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Remote Patient Monitoring for Oncology

With the emergence of telemedicine as a routine form of care in various venues, the opportunities to use technology to care for the most vulnerable, most ill cancer patients are extremely appealing. Kencor’s technology and ecosystem excels in this area, providing both the healthcare provider and the patient care and service that is unmatched in the industry.

Patients no longer need to rely only on in-person visits to help manage their cancer care. Remote monitoring technology from Kencor allows us to track how your treatments are progressing with the assistance of SAMi™ and Bluetooth-enabled devices such as weight scales, blood pressure devices, and pulse oximeters.

These remote monitoring devices track valuable patient information that doctors can review and use to make treatment changes and updates. Blood pressure, oxygen or glucose levels, body weight, body fat — all of this vital data can be captured and sent to a care team as data over a secure connection. Remote monitoring of oncology patients’ symptoms using digital technologies may be a cost-effective method of improving outcomes. Remote monitoring typically involves recording patient symptoms and vital signs, and then uses algorithms to detect changes in these measures.

Enhanced Patient Engagement

Patient engagement is patient participation, empowerment, knowledge, willingness, collaboration, and self-advocacy. As it is of the utmost importance with regard to oncology, patient engagement is also inclusive of the patient’s family and caregivers. The pressure on healthcare practices to adopt a culture of patient engagement is gaining momentum, mainly as a means of improving patient satisfaction, improving clinical outcomes, and reducing costs and it leads to greater patient satisfaction and empowerment, and thus an improved patient experience.

Choosing the right technology platform is a key factor in successfully achieving patient engagement. Kencor improves patient-provider communication; allows access to and review of test results; allows appointment scheduling and prescription refill requests; grants access to handpicked, trustworthy, and accurate online healthcare information. Most patients with cancer (80% or more) are willing and able to regularly self-report patient-reported outcomes (PROs) during treatment.

The Kencor SAMi™ Oncology Dashboard is a full-featured interface where you healthcare team, medical professional, and doctor can closely monitor your vitals and make adjustments when you need them most.

Benefits for the Patient

  • Personalizes and enhances the patient experience
  • Empowers patients
  • Improves health-related quality of life (HRQL)
  • Decreases distress
    • Information at patient appointments is often overwhelming for the patient and/or caregiver, especially the initial consultation. Such information would be easily accessible at any time for the patient to review.

Benefits for the Healthcare Provider

Improves practice efficiency, workflows, clinical outcomes, and survival

  • Remote patient monitoring is especially important during treatment and in the immediate post-treatment period
    • Oncology Hospital at Home (HaH) programs allow at-home cancer care as opposed to more traditional outpatient and inpatient cancer care. HaH programs are gaining popularity. RPM is a critical tool for a successful HaH program.
  • Patient education (for example, chemotherapy and radiation teaching, survivorship, etc.). These are often time-intensive in-person appointments and may include multiple staff (MD, NP, RN).
  • Triage
  • Allows direct communication from the patient to the care team and therefore bypassing administrative/non-clinical staff
  • Allows direct communication from the care team to the patient re: appointment reminders, medication reminders and/or changes
  1. Improves clinical outcomes, namely reduces ER visits, lengthens the time patients tolerate cancer treatment, detects recurrences earlier, and improves survival
  • Ongoing PRO-TECT trial designed to test nationally whether patients' outcomes and utilization of services can be improved through symptom monitoring via patient-reported outcomes between visits
    • Randomized trial, 50 sites. Enrollment of over 1000 patients
      • Outcome measures will include physical functioning and overall survival as well as several additional secondary measures
  1. Improves survival
  • Two randomized controlled trials (RTC) demonstrated overall survival benefits when integrating PROs into routine cancer care
    • RCT at MSK led by Dr. Ethan Basch studied the impact on clinical outcomes using symptom monitoring. Total enrollment of 766 patients from 2007-2014. Patients in the intervention group were prompted on a weekly basis to report on 12 common symptoms using the web-based Symptom Tracking and Reporting (STAR) platform.
      • Results showed an improved HRQL, less frequent ER admissions, longer duration of chemotherapy, and a slight survival advantage (approximately 5 months; P=0.03) in the intervention group
  • Recruitment from five centers in France from 2014-2016, total of 121 patients. Survival benefit in the control group of approximately 7 months (22.5 months in the intervention group vs. 13.5 months in the control group; P = 0.005)
  1. Reduces hospital admissions, ER visits, and treatment delays
  1. Improves patient compliance and adherence and, subsequently, health outcomes
  1. Improves satisfaction by remote monitoring of patient-reported outcomes (PROs)
  • Breast cancer pilot study in 2019 showed electronic PRO monitoring improves satisfaction
  • Monthly questions using NIH PROMIS
  • PRO monitoring can be an important tool to transform the survivorship care plan from a document to an active process of proactively monitoring symptoms and adherence
  1. Decreases the outmigration of dissatisfied patients
  1. PROs are increasingly evaluated in randomized clinical trials
  • No consensus on methods of PRO analysis

Positive financial impact

  1. Reduce costs
  • Symptom monitoring with PROs during cancer treatment. MSK randomized controlled trial of over 700 patients
    • Less frequent ER admissions in the intervention group (34% versus 41%; P=0.02)
    • Less hospitalizations (45% versus 49%; P=0.08)
    • Remained on chemotherapy longer (mean, 8.2 versus 6.3 months; P=0.002)
    • Allows for earlier medical intervention, patients maintain greater level of function, and increased treatment compliance
  • Decreases overall number of “no-shows.” Patient engagement leads to improved patient compliance re: appointments, tests, etc
  1. Value-Based Payment Model
  • CMS Innovation Center released details of Oncology Care First (OCF) for public comment in November 2019
  • New form of prepayment that encourages cost reduction
  • Electronic patient reported outcomes (ePROs) would be required
  1. CMS final guidelines for remote monitoring
  • Expanded reimbursement for RPM delivered “incident to” general supervision
  • CPT Codes 99453, 99454, 99457, 99458
  • Guidelines are more favorable; however, some questions remain