5 ways remote monitoring can improve patient care for clinicians
Embracing remote patient monitoring for patients with chronic conditions is a crucial step forward in healthcare. In a new podcast episode of Cadence Conversations, two clinicians from Utica Park Clinic in Tulsa, Oklahoma discuss the numerous benefits of using Cadence's program for both patients, as well as healthcare providers.
Dr. Matthew Else and nurse practitioner Devon Morris are utilizing the Cadence program with their patients at Utica Park as part of the recently announced partnership with Ardent Health Services. Throughout the podcast, both clinicians described how their patients are more engaged with their daily health, how they are experiencing fewer ER visits and hospitalizations, as well as the ease of making remote medication adjustments using Cadence's program.
For clinicians, according to Else and Morris, Cadence can significantly improve the management of patients with chronic conditions, such as hypertension or type 2 diabetes, while simultaneously reducing administrative burden and improving their workflows.
If you are a clinician who is considering utilizing Cadence with your patients, or you are a clinical leader interested in whether Cadence's program is a good fit for your health system, you can learn more about Cadence's program here.
Here are the five ways that remote monitoring can improve patient care for clinicians.
1. Enhanced patient-clinician connection
One of the most important benefits of Cadence's program is the enhanced connection between clinicians and their patients. This improved connection is advantageous for both patients and clinicians, allowing for better communication and more streamlined care. When healthcare providers can better understand and know their patients, they can make more informed decisions about their treatment – all from the comfort of their own homes.
Dr. Matthew Else and Devin Morris both express the positive experiences they have had in this regard. For example, Dr. Else emphasized the importance of keeping track of patients' health, not only periodically in the clinic, but also throughout the entire year.
"What initially interested me about Cadence is the ability to keep in touch with my patients. We need to have eyes on them throughout the year, check in with them regularly and have that monitoring outside of the office," Else shared.
By using the Cadence program, clinicians can monitor data collected daily and Cadence's care team serves as an extension of the clinician and can intervene if necessary to adjust patients' medications.
Devin Morris shared similar positive experiences, saying the program has helped improve the connection between him, his staff, and his patients.
"Some of the best feedback that I'm getting from our patients is that they feel like we have an extra close connection because we're seeing their health not just for a blood pressure check when they come in for every follow up visit, but they feel like we're watching them more closely," Morris shared. "After we've set them up with Cadence, they say, “Wow, it really feels like you're paying extra special attention to our care. It also makes me feel comfortable knowing that somebody else is watching my blood pressure more closely.”
2. Efficient monitoring helps to reduce ER visits and hospitalizations
Using a remote monitoring program not only facilitates an enhanced connection between clinicians and patients, it also assists in providing improved patient care overall and leads to better patient outcomes.
Currently, Cadence's program is used to manage patients with various chronic conditions, including hypertension, type 2 diabetes, and Chronic Obstructive Pulmonary Disease. With the convenience of daily data collection, clinicians are better able to track and monitor their patients' health, leading to more accurate decisions about medication and other treatment options. Moreover, patients also appreciate the ability to stay on top of their health from the comfort of their homes, without needing to make frequent trips to the clinic for simple medication adjustments. The program has led to positive clinical outcomes, including increased use of guideline-directed medical therapy (GDMT).
Both Dr. Else and Devin Morris highlighted the significance of consistent monitoring and how it has positively impacted their patients. For example, Morris mentioned two specific cases where the Cadence program led to crucial health interventions: one in which a patient's health condition was flagged by a nurse, leading to the discovery of an important health issue that required follow-up, and another in which a high pulse rate was detected, ultimately resulting in the patient receiving a pacemaker. In both of these instances, Cadence clearly played a vital role in ensuring optimal patient care.
Not only does remote monitoring allow clinicians to have continuous access to valuable health data, it also greatly reduces the likelihood of hospitalization for patients.
"If we see something going on, if your weight is trending up and your blood pressure is increasing, we're able to catch that before you end up in the hospital and we can make adjustments over the phone so that the next time that you come into the office, everything is perfect and you don't have to see me for another six months. It just allows us to have a team approach and make sure we're taking as good of care as possible," Else shared.
3. Simplified medication adjustments via remote data
With the help of advanced technology like Cadence, clinicians are able to track their patients' health remotely, getting access to real-time data on a daily basis. This has been particularly useful for medication adjustments, where changes to dosages and medication schedules might need to be made as patients' conditions fluctuate. As a result, clinicians can make these adjustments quickly and efficiently, and patients don't have to travel long distances to the clinic for minor changes in their treatment plans. In addition to the technology, Cadence has a care team of clinicians who act as an extension of the provider and help make these medication adjustments efficiently and on their behalf.
Dr. Else and Devin Morris both shared their positive experiences with this aspect of Cadence's program, saying Cadence allows healthcare providers to quickly catch any deviations from normal parameters and make necessary medication adjustments in real time.
"This program allows me to collect data on them daily, make sure that their conditions are staying more controlled. And if something is getting just outside of range, we quickly have a nurse that is able to reach out to them, ask them some questions and potentially make medication adjustments that can get them back into our goal ranges," Else shared.
Similarly, Morris shared an example of one of his patients with type 2 diabetes, saying that Cadence helped him to titrate the patient's medications while easing some of his own workload.
"One example is with our patients with diabetes. In the past, if I had a patient who was newly diagnosed with diabetes, I would have the patient contact us or send us a list of their blood sugar levels over the next week or the next two weeks, and then adjust their medications accordingly. Now, we've been able to have somebody else partner with us to do that work, which has freed up my time during the day. And in the same way, I feel comfortable and confident knowing that the patients are getting their blood sugar levels under better control," Morris shared.
4. Reduced administrative work for clinicians
At a time when clinicians are facing increased administrative burdens and experiencing significant staff shortages, remote monitoring has also helped significantly lessen the burden on medical staff, who are then free to focus on providing the best care possible for their patients.
Both Dr. Else and Devin Morris shared how Cadence's program has successfully reduced their administrative burdens, allowing them to focus on what matters most - delivering the best possible care to their patients. According to Dr. Else, remote monitoring has enabled him to regularly collect data from his patients, identify trends, and make appropriate adjustments without the need for a clinic visit.
"My patients are able to make their adjustments on the medications without having to come into the office. It can be quite burdensome to make it into Oklahoma sometimes. I have patients out in rural areas that it could be an hour or two hour drive in order just to come into the office to make a medication change. So the ability to reach out to my patients remotely and quickly make some changes that can affect and even protect them for the future is pretty amazing," Else shared.
Similarly, Morris discusses how this type of monitoring minimizes the amount of time clinicians must dedicate to administrative tasks, such as organizing phone calls, processing paperwork, and manually adjusting treatment plans.
"The administrative burdens associated with my role as a clinician in internal medicine sometimes can feel overwhelming so anything I can do to offload that is something I'm interested in. Working with Cadence has allowed me the opportunity to delegate some of those other tasks so that it frees me up to do other things," Morris shared.
By minimizing the amount of administrative work involved in patient care, clinicians can dedicate more time to providing personalized, attentive treatment to their patients, and especially those who are at highest risk. In turn, this enables them to offer a higher level of care and better support patients in managing their health.
5. Maintain control of patient care with a team-based approach
A big concern often expressed by clinicians is that they will lose a degree of control over their patients by offloading care to Cadence. Although both Dr. Else and Devon Morris said they initially had that concern, they now feel the opposite; that Cadence has helped ease their administrative burdens while they still maintain control over the patients' care. An important aspect of the program is that Cadence's clinical team serves as an extension of clinicians, working in consult at every step of the way.
"A big concern that I had when starting the Cadence program was losing control of the decisions as far as what my patients are going to be taking. That is a concern I no longer have. The nurse is able to review my notes and see what the patient has tried before, as well as what I may have mentioned in my last note about what we plan to increase or switch to in the future. In addition, whenever the nurse is wanting to make a change, they reach out to me and confirm whether or not that is something that I'm agreeable with and not in a burdensome way. It's more of a, “Hey, I'm checking in to let you know this is what the patient is experiencing. Is it okay if we move on to this?” So it's still where I'm part of the decision making, but not where I have to gather all the history and come up with this plan," Dr. Else shared.
If you're interested in learning more information about Cadence and how to get involved, visit Cadence.care and please get in touch with our team.
Read the full transcript of the conversation below:
Episode Transcript
Introduction: Welcome to Cadence Conversations, where we're talking with prominent physicians, healthcare leaders, and tech entrepreneurs about their experiences driving innovation and progress. This week, we visited Utica Park Clinic in Tulsa, Oklahoma, and spoke with two clinicians who are using Cadence with their patients as part of our partnership with Ardent Health Services. First, you will hear from Dr. Matthew Else. Dr. Else told us his patients regularly drive an hour or more, just to come into the clinic so he can make simple adjustments to their medications. He's finding Cadence's program to be beneficial to his patients because it's saving them time and allowing them to become more engaged with their own health. Take a listen.
Dr. Matthew Else: My name is Dr. Matthew Else. I'm a family physician with Utica Park Clinic in Tulsa, Oklahoma.
What initially interested me about Cadence is the ability to keep in touch with my patients. As other physicians know, when these patients have chronic conditions, it's not something where we can see them for a glimpse just once or twice a year. We need to have eyes on them throughout the year, check in with them regularly and have that monitoring outside of the office.
This program allows me to collect data on them daily, make sure that their conditions are staying more controlled. And if something is getting just outside of range, we quickly have a nurse that is able to reach out to them, ask them some questions and potentially make medication adjustments that can get them back into our goal ranges.
So far, the program has been exceeding my expectations. My patients really like it. They know that someone is keeping an eye on them pretty much all the time. They are able to make their adjustments on the medications without having to come into the office. It can be quite burdensome to make it into Oklahoma sometimes. I have patients out in rural areas that it could be an hour or two hour drive in order just to come into the office to make a medication change. So the ability to reach out to my patients remotely and quickly make some changes that can affect and even protect them for the future is pretty amazing.
How Remote Monitoring Allows Patients to Stay More Engaged in Their Own Health
Since starting with the program, I do feel like my patients are more engaged in keeping track of their own health. I have patients that are saying that they didn't realize that their blood pressure was actually a little bit out of range. So the Cadence program allows us to keep on track and get into good habits of checking our weight and our blood sugar and our blood pressure daily and then preventing those swings in health by keeping them under control on a daily basis.
So knowing that someone is watching a lot of these blood pressures or these blood sugars remotely and catching these small trends in the wrong direction gives me peace of mind knowing that it's going to be less office visits for them in the future where we're trying to get things under control. I know that they're being taken care of and someone is keeping an eye on them even when I can't.
It does relieve some weight on my shoulders knowing that there's a team approach to taking care of these patients.
The best thing about the Cadence program is that you have a medical team working to keep an eye on you at all times. A lot of times, you will come to the office and you're not able to give an accurate list of your blood pressures at home or you forgot your blood sugar log at home. This allows us to see remotely what's going on. If we see something going on, if your weight is trending up and your blood pressure is increasing, we're able to catch that before you end up in the hospital and we can make adjustments over the phone so that the next time that you come into the office, everything is perfect and you don't have to see me for another six months. It just allows us to have a team approach and make sure we're taking as good of care as possible.
The Cadence program is even excellent for caregivers. It allows you some peace of mind knowing that your mom or your dad's blood pressure is being monitored and we're trying to prevent a potential stroke from happening. It's very difficult to live your own life and be able to think about yourself when you have to take care of someone else. So the Cadence program really allows us to be in the home and trend things for you in order to take a little bit of the burden off of your shoulders.
So far, working with the clinical team at Cadence has been pretty seamless. It's very structured in what kind of decisions are going to be made so it doesn't seem like someone is stepping out of bounds if a medication is being offered to be changed.
A big concern that I had when starting the Cadence program was losing control of the decisions as far as what my patients are going to be taking. That is a concern I no longer have. The nurse is able to review my notes and see what the patient has tried before, as well as what I may have mentioned in my last note about what we plan to increase or switch to in the future. In addition, whenever the nurse is wanting to make a change, they reach out to me and confirm whether or not that is something that I'm agreeable with and not in a burdensome way. It's more of a, “Hey, I'm checking in to let you know this is what the patient is experiencing. Is it okay if we move on to this?” So it's still where I'm part of the decision making, but not where I have to gather all the history and come up with this plan.
How Cadence Eases Administrative Burdens for Clinicians
The Cadence program has definitely eased a little bit of the burden on my assistant as well. I'm often messaging her, letting her know that I need to have this patient come in to have their blood pressure rechecked because they're asking for a medication refill and they haven't been seen for six months. So the Cadence program allows us to keep these blood pressures monitored remotely, look through some of the data that the nurses have sent us and see that the blood pressure is controlled and that we can go ahead and move forward with that refill rather than having to have my assistant reach out to them, tell them we need to do labs, bring them in and find time to schedule. It just takes care of it all remotely.
The best reason to use the Cadence program is to take care of our patients. It is easily the best way to make sure that their health is under control. Keep an eye on them throughout the day and making sure that we're making the best decisions for them. A lot of times when they come to the office, their blood pressure can be extremely high because they're a little anxious. But at home it's actually excellent. And when they come into the office, they always forget to bring their blood pressure log. So this remote monitoring program allows us to get an actual picture of what the patient is doing at home, how they're living, how their health is, and allows us to take the best care of them possible.
Interlude: Next up, you will hear from Devin Morris, a nurse practitioner in the internal medicine group, who has also had a great experience using Cadence with his own patients at Utica Park Clinic. Devon will share some of the success stories he's seen with his patients and also talk about the many benefits he is seeing as a clinician from using Cadence's program.
Devon Morris: My name is Devin Morris. I'm a nurse practitioner at Utica Park Clinic practicing internal medicine. The Cadence program has been really great. My first patient was set up in December of 2022 and it's been really neat to see just how the patients have responded. It's also been incredibly helpful for us as clinicians. Particularly, we've been able to see what is happening between those visits. So when a patient comes in for a follow up visit, I can look at a trend of what their blood pressure readings have been, or I can look at a trend of what their weights have been, and this has been particularly helpful in managing their care, not waiting every three months or every six months, but to be able to manage their care consistently.
As a patient, Cadence is incredibly helpful. The benefit to Cadence is knowing that your health is being monitored consistently. Some of the best feedback that I'm getting from our patients is that they feel like we have an extra close connection because we're seeing their health not just for a blood pressure check when they come in for every follow up visit, but they feel like we're watching them more closely. They like the outreach that the nurse practitioner that's working with Cadence is giving as well, which has been particularly helpful.
So what's really nice is that the patients can then, when they come in for these follow up visits, after we've set them up with Cadence, they say, “Wow, it really feels like you're paying extra special attention to our care. It also makes me feel comfortable knowing that somebody else is watching my blood pressure more closely.”
Historically, I think people have felt comfortable knowing that they have a blood pressure cuff at home, and they can check it periodically. But the difference with Cadence is that you have a health professional who is then looking at that data, assessing trends. And when you know that somebody is monitoring your health that closely, there's a level of comfort. There's a level of knowing that the likelihood of me having this unexpected, or this preventable E.R. visit is going to decrease.
Stories of Patient Impact for Clinicians Using Cadence's Program
I have a couple of stories I would like to share. The first involves Elizabeth, she's the nurse practitioner that works with Cadence, and there was one patient where she reached out to me through our Epic electronic health record, and she said, "I'm thinking about doing this with one of your patients," specifically talking about one of the blood pressure medications. "But I noticed that previously in his chart, this other chronic condition was documented, but I haven't seen it documented yet again recently."
And so this led us to a search of going through and making sure that we weren't missing a vital piece of this patient's health. And that helped us guide not only the medication that was chosen to help get the blood pressure under control, but it also helped us understand that there were other pieces of the patient's health that we needed to follow up with.
Another particular case was a patient who was monitoring their pulse, and their pulse was extremely high. When we received notification of that, we got the patient in with the cardiologist, and then they then had a pacemaker put in not long after that, which was a very important and pivotal part of their health.
How Cadence Makes Clinicians' Workflow Smoother
Cadence has made my workflow much smoother. We have it set up through our EHR, through Epic that it's so easy to order remote patient monitoring for our patients. And on top of that, we have a bulk ordering system set up so that we can see how many times they've been hospitalized for heart failure, for example, how many times they have had a blood pressure that was out of control. We can then collate that data and put together a list of patients who would be ideal and bulk order remote patient monitoring for those patients.
The administrative burdens associated with my role as a clinician in internal medicine sometimes can feel overwhelming so anything I can do to offload that is something I'm interested in. Working with Cadence has allowed me the opportunity to delegate some of those other tasks so that it frees me up to do other things.
One example is with our patients with diabetes. In the past, if I had a patient who was newly diagnosed with diabetes, or maybe their diabetes wasn't well controlled, I would have the patient contact us or send us a list of their blood sugar levels over the next week or the next two weeks, and then adjust their medications accordingly. Now, we've been able to have somebody else partner with us to do that work, which has freed up my time during the day. And in the same way, I feel comfortable and confident knowing that the patients are getting their blood sugar levels under better control.
The reason why clinicians would benefit from working with Cadence is that it's a support. It's a tool knowing that in primary care we have a lot of patients that we manage. And one of the things that we hate to see is when our patients are hospitalized or go to the E.R., especially if it's something that had we known their blood pressure was steadily increasing or that their weight was steadily increasing, indicating a possible heart failure exacerbation, that we could have taken action beforehand.
What Cadence does is it allows us an opportunity to know more consistently what is happening with our patients. No longer are we having to wait every three months for their follow up visit or every 6 to 12 months when they come in for their annual visit. We can know what's happening with our patients consistently. And when we know that, it changes everything. It changes how we manage our patients’ health and it reduces hospitalizations, and that's really what we're after.
Conclusion: Thanks again to Devon and Dr. Else for sharing your experiences with us. If you're a clinician and you're interested in learning more about Cadence and how to get involved, visit Cadence.care and please get in touch with our team. To make sure you get updates on our future conversations, please subscribe to Cadence Conversations wherever you listen to podcasts. And for more information about Cadence and how to get involved, visit Cadence.care. At Cadence, we believe that everyone deserves to receive the best care possible and we won't stop working until that vision becomes reality.
