Texting is the Missing Link for Effective Patient Monitoring

With healthcare consumerism on the rise, the time is ripe for medical providers to consider text-based communications to attract, manage and monitor patients, especially with new federal incentives for RPM reimbursement and other RPM enhancements expected to be approved later this year.

Patients want convenient, easy access to their healthcare providers, especially when it comes to communication. Physicians and other qualified healthcare professionals are looking for ways to implement more virtual care options. Even the Centers for Medicare and Medicaid Services (CMS) recognizes how the advances in communication technology has changed patient expectations.

Physician practices, home health agencies and other medical providers can capitalize on this trend by adopting text-based, HIPAA-compliant, telehealth communication measures that meet patients where they are.

84% of patients would rather text with their provider than talk to them on the phone. Speed, convenience and, quite often, clarity are just a few of the practical reasons both patient and provider should be interested in the proposed 2019 CMS changes that will allow alternative communication options.

Text-based communications are no longer simple notification tools. Now, patients and providers can have true clinical conversations that include image and document sharing in real-time, enhancing the care experience and utilize services like remote patient monitoring (RPM). The size of the U.S. remote patient monitoring market was estimated at $15 billion in 2017, and it’s expected to double in size to more than $31 billion by 2023.

With healthcare consumerism on the rise, the time is ripe for medical providers to consider text-based communications to attract, manage and monitor patients, especially with new federal incentives for RPM reimbursement and other RPM enhancements expected to be approved later this year.

Here are five reasons why providers should consider text-based or store-and-forward options:

Patients are younger and more tech savvy

Nearly one-half of all U.S. residents (159.2 million) were born after 1980. Of course, the youngest patients may not yet be communicating directly with their medical providers, but a recent Harris poll revealed, 74% of people between the ages of 18 and 34 are the ones most likely to be interested in telehealth alternatives. And, according to a Gallup poll, 70% of respondents in the 18-29 age group use their phones most often to read and send texts.

With the deluge of email we all face, it’s no wonder that texts are thought to be more immediate and more personal, a critical consideration in the healthcare industry as the consumerism mindset is rapidly changing everyone’s expectations.

Lifetime patient value is high

Lifetime patient value calculators abound on the internet, and the results from your organization probably will vary, depending on your specialty and your market. In 2016, U.S. healthcare spending totaled $3.3 trillion, or $10,348 per person annually. Multiply that by the average life expectancy of 78 years, and that’s more than $800,000.

With the patient lifetime value continuing to climb, it only makes sense that medical providers should be looking for every advantage to boost patient loyalty and retain their business for as long as possible. One of the easiest ways to maintain that loyalty is to communicate with patients on their terms, using platforms that they find the most convenient, thus demonstrating a more patient-first focus.

Medicare now covers some RPM services

Starting Jan. 1, 2018, Medicare now pays for remote patient monitoring under CPT code 99091, which covers collection and interpretation of physiologic data (ECG, blood pressure, glucose monitoring) digitally stored and/or transmitted by the patient and/or caregiver to the physician or other qualified healthcare professional requiring a minimum of 30 minutes of time. The code can be used once per patient per month.

Current restrictions include the need for a face-to-face visit for new patients and those who haven’t been to a provider in a year and a requirement that the provider be involved to interpret data, alter a care plan or communicate findings to the patient.  Unlike telehealth, remote patient monitoring is not constrained by Medicare as to location of services or location of patient, making it an attractive way for physicians to help patients manage their conditions while receiving reimbursement.

Additional RPM and virtual care services are on the way

Starting in 2019 CMS is expected to enact additional codes that allow for virtual check-ins (HCPCS code GVCI1) and asynchronous images (HCPCS GRAS1).

Virtual check-ins or “Brief Communication Technology-Based Services” will allow providers to conduct a “brief non-face to face check-in with a patient via communication technology, to assess whether the patient’s condition necessitates an office visit.”

Asynchronous image or “Remote Evaluation of Pre-Recorded Patient Information” reimbursements will allow providers to review “recorded video and/or images captured by a patient in order to evaluate the patient’s condition.” These “store-and-forward” communications can help determine if or when an office visit may be necessary.

Beyond reimbursement, remote patient monitoring through text messaging often creates a more open exchange between the patient and provider related to questions about care, pre and post op instructions and current health status without the patient coming into the office. A quick back-and-forth message between provider and patient can put a patient’s mind at ease or trigger an office visit that could prevent a more serious event such as an ED visit or even hospitalization.

HIPAA-Compliant communications platforms are available

Direct communication via text between patients and providers violates HIPAA standards, unless those communications are encrypted and/or the patient consents to sharing protected health information (PHI) through this method.

When looking for a text-based, telehealth service providers should ensure the platform is HIPAA-compliant, allows them to obtain consent on the front end, conduct direct communication with the patient (bypassing the need for portals) and doesn’t require the patient to download a special app.

Additionally, providers should look for an encrypted system that stores all communication (text and images) as part of the patient communication record, as patients are increasingly comfortable with sending photos and documents regarding their condition through text messaging.


Patients of all ages are becoming less tolerant of unnecessary, traditional phone calls that interrupt their life and are looking for communication alternatives, and the CMS is looking for ways to incentivize physicians to quickly implement these types of services.  When done in a HIPAA-compliant manner, text-based communications allow providers and patients to communicate in real time, exchange multimedia messages and bring immediacy to the care experience, and creating a win-win for everyone.

Kathy Ford is president of Rhinogram. A healthcare industry veteran with 25 years of experience, she has held roles in sales, marketing leadership, executive level portfolio ownership, with M&A responsibilities at companies such as GE Medical Systems, McKesson, Siemens Medical, Carestream Dental and NantHealth.