The Impact of Regulatory Changes on the Expansion of Remote Patient Monitoring and Its Potential to Transform Telehealth Post-Pandemic

Remote Patient Monitoring (RPM) is a way to collect health information from patients using digital devices outside of the doctor’s office. Devices like blood pressure monitors, glucose meters, pulse oximeters, and heart monitors are common. These devices send health data to doctors either all the time or sometimes. More doctors used this method during the COVID-19 pandemic because it helped keep patients safe and allowed care from a distance.

Telehealth is a broader idea. It means giving medical care through video, phone, or other technology. From January to March 2020, telehealth visits in the U.S. went up by 50% compared to 2019. In late March, visits increased by 154% because many people stayed home to avoid the virus.

Regulatory Actions During the Pandemic Expanded Telehealth Access

At the start of the pandemic, agencies like the Centers for Medicare & Medicaid Services (CMS) made new rules to help telehealth and RPM grow. These included:

• Allowing doctors to treat patients across state lines.
• Letting patients use telehealth from home, not only from special clinics or rural areas.
• Paying doctors the same for telehealth visits as in-person visits.
• Making more types of healthcare providers eligible to offer telehealth.
• Permitting phone-only visits without video.

These changes made telehealth more popular among many patients. For example, 63% of telehealth visits early in 2020 were by women aged 18 to 49. COVID-19-related telehealth visits grew from 5.5% to 16.2% in March 2020. Telehealth helped reduce visits to emergency rooms, keeping hospitals less crowded and reducing infection risk.

At the state level, over 22 states passed laws or orders requiring better telehealth insurance coverage. Many included payment equality and coverage for phone visits. These efforts aimed to help people who have trouble getting online or using technology, like older adults or those with mental health needs.

Remote Patient Monitoring Gained Strong Momentum with Regulatory Backing

RPM moved from being a minor tool to a common method for managing long-term diseases like high blood pressure, diabetes, and heart disease. CMS data shows that payments for RPM grew from $5.5 million in 2019 to more than $101 million by 2021. That is almost 19 times more. Also, 34 state Medicaid programs paid for RPM by early 2023, although some have limits on coverage or which providers can offer it.

Research showed RPM helps:

• Mayo Clinic found high-risk COVID-19 patients using RPM had fewer emergency visits, fewer ICU stays, fewer hospital stays, and lower death rates.
• A Cleveland study reported an 87% drop in hospital stays and 77% fewer deaths for COVID-19 patients who used RPM after leaving the hospital.
• Mass General Brigham showed RPM helped people with high blood pressure lower their numbers and cholesterol.
• UC Davis found managing medication remotely through RPM improved heart patient care more than usual methods.

These findings show RPM helps find health problems sooner, manage chronic diseases better, and keeps patients involved by letting them check their own health data.

The Approaching Telehealth Policy Cliff and Its Implications

Even with good progress, many of the relaxed rules during the pandemic will end on September 30, 2025. This “policy cliff” could undo many gains by bringing back older limits like where telehealth can happen and how doctors get paid.

If no new laws pass, changes may include:

• Going back to limits on where patients can use telehealth, mostly in rural or certain clinics.
• Stopping Medicare and Medicaid payment for Hospital at Home programs, forcing providers to pay costs or stop home care.
• Cutting back on telehealth at federally qualified health centers and rural clinics.
• Removing some providers like occupational, physical therapists, and audiologists from getting telehealth payments.
• Limiting phone-only visits to certain groups like people with substance use problems or dialysis patients.
• Making mental health patients see providers in person before and during telehealth treatment.

Health administrators and IT managers must prepare for these changes. They should study how patient visits, revenue, workflows, and technology might be affected. Good communication with medical staff and patients, financial checks, and backup care plans will help.

Integration Challenges and Opportunities with Electronic Health Records

RPM produces a lot of patient data. In 2021, 78% of office doctors and 96% of hospitals used certified electronic health records (EHRs). These systems can combine RPM data with patient records to help care teams work together.

Still, the large amount of data can overload doctors, causing “alert fatigue,” which means they get tired of too many alerts and might miss important ones. Mayo Clinic created command centers with staff who sort RPM data to find urgent issues. Artificial intelligence (AI) tools help with this, too.

AI and Workflow Orchestration in RPM and Telehealth Management

AI and automation help manage RPM and telehealth data better. AI can pick out important alerts and reduce work for providers. For example, Oracle Health uses AI to analyze live data and highlight what needs action to help doctors decide quickly.

Automation also improves front-office tasks such as:

• Automatically scheduling appointments and follow-ups based on RPM alerts.
• Prioritizing patient calls or messages when readings are unusual.
• Starting medication changes or telehealth visits through integrated care plans.
• Helping patients learn and fix problems using AI chatbots.

Companies like Simbo AI use AI to manage patient phone calls about RPM alerts, schedule urgent visits, and guide patients without adding work for staff.

For health care managers, using AI and automation can lower costs, make patients happier, and improve workflows. They must keep data safe, follow laws, and give training and help to staff and patients. The American Medical Association says patient trust and quality data need good training and support.

Sustaining Telehealth and RPM Post-Pandemic

The growth of telehealth and RPM during the pandemic was large, but keeping these programs needs dealing with upcoming rule changes. Some states made permanent rules for phone visits and payment equality but these vary a lot. Insurers’ future willingness to pay will affect how doctors keep using virtual care.

Medical leaders should watch policy changes, especially from CMS and Congress, about telehealth rules. The National Consortium of Telehealth Resource Centers suggests organizations study how patients are affected, update care rules, and plan backup care options.

Collecting data is important to prove telehealth should stay. For example, Oregon used records showing a 3,000% jump in telehealth use in 2020 to support laws. Studying telehealth’s effect on access, cost, and health is key, especially for poor people or those with limited English skills who use telehealth less. These groups may need special help and information.

Remote Patient Monitoring’s Broader Clinical Applications

Besides chronic disease care, RPM is growing in areas like checking patients after surgery, maternal health, rehab, and lung care. Devices that give constant or near-constant data let doctors quickly change treatments when needed. For example:

• Mayo Clinic uses remote ECG devices to watch the heart rhythm of rural patients, cutting down on office visits.
• UC Davis found adjusting medications remotely helped heart patients without office visits.

This shows RPM can keep care going and reduce hospital visits and readmissions. For practice leaders, using RPM in more services can grow care options and keep patients coming back.

The Role of Medical Practice Leaders in Adapting to Change

Medical administrators, owners, and IT managers play key roles in adjusting their organizations to healthcare changes:

• Check how telehealth and RPM affect clinical and front desk work.
• Use AI and automation to improve phone calls, data sorting, and patient contact.
• Follow data security and privacy rules to keep patient info safe.
• Provide ongoing training for staff on new tech and workflows.
• Help patients with clear instructions, technical support, and easy tools to encourage use.
• Create clear plans to explain policy changes and financial effects.
• Work with insurance companies and lawmakers to support lasting telehealth and RPM payments.

Good management of these points can help health organizations keep benefiting from telehealth and RPM, even as rules change.

Final Remarks

Rules for telehealth and remote patient monitoring are at an important point. Relaxed laws during the pandemic allowed these services to grow quickly, but upcoming changes will create challenges. Preparing now is important for medical practices and health systems. Using AI and automated workflows can help manage data, reduce staff load, and keep quality care during these shifts.

Healthcare leaders in the U.S., especially those relying on remote care, will need to watch carefully, stay flexible, and invest in technology and training to keep telehealth and RPM programs going.