Costs are Related to What you Want
Let’s discuss something that is very close to everyone’s hearts when assembling any Remote Patient Monitoring (RPM) package. The costs. Even when it’s recognized that RPM is cost effective due to the advantages it provides in increased savings and revenue, the actual capital and operational costs are of interest to anyone thinking about going remote. Because of all the hardware, software and service components of a RPM program, there is no one straightforward answer as to the costs of building and maintaining a RPM package. But by understanding what is it that you want from the system, you can expect a wide range of annual costs per patient. We’ll explore what each of those things are, and how they add to your overall cost. This way, there are no surprises, no hidden fees, rather you get an accurate understanding of the type of remote patient monitoring kit that is possible to assemble.
Wide Range of Costs
One of the world’s leading authority of remote care, The Journal of Telemedicine and Telecare found that equipment purchasing, servicing and monitoring cost of RPM programs ranged from USD $275 to USD $7963 annually per patient. They discovered that monitoring multiple vital signs was more costly than monitoring a single vital sign, and that costs had generally decreased over the years due to cheaper technology. This clearly demonstrates that all programs are not the same, and the price tag is a reflection on what you include in the program. From exchanging with vendors in more recent times, that aforementioned range of prices is unfathomable at both ends. We turn to Software Advice, that list all the major remote patient monitoring software in their site, for a far narrower price range of $1000 USD to $2000 USD as the avg. annual cost per patient.
Why is The Unit Per Patient Per Year?
Devices used to measure vital signs may be reused or used at the same household for more than one patient. But every patient will have their own patient portal where they can upload their readings and where their care plans can be managed remotely. Thus, it makes sense to quote costs per patient. Having a kit for every patient is cost prohibitive, says Ravi Ramani, Cardiologist at UPMC. So it’s important you decide which patients get the kit to prevent your budget from ballooning. But it’s true that the price per patient decreases with the volume of kits ordered due to economies of scale. So organizations have to find that optimal point, but that doesn’t change that costs are best reflected on a per patient basis. On quoting price annually, it makes more sense to do so to offset the cost of equipment purchase or lease over a period of time, in this case a year.
Some Considerations to Start with That Will Affect Costs
Buy or Lease?
You can choose to either buy or lease the kits, that include the software, the vital signs measuring devices, and the mobile devices where the software will be installed or downloaded. If you lease the kits, you are not concerned about what happens to the devices when your lease contract is up. You are free to renew the contract, choose another vendor or shut down the project. But if you choose to buy the kit, where after the end of the contract you end up retaining all the devices, then you would want to make sure that you can reuse those devices. Leasing is obviously cheaper on the short run as you are not paying for the ownership of devices, but buying is cheaper on the long run. If buying, make sure you understand how the cost of equipment or devices is paid off, because once paid off, there should be a decline in monthly costs.
Open Architecture vs Lock In
Open architecture technologies ensure that a client organization is able to choose the different components that are used to build a RPM program. There is interoperability between software and devices of the program and other external software and devices. This ensures that there is no vendor lock-in, enabling the client organizing the pick and choose which components of the program it wishes to retain, and which components it wants to upgrade. Open architecture is cheaper than lock-in the sense that it gives you wiggle room to assemble a cost-effective RPM kit.
We will break down the costs into the following components:
Set up and Training
It is great to use something out of the box. Is also cheaper, because everything is standardized beforehand as to the setting up of the devices and software. But what if white glove assistance during this stage is required such as the customization of software to reflect bigger letters. Such type of white glove assistance is available, and it would be covered in any set up fee component of service. Having help during the initial roll out period is a source of relief for organizations who have not done this before, and it is worth the set-up fee. There is also the question of level of integration, where you can just exchange patient demographics or incorporate RPM workflow directly into the EMR window. Expect to pay more if you require extensive customization and integration. Training sessions are normally offered as a part of the quoted package for free. You only pay if you need extra hours.
Sensors, AKA the measuring devices
Sensors are synonymous with the devices that have them which measures the patient’s vital signs. Broadly, there are wearable devices and external devices. Both are wireless. Wearables are generally more expensive such as smartwatches fitted with activity, sleep and pulse detector or smart patches that you attach to a part of your body that collects other signs. If they are wearables from a recognized company, they are harder to integrate with.
Subscription and Maintenance Fees
If your selected partner has both a patient facing software platform and a doctor facing platform, the end price will be higher. The patient facing platform will allow the patient to see a digitized version of their care plan, how the readings they have been taking fit into their care plans, receive reminders from their care team, etc. Also, once the information is collected in the software, it can be transmitted to the care teams via internet. If you do not need a patient facing software platform, then there are devices out there which transmit the information directly to the care team, but the patient is in the dark about what is going on. On the physician’s side of things, they may get a similar or different interface that allows them to remotely communicate and coordinate care for their patients. One thing that will be very different on their side however is the availability of a dashboard, where they can centrally see patient data and perform analysis as necessary. This is considered a value addition, and the availability of such a dashboard will raise the prices.
Mobile Devices and Connectivity
Smartphones and tablets are the preferred mobile devices in remote patient monitoring programs. Tablets are cheaper than smartphones. But smartphones are more ubiquitous, meaning your patient body may already have such a phone, or even if they don’t, it can be fair to pass the costs down to them by asking them to get one. But from a user experience point of view, especially for the older population, a tablet is always better. So if you decide on having a component of the budget dedicated to devices only, tablets would be the way to go.
These is connectivity aspect to these mobile devices, where they have to receive information from the vital signs measuring devices and transmit that information to the physician facing platform. It is common for the first part to be done via Bluetooth, where the device and the platform in the smartphones or tablets are integrated. But in order for this data to be transmitted, either Wi-Fi or a cellular connection is required. Wi-Fi is cheaper, while a cellular connection is more expensive.
There are levels of customer support. The price will vary depending on the immediacy and frequency of help received. Some firms will have a ticket-based system only, where immediate communication is not possible. Others will make chat lines/phone lines available at all times to get the help that you need. If you anticipate support to be a big issue, then perhaps going the concierge route may be the best option where you are assigned a dedicated support person. This will carry the heftiest price tag out of the three.
What About Staff?
This may be reaching a bit outside a RPM system as traditionally staffing is not part of the costs of a remote patient monitoring kit. But for planning any project and calculating ROI, employing staff who will be managing the system is a big part of the cost equation. Dr. Kvedar, Founder and Director of The Center of Connected Health says one telehealth nurse can manage about 80-100 patients. So if you are interested, you can divide their yearly salary by 80 –100, to get an idea of the annual staffing costs per patient.
Be Wary of All Costs
We hope you found this post useful in understanding all costs you have to take into account when deciding on a RPM package. It is recommended that you separate upfront investment and variable costs, versus calculating it together as variable costs. That way, you know exactly what you are being priced for. RPM packages or kits are designed to be flexible solutions, so if you don’t inquire about the cost breakdown, vendors will be only too happy to sell you package without justifying the price. At the end of the day, RPM by nature is a cost-effective approach for the lifetime management of the patients so you are expected to recoup the costs and achieve great returns on your investment. That is all the more reason to know the ins and outs of what you will be getting for the price that you will be paying.
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