Two physicians from Community Health Systems (CHS) spoke with Dr. Randy Curnow, Medical Director at Cadence, about how they are using Cadence's remote patient intervention program and the positive impact that Cadence's technology and clinical care team are having on their patients.
The conversation took place during a recent event hosted by Cadence and CHS, and was recorded and released as a new episode of Cadence Conversations, a podcast from Cadence featuring prominent physicians, healthcare leaders, and tech entrepreneurs discussing their experiences driving innovation and progress within the healthcare system.
Other episodes of Cadence Conversations include: Dr. Toby Cosgrove, former President and CEO of Cleveland Clinic, discussing partnerships between technology companies and health systems, Dr. David Shulkin, 9th Secretary, U.S. Department of Veteran Affairs discussing the future of remote patient monitoring (RPM) and advanced heart failure specialist and cardiologist at the Duke University Medical Center Dr. Marat Fudim discussing how RPM can transform cardiology practices.
Two physicians featured in the conversation include Dr. Eric Cheung from South Baldwin Medical Group in Foley, Alabama, and Dr. Scott Musick from Northwest Physicians serving communities across Northwest Arkansas. Each physician began by discussing their experience working with patients with chronic conditions in the CHS system, and how they have rolled out Cadence's remote patient intervention platform to benefit these patients.
"Our team down here in Foley has been really excited about getting patients enrolled," said Cheung. "Overall, my satisfaction has been pretty high and furthermore, my patients have been incredibly satisfied with the Cadence team."
Similarly, Musick noted about Cadence, "I just feel I have a little watchman watching all my patients with congestive heart failure and I've been really happy with the product so far."
According to Cheung, Cadence's technology has had a positive impact on both his own experience, as well as the quality of care he is able to deliver for his patients.
"What I love about this program is we have some technology, which is basically a tool for us to now see how our patients are doing in between visits and also be able to provide more real-time intervention to our patients," he said. "And I think what it does is it just provides better care."
"When I see our patients back in follow-up that have been involved in remote patient monitoring, a lot of them are very satisfied, but also the results are they're taking their medications correctly and also their blood pressure is down, and overall, they feel that their care is better," Cheung continued.
Cheung also discussed several of the benefits for patients who are working with Cadence's clinical team, noting that it has helped those patients feel more connected to a professional and therefore better able to manage their care.
"I've been very cognizant to make sure I ask my patients who are on the Cadence and universally, I can say that their satisfaction is very high. Patients are happy because I think they're in touch with a clinical professional more often. And truthfully speaking, they feel more connected to our practice and they feel that they're not alone in their care."
Meanwhile, Musick discussed some of the misconceptions that physicians tend to have about remote patient monitoring, and shared that one of the biggest benefits of working with Cadence has been the amount of time it has saved him in his daily practice.
"This is a very simplified monitoring program that doesn't require a lot of work from me or my staff and my patients get the benefit from it with little to no cost. So it's kind of a no-brainer for me," Musick noted. "I will have all of my CHF patients on it because I just feel it's good to keep them out of the emergency room."
Listen above to the entire conversation and be sure to subscribe to Cadence Conversations wherever you get your podcasts in order to listen to future episodes.
Read the full transcript of the conversation below:
Table of Contents
- Remote Patient Monitoring Impact on Patient Engagement
- Use of RPM in Varied Clinical Scenarios
- Patient Satisfaction with Remote Intervention Programs
- Understanding Physician Resistance with Implementing RPM
- Challenges Treating CHF in an Emergency Room Setting
- RPM Enables Earlier Clinical Interventions
Introduction: Welcome to Cadence Conversations, where we're talking with prominent physicians, healthcare leaders, and tech entrepreneurs about their experiences driving innovation and progress.
I’m Randy Curnow, Medical Director at Cadence. This week, we have something special for you: I recently had a chance to speak with two physicians who are using Cadence as a part of our partnership with Community Health Systems. Cadence has been working with CHS since February, and I caught up with these physicians about how the program is going for them and what kind of impact Cadence is having on their patients.
You’ll first hear from Dr Eric Cheung, Medical Director at South Baldwin Medical Group in Foley, Alabama, and then from Dr. Scott Musick, Medical Director at Northwest Physicians serving communities across Northwest Arkansas.
So let's get to this week's Cadence Conversation.
Eric Cheung: Yes. Hi, my name is Dr. Cheung. I've been in practice for about 25 years, and I guess our group is honored to be one of the pilot sites to really engage technology and especially a new partnership with Cadence. And I think our team down here in Foley has really been excited about getting patients enrolled. They're very engaged in seeing the follow-up from our patients and overall, my satisfaction has been pretty high and furthermore, my patients have been incredibly satisfied with the Cadence team. And I think when you say the team, I think there's a large support system that is behind the referral when we send our patients to Cadence. And that's one of the things that my patients really love about the program thus far.
Remote Patient Monitoring Impact on Patient Engagement
Randy Curnow: Can you tell us a little bit more about what initially interested you in the program?
Eric Cheung: I think remote patient monitoring has been available at least as a CPT code for a number of years. And I think a lot of us as primary care physicians have waited for the technology and the program to catch up. And I think this is one of the tools, I think, we've all been looking at as primary care physicians that basically increase our engagement with the patients.
I think a lot of times when we give a patient an intervention specifically for hypertension, we say, "Hey, this is the medication we plan to give you. This is what our anticipated effects are. This is our side effect profile. And we will see you back in X number of times, which is possibly a month or even two weeks at the earliest to maybe three months, depending on your next appointment."
And we really don't know what happens in the meantime with that patient. So what I love about this program is we have some technology, which is basically a tool for us to now see how our patients are doing in between visits and also be able to field those questions, engage the patient a little bit more in between visits, and provide more real-time intervention to our patients, which is kind of similar to what we do in the hospital setting or an acute care setting.
And I think what it does is it just provides better care. And to your point earlier, with the engagement increases the level of trust with both Cadence and our practice, and ultimately, that improves our compliance with our patients. And when I see our patients back in follow-up that have been involved in the remote patient monitoring, a lot of them are very satisfied, but also the results are they're taking their medications correctly and also their blood pressure is down, and overall, they feel that their care is better.
So I feel that any time that we have some type of technology that helps us engage our patients is really important. And I think that was probably the main reason why I was really interested in the program.
Use of RPM in Varied Clinical Scenarios
Randy Curnow: So it sounds like it's going pretty well so far.
Eric Cheung: Yes. I've used a bunch of different scenarios for my patients ranging from controlled hypertension, uncontrolled hypertension, congestive heart failure, transitional cares from hospitalization from congestive heart failure exacerbations to patients who are symptomatic on blood pressure medications, patients who I feel need a little bit more engagement. So I've kind of used it on various clinical scenarios.
Patient Satisfaction with Remote Intervention Programs
Randy Curnow: How have your patients been doing with the program? Have they been giving you any feedback?
Yeah, I think I've been very cognizant to make sure I ask my patients who are on the Cadence and universally, I can say that their satisfaction is very high. Patients are happy because I think they're in touch with a clinical professional more often. And truthfully speaking, they feel more connected to our practice and they feel that they're not alone in their care. And I think that's where the real benefit of the program is with chronic care management.
Understanding Physician Resistance with Implementing RPM
Randy Curnow: Well, I think that's such a great point, Dr. Cheung, that we really try to make it an extension of your practice, not some different entity integrated with your practice, and help strengthen that bond between the patients and their primary care doctor. Dr. Cheung, what would you tell your colleagues who are considering the program?
Eric Cheung: I think just like any tool, medication or intervention, I think you got to look at this and say, "How is it going to benefit my patients, number one?" And I think there's various reasons that it can benefit your patient. And I think there's a little bit of reservation sometimes, especially with a program like this that someone is going to take away my patient.
And I think that's one of the biggest fears I had initially, and that someone's going to manage my patient better than I am, and I'm not going to see my patient anymore. But I think having this experience for over about a month and a half now, I think this has actually done the opposite. I think your patients really see you as being the coordinator of care, the overseer of your care.
And I really feel that the Cadence team and the engagement has really augmented our practice and really helped our patients be more compliant with their medications. They see the value of what we're trying to do. They're more engaged in their care. And I think using that as a tool to get the means of the engagement I think is really important.
It was great to hear from Dr Cheung on his experience with the program so far and the success he’s seeing for his patients. I then had a chance to check in with Dr. Musick on his patient rollout and working with Nicole Comstock, one of Cadence’s well-trained and highly experienced nurse practitioners who functions as an extension of his team.
Challenges Treating CHF in an Emergency Room Setting
Randy Curnow: Well, Dr. Musick, thank you again for joining us today. And we just wanted to get your initial impressions. Can you tell us what initially interested you in the program?
Scott Musick: We've been on a quality program here for a while with a ACO and a CIN and medical loss ratio is completely driven by inappropriate readmissions and ER visits and all of those quality metrics that we're measured on. And I've thought for a long time, the only way to really control that is to catch it before it happens. And I worked ER for 13, 14 years. And if you have a congestive heart failure patient come into the emergency room, they're getting admitted. There's just no way around it.
If they're there because they're too short of breath, you're really lucky if you can pull enough fluid off of them in a couple of hours to send them home. You're going to admit 95% of those. And if we can catch that early, change their medicines as soon as that weight gain begins and that shortness of breath occurs, then we're going to keep them out of the emergency room, which is going to keep them out of the hospital, which is also going to make them feel better.
Which is, of course, the primary goal here is those patients don't want to be in the hospital just as much as we don't want them in there. And they don't know what to do a lot of times, they're like, "I take my weight every day. I take my blood pressure every day." I go, "Well, what do you do if it goes up?" They go, "I keep monitoring it." "Okay, that's great. But what if it goes up 10 pounds?" "Well, that's bad, but I don't know what to do." I'm like, "Well, you should probably call me." "Oh yeah, that's a good idea."
RPM Enables Earlier Clinical Interventions
So now with this in place, I just feel I have a little watchman watching all my patients with congestive heart failure and I've been really happy with the product so far.
So I've had multiple impact where they were gaining weight, blood pressure out of control, shorter breath. And Nicole's been able to deal with those patients, change their medicines, increase their diuretics, pull some fluid off, keep them out of the ER, and to what you just said a minute ago, I don't even know it's happened until it's done and the patient comes in to see me. So I love that part of it.
They come in and I go, "Hey, how are you doing?" "Oh, they changed my medicines." Like, "Who's they?" "Oh, the Cadence people." I'm like, "Okay, great." So then I have a note there from Nicole and go through it with them and see what she did and it's done. And I had a lot of people that were worried about this leading to less office visits because, "Cadence would be stealing my office visit."
Well, that's not how this works at all. Because the way they, especially Nicole, does it for me is, "Hey, change this, do this. Then go see Dr. Musick in two days on Monday morning to make sure that we're good. They're weight's back down. That you're not short of breath." So it's a really nice partnership.
Randy Curnow: Well, that's great information. Dr. Musick, can you give us any feedback from your patients? How's that been going?
Scott Musick: Great. Our user rate I think is well over 90% of days our patients are weighing and taking their blood pressure. I've had zero complaints. Had one person ask about the copay, but that was just one patient who had a copay. No one really feels it's invasive.
Scott Musick: Most of them have been taking their blood pressure and watching their weight anyways. And it's just a comfort to know, I think for a lot of them, that it is being monitored. It's not just up to them to make a decision with what to do with that information.
Randy Curnow: Dr. Musick, what would you tell colleagues who are interested in joining this program and are considering it?
Scott Musick: That this is different than what I've been involved with before. This is a very simplified monitoring program that doesn't require a lot of work from me or my staff and my patients get the benefit from it with little to no cost. So it's kind of a no-brainer for me. I will have all of my CHF patients on it because I just feel it's good to keep them out of the emergency room.
Randy Curnow: That's fantastic.
Thanks again to Doctors Cheung and Musick for sharing those experiences with us. If you're a physician and interested in learning more information 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.
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