Twenty years ago, Greene County Health Care in Snow Hill, North Carolina, was interested in installing an electronic health record system, data warehouse and practice management system. So Greene County became one of the first health center control networks to fully jump into the digital space.

Telehealth and remote patient monitoring was a logical additional step, said Doug Smith, CEO of Greene County Health Care. Ten years ago, Greene County piloted a telehealth program and kept at it. That's the background behind the organization's more recent interest in virtual care.

"Virtual visits were the thing of the future that now are coming on strong, so we started to do it, but obviously COVID-19 and the risks of infection and people being afraid to go into a doctor's office stepped up our interest," Smith said.

Last year, Greene County Health Care was awarded $948,576 for remote monitoring and diagnostic equipment and a telehealth platform subscription to provide COVID-19 screenings using interactive voice recognition, as well as to monitor patients remotely using connected devices and to evaluate the monitoring data for abnormal readings and follow-up care.

"A problem we faced was that at least around here, many people are not familiar with this kind of technology, so although they were scared to go up to the office, they weren't thrilled with a virtual visit either," he explained. "We continue to work our way through these issues."

Also on the afraid-to-come-into-the-office front, there are the patients with chronic conditions. The FCC was particularly interested in COVID-19 because it received dollars for that purpose, so Greene County wrote the grant request in a way that focused on monitoring a number of chronic conditions through a number of RPM devices such as pulse oximeter, weight and blood pressure, providing early warning signs for COVID-19.

"Virtual visits were the thing of the future that now are coming on strong."

Doug Smith, Greene County Health Care

"This allowed us to provide better management of chronic care of certain individuals because they weren't coming into the office," Smith said. "Also, we have a patient population that largely is uninsured. It's around 80% uninsured. So they get a sliding-fee scale, and we can generally get them into the office; but during COVID-19, it has been very hard to get a number of these people into the office for their regular check-up visits.

"So having them on remote patient monitoring with remote care managers monitoring all of the readings was very helpful," he continued. "We get alerts that contact providers when there is something significant for the provider to look into. That way, the provider has the option of having the patient scheduled for a visit; administrative staff try to get the patient to come in for a visit or set up a telehealth visit."

At Greene County, medical and behavioral health providers use the telemedicine technology. Vendor Connect America installed the remote patient monitoring technology; Greene County hired a care manager through Connect America who has more than 20 years of experience with this kind of care management. The FCC funds sparked the RPM surge.

Through other funding, Greene County was able to start a three-year program for RPM with hypertensive patients. It involves a connected health blood pressure cuff and about 1,000 patients.

"The technology has been shown to reduce blood pressure, to get more people compliant with treatment," Smith noted. "We have $157,000 in outside funding for this, and we have provided another $300,000 or so over the course of the three years. We should have 1,400 people with some remote patient monitoring going."

Twitter: @SiwickiHealthIT
Email the writer: bsiwicki@himss.org
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