Hello and welcome to today's webinar, we're so excited to have you here joining us for how remote technology improves patient experience outcomes and creates ancillary revenue. Just a few housekeeping notes before we get started. All attendees are in listen-only mode and we're going to be using the Q&A function today to gather questions for our speakers. So as you have questions, please just drop those into the Q&A box and we'll be getting to those through the session. The webinar is being recorded and will be available in the AOE Learning Center and all registrants will be sent to that after this webinar. Today we have Mike Rodriguez who is the VP of Physician Partnership Development from PrescribeFit joining us as well as Ryan Pratt. So now I'm going to be turning it over to Mike to get us started. Thanks for joining everybody. Again, thanks for the introduction and I really appreciate the opportunity with AAOE to present our experiences with remote patient monitoring to you all. And Ryan, I'll let you introduce yourself as well, but I'm the Vice President of Physician Partnership so I handle all the new practice engagements within our Lifestyle Health Program with practices. And Ryan, would you like to introduce yourself? Yeah. Hi, I'm Ryan Pratt. I'm the VP of Marketing and Patient Outreach for PrescribeFit. I'm going to be helping out today running a few polls in the middle of this presentation. Thanks everybody. All right. So I'm going to spend the first 30 seconds of this call to describe kind of who PrescribeFit is and why we feel validated to be able to speak with you about remote monitoring. But also the main goal of this is to educate you on the opportunities within remote patient monitoring. Again, we're going to be providing a point of view within our experiences and how we're positioned within the market for orthopedics. But really the goal is for you to walk away with some thought processes on how to think about a larger strategy across the practice and also some takeaways as you're going into either evaluating new programs or maybe building out programs you're already working with today. So we'll talk through some of those benefits, some of the insurance nuances there, how you navigate the various models, and then our approach around Lifestyle Health and how we're working with orthopedics. We'll have some questions at the end, but there is the Q&A feature at the very bottom. Feel free to buzz a question in there. Ryan's going to keep an eye on that as I'm talking and interrupt me as needed there. We also have a couple of polls throughout, so we'll prompt you on those and Ryan will run through those once we get to those in the presentation. So all right. Thanks again. PrescribeFit is essentially a patient optimization company, and we're focused on the orthopedic market, really around the Lifestyle Health application for your practice. We work on behalf of orthopedic practices and have been doing so for almost four years now to really drive a Lifestyle Health program. You know, obviously there's a large prevalence of patients that could use the support to get healthier, and that's really where we fit as that ancillary partner. So, you know, whenever you think about remote patient monitoring to kind of frame the structure of this call, think about what is it that exists widely across your practice that your clinicians and physicians are counseling on, maybe referring out, but there's not really necessarily a mechanism to capture the value of the time spent or knowledge provided to those patients. So that's really a great starting point of how can I use remote patient monitoring to capture that experience? That's really a good use case scenario. Orthopedic practices really have excelled, especially in the private space, of providing a single source, a single point of care for their patients and connecting that care to make a very efficient and solid patient experience for the musculoskeletal issues. So, you know, it's far more efficient than large health systems, and again, remote monitoring is going to allow you to build on that strategy that's made private practice orthopedics successful to this point. So if you were wondering, you know, why are orthopedic leaders on a call hosted by a Lifestyle Health company, we hope that might answer some of those questions, and hopefully this framework helps you build out a successful program. So again, our framework is, you know, we want to play a role to help you with your obese patient population, and we use remote patient monitoring to do so, and it starts really here. You know, 40% of the population is obese. If you look locally in an orthopedic practice, it's closer to 55%. So these conversations are happening on a very consistent basis with your patients, and obviously the connections around obesity and musculoskeletal issues and complications further down the line. So, you know, as we talk about, you know, again, wider practice use, Lifestyle Health and optimization does play a role there. You know, if there is a patient optimization strategy currently in your practice, there are ways to support that around, you know, your pre-, the whole perioperative experience and postoperative, you know, whether it's decreasing BMI, helping patients navigate their diet and their nutrition, tobacco cessation, all the other pieces that impact outcomes. And more and more recently, there have been some studies around the benefits of Lifestyle Health as it reduces swelling and other postoperative complications. So definitely a piece to consider there. And if your practice is similar to other practices we talk to, we do hear often that, you know, the current mechanism is to provide some generic advice, whether it's a flyer or maybe they're referring across town to a bariatric clinic. And Duke did a nice study a few years ago around what makes a program successful for patients. And it's really finding a program that is overseen by the physician that is monitored. That's kind of the basis of it. And then, you know, what that does is it's driving motivation. It drives patient compliance and adherence. And it does hold them more accountable. So having a connected program does prove out to be a lot more beneficial for your patients. So quick introduction there, and let's start with our first poll here, Ryan. Yeah. So we've got three polls here today, each of them just going to have two questions. So this first one, I'll read these to you as you look at them, give some time to answer. What percentage of your patients have a BMI at or above 30? So just a guess is fine. You may not know this off the top of your head. And then the second question, what words would you use to best describe your weight loss advice today at your practice? And that one is multiple choice. So you can select any or all that apply there. Okay. We've got some answers coming in, and it's looking like 50%, which is about what we hear. 55%, as Mike mentioned earlier, is usually what we hear at orthopedic practices. There's definitely a growing trend there. And then second one, what words best describe your weight loss advice today? A lot of generic, a lot of people saying generic, and some people saying non-existent, which again, we've done a webinar similar to this a couple of times in the past, and we get a lot of that. Great. Good framework there. So sounds like you're fitting with what we already know. Sorry, here, let me back out of this. So again, remote patient monitoring allows for that virtual connected care. So you're really able to see the scale and efficiency that whenever your physician is making a recommendation to a patient or prescribing a particular care path for that patient, where they can leave the clinic, but still have connections to the clinic and their care team throughout as they're on their journey. So in a weight loss example, lifestyle health example, this is kind of how the flow of lifestyle goes, right? You have certain events where you're on the wagon, then all of a sudden something happens and you start to gain weight again, or you fall off some of your habits you've developed. But having a connected individual or person within the practice to keep monitoring you and making sure you're staying on track, keep providing a personalized program to making sure that you're having a convenient mechanism for completing those tasks at home. That's really where remote patient monitoring can play a nice role. Oftentimes we hear, I don't know about our patient population, I don't know how well they would really adhere to something that's virtual or remote. And I think COVID really kind of exponentiated the need for it, but patients are very comfortable with virtual technology and especially something that's connecting them back to their health care provider. 62% of patients are saying they'd choose a virtual program for wellness, 88% saying a device monitoring at home would help them manage their health. We have similar results with even the elderly population using this technology very easily. It's a convenient option and it does drive compliance whenever you really connect the whole path. So whether it's injections or PT and lifestyle health and having everything under one umbrella managed by their ultimately their physician makes a very seamless and connected experience for them. Talking a little bit about the RPM industry as a whole, where we fit in the health care industry is underneath telehealth, but it does have its own family member. So there's two family members, it's physiologic and therapeutic. It's important to know kind of how these two play together, especially if you haven't gone down this path yet, there are differences in how they're regulated. Physiologic monitoring, obviously you're tracking physiologic metrics. For our program, we're tracking weight and therapeutic monitoring, you're tracking things more like PT or range of motion, or if it's a connected implant, that will be under the RTM category. Probably if I had to call out a couple key pieces of the differences is you've got general supervision versus direct supervision. So general supervision allows for a full remote team to execute a plan on behalf of your physician. So for PrescribeFit, we can employ a whole coaching team that works directly for your physician with their patients, but they don't have to be in your office, you don't have to be supervising them, that's on us to supervise and adhere to the standards of quality there. The direct supervision with therapeutic codes, you'll need to have somebody in your clinic, it's a little bit more manual process there. And usually you'll see that within like a PT department, maybe there's an individual there that's assigning those therapies and tracking those and doing the billing on that. The other piece is, you know, which patients qualify? So is it something that can be used, you know, largely across patients regardless of specialty or if they're operative, non-operative, or is it a smaller subset of patients? The other side is compliance and retention. You know, are patients going to show up to the sessions? Are they going to stick with it for the minimum guidelines that CMS outlines? And I'll cover what that looks like. And also with the retention standpoint, you know, these are monthly codes, so how long can you keep patients in the program? So all of those are good considerations whenever you're considering which family member to start with. They can be used in conjunction, but there is some nuance there as well. poll number two. Another two questions here. First one is, are you considering remote patient monitoring technology today? Pretty straightforward. Second question is, what's most important to you when evaluating innovative new services or solutions for your practice? And that one, again, is multiple choice, so you can select as many as you feel apply there. I'm surprised you attended this webinar. I assumed that you were considering remote patient monitoring technology. Majority of you are saying that. We do have one person who says not seeing a need to get at their practice. And we've got a couple that are already using RPM technology as well. All right, and then second question. Lots of answers here. It looks like top two by far are ease of implementation for your practice. In fact, that's 100%. Every single person has said that so far. And cost to practice is another big one. After that, we've got ease of use for patients, ease of billing, and ongoing physician staff time required. But yeah, ease of implementation is by far the number one there. Yeah, not surprising there. I think every practice we talk to has a lot of demands put on it. And I think they're only growing with staffing issues that are still seeming an issue. So that plays nicely into our next slide here where thinking about the service level. So service level varies widely across these programs from kind of a self-serve to all the way a full service. I'll cover what full service looks like. And then you can kind of iterate based on your own imagination for the other models there. But every vendor comes with two pieces here. So you're either going to have a mobile app and or a device. You have to have some device that's tracking the data from your patients. Now the app is a feature. And depending on how much interaction the vendor has with the app is whether or not the patient has a relationship with the app or with an individual that's also guiding the app. So for example, if you have a coaching service that's using an app to drive the coaching program, then that would be a little bit more of a one-on-one human interaction than just a mobile app interaction with the patient to collect the data. But then the other aspects of the program are kind of what you're describing or answering in your poll where, you know, implementation, who's going to help with that? What's the ongoing demands? What all do we have to worry about around data collection and auditing and really getting patients into the program and a seamless experience to where they have a good experience and it reflects very positively on the practice. And so all of those items really do fall under a full service program. If you're looking at it, you know, who's going to handle patient education and outreach, all the IT related issues that can and ultimately do come up, are they going to handle it for you? Is it going to be falling on your team? Where is all the data that supports your billing and really leads to your clinical decision making? Where does all that live and how easy is that to access for your team there? So that's really when you think about full service is you have your practice doing everything that it currently does, and then your remote patient monitoring vendor really sets up like its own ancillary department so you can offload that workload to them. And that's kind of what I touched on here is really think about remote patient monitoring as a ancillary that you're going to set up as its own department. That's really where we see these programs work well. As we'll talk about in the next slide here, there's not a ton of money in remote patient monitoring reimbursements, but there's enough there to where you can provide a streamlined service. It can cover for itself without having to exhaust a lot of resources that you already have on your team. So this is the physiologic code set. Therapeutic codes are going to reimburse generally the same. They do have some of the same metrics needed to achieve to be able to bill for these. So every, you know, every, both sets are going to have your one time patient setup and education. And then on a monthly ongoing basis, you're going to have a transmission of data and then 20 minute increments of interpretation and management. So at a national average, if we're just using Medicare, you know, commercial is showing to cover this, you know, there is some nuance with it, but again, you know, how you approach all the payers is another strategy in itself. But the 16 days on a 30 day period is what your 99454, your transmission of data. And so that'll be similar to the RTM equivalent. You need to, patient needs to register their data 16 days out of a 30 day period to use that code. And then your 20 minute increments, you know, depending on what service you're going with. If it's a coaching program, you know, we meet with patients 15 minutes a week, and then we have charting and other things in addition to that. So, you know, we hit the 80 minutes, the majority of the time each month. You know, others that are maybe more tech heavy on their collection, maybe they have a little bit less for these, these interpretation management codes. Our program has a patient retention rate of nine months. So if you apply that, you know, these reimbursement potential to a nine month population, and if we just use a hundred patients for a practice, you can see what your revenue potential is there. I'm sure there's going to be some questions around that. So let's go ahead and do this third poll. Yep. Yep. Last two questions. We'll get through these pretty quickly here. We got like 10 minutes left. So first question, how many patients does your practice see per week, both surgical and non-surgical? And again, just a guess or an estimate here, trying to get a feel for if the audience is at really large practices or smaller independent practices. Second question, what percentage of patients are covered by Medicare or Medicare Advantage plans at your practice? So again, another guess here, it's like we've got people for some pretty decent sized practices. Quite a few around a thousand patients and actually quite a few are responding between the 5,000 and 10,000 patients, so it's pretty big practices. And then percentage of patients that are covered by Medicare or Medicare Advantage plans. It's looking like the average is 26 to 50%, which that's pretty typical. That's what we see from most of our partner practices. All right, great. So next slides here cover really what's the opportunity. So we picked one practice and ran a case study with them over a two-year period, and this is what we would call kind of an optimized practice. It's a nine-physician group, all physicians participating, and we've rolled out to both Medicare and commercial payers. So the practice has seen $1 million in reimbursement utilizing the physiologic codes. Compliance rate, very high there, 91%. Reaching that full 60, so 60 minutes was actually back early on when we did the case study. It's now 80-minute potential, but 86%, we're actually reaching that full 60. Actually whenever we've been running data the past few months, we're over 90% now with our 80 minutes for the program each month. And again, as we go through the insurance stages of how we're vetting insurance and which programs play well with the RPM codes, we're at close to 94% acceptance rate there. On a clinical standpoint, you've got really awesome results. Patients respond well to a weight program when it's driven by the orthopedic physician because they've got a couple things motivating them. One is pain. The other is really activity levels, right? I mean, same reasons patients are coming in to see you to improve their activity level is really the same reasons why they need to improve their lifestyle health. So for a single orthopedic practice to really claim this at the time of the study here is pretty impressive. We're 6,000 pounds lost, up to almost 40% of their body weight loss at the kind of peak of the curve there. And then we're also tracking pain. Pain is relative to weight and diet, and we do see a nice reduction and improvement in those pain scores. From a patient perspective, the average age is 67, so elderly population using this technology and interacting virtually very easily in a seamless fashion, 192 days in the program. Retention is, again, I'll emphasize it again, is a very important piece of having a successful remote monitoring program, keeping patients engaged longer term with the practice. Oftentimes physicians, if they're a little bit more conservative with the recommendation, they might lose some patients to follow up if they're saying, hey, you need to go lose some weight before procedure or come back and see me in three or four months. There might be somebody else in town that'll do that procedure. So here's something that you can really provide and keep them engaged with the practice while they prepare for a procedure. So I'll close with this, is when we're thinking about a program, this is kind of the top three questions that I would ask your vendor, and it sounds like answering some of your poll questions, it would apply to you as well, is the demands of implementation, ongoing support, really knowing that you're not really going to necessarily have an extra headcount to manage this successfully, especially. And what results? Retention, compliance, and that coding potential are probably the top three when it comes to financial and also experience directly relates to retention. If patients are having a good experience, they're going to stay in the program. And then how do you ensure long term success of the program for the practice? That is a key one. Are they giving you a partnership program or are they giving you sort of an out of the box program and letting you run it on your own? So from there, let's answer some questions. So we got about four minutes or so. Yeah, I haven't seen any pop in there yet. Okay. Yeah, we've got a few minutes here. Obviously, if you think of something afterwards, Mike's email address is right there on the bottom of the screen. So don't hesitate to shoot him an email later too. Nothing. No questions. No questions? All right. Well, maybe I did a good job. So it's been an interesting, you know, probably I'd say two, two and a half years or so where we've seen a real increase in remote monitoring. I mean, even two years ago, I was explaining what it was. Now it really seems that practices are starting to have an interest, starting to see more players in the market, providing services and really trying to find, you know, what's the best home for this type of service in our practice. So if I can help with, you know, even just giving you some more information over our four years of experience, let me know. No pressure there. Just, just happy to help and, and show you what type of efficiencies can be gained with this program. So. All right. Well, you'll see Mike's email on the screen. So if you do find that you have follow-up questions, definitely keep that to file. Want to thank Mike and Ryan so much for putting this presentation together for everybody. As I said at the beginning, this recording will be available and the link sent out to everyone post-webinar. If you have other questions in the meantime, don't hesitate to reach out to Mike or reach out to us at education.AOE.net and we're happy to help. Thanks everyone. Have a great afternoon. Thank you. Appreciate it.

remote technology

patient experience outcomes

ancillary revenue

orthopedic practices

remote patient monitoring

virtual connected care

reimbursement potential