necessary

Why designing the workflow is important

Remote patient monitoring often alters practice interaction with patients. A clear workflow is vital to ensure everyone understands their role and how to maximize the value of RPM through procedures that:

  • Streamline the patient experience to drive adherence and accurate data collection
  • Manage and analyze incoming data
  • Detect and report clinically relevant data to the appropriate care team members
  • Facilitate clinical interventions and changes to care plans as necessary

Best practice

Ensure your workflow addresses the RPM-specific requirements below. Then, when adapting your organization-specific workflow, consult the Workflow Design Checklist in the resources for specific considerations.

  • Patient Engagement and Education: identifying and enrolling patients, tracking eligible patients, fielding patient phone calls, supporting patient troubleshooting, reminding patients to participate, etc.
  • Device Management: inventory, distribution, tracking, cleaning and calibration
  • Data Monitoring: reviewing incoming data, discussing data with patients, flagging areas of concern, etc.
  • Managing Interventions: making medical decisions based on data, reaching out in emergency situations, discussing medical changes with patients, etc.
  • Coding and Billing: knowing codes available for RPM, integrating CPT codes into the EHR, understanding documentation requirements, etc.

Avoiding a misstep

Protect physicians from an overwhelming influx of data. Identify a process to quickly identify medically relevant data requiring their attention, by:

  • Defining protocols and empowering staff to work at the top of their medical licenses, especially when it comes to patient engagement and initial data analysis
  • Utilizing your vendor as a resource for data screening and analysis
  • Partnering with third-party data analytics or monitoring service to identify clinically relevant data points and escalate based on protocols

Quick tip

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If immediate EHR integration is not feasible at your organization:

  • Have a specific and timely plan for how and when integration will happen
  • Identify phases of integration, if necessary, which will allow you to get basic functionality in a timely manner, even if full integration will come later
  • Align with your vendor about when and how integration will occur
  • Earmark funds to finance future integration
  • Identify a temporary workflow that will allow your staff to manually transfer data into your EHR
  • Be transparent with your staff about how and when the EHR integration will occur and how this will impact workflow

Practice spotlight

When Froedtert and the Medical College of Wisconsin decided to implement remote patient monitoring for diabetes and hypertension, they needed to develop a complex workflow across multiple departments. Representatives from each pivotal department assembled to collaboratively map the workflow. Each department’s specific role was defined, and standard communication templates were created to ensure consistent documentation and efficient handoffs between departments. Each department also created internal workflows that delineated specific communication procedures at each handoff point. One master workflow was compiled and communicated to ensure all departments understood how their actions impacted the other departments. The team continued to improve the workflow through weekly meetings.

—Rachel Drury, Pharm. D, Ambulatory Pharmacy Coordinator at Froedtert Health

Resources

DOWNLOADS

Playbook: Step 7-Design Implementation Workflow

Now that you have completed Step 7 in the AMA Digital Health Implementation Playbook, continue with Step 8: Preparing the Care Team. You can also go back to Step 6:  Contracting, or visit the playbook main page to review all 12 steps.

AMA Digital Health Implementation Playbook

Download the Playbook to review all 12 steps to implement and scale remote patient monitoring in practice.