News – PH – The Role of Technology in Lipid Management


Telehealth has made leaps and bounds over the past year as medical offices become accustomed to the COVID-19 pandemic, such as virtual visits, remote patient monitoring (RPM), continuous glucose monitoring (CGM), and other tools to help doctors manage their Meeting patients where they are needed

Telehealth has made leaps and bounds over the past year as medical offices get used to the COVID-19 pandemic, including virtual visits, remote patient monitoring (RPM), continuous glucose monitoring (CGM), and other tools to help doctors meet their patients there where they are needed

What role does telemedicine play in heart health, especially in lipid management? Medical Economics®, with support from our partner brand at Practical Cardiology®, has assembled a panel of lipid management experts to discuss the role of technology in helping patients manage their heart health The transcript has been edited for length and clarity. p>

Guy Mintz, MD.Board Certified Lipidologist and Director of Cardiovascular Health and Lipidology at Sandra Atlas Bass Heart Hospital at North Shore University Hospital, Northwell Health

Lucia Novak, CRNPBoard Certified Nurse, Co-Executive Director of the Capital Health and Metabolic Center at Capital Diabetes and Endocrine Associates, and Associate Editor of the ADA Clinical Diabetes Journal

Medical Economics® (ME): What role did it play in relation to remote monitoring and telehealth in treating your patients with diabetes and other heart conditions? How did you use it?

Novak: That saved our practice, and it really has allowed us to continue providing the high quality care our patients need when we can’t have it in front of us. In an endocrine practice, we usually monitor glucose and many of our patients now use continuous glucose monitoring and insulin delivery via a pump And usually the two communicate with each other All these technologies are available via bluetooth in the cloud and then in the cloud on our server and then we can access the data without the patient actually there And with this kind of information on hand, you can make the necessary adjustments in treatment, have important lifestyle discussions and everything else, especially because in the COVID-19 world, the patients most affected by the poor results were those with pre-existing type 2 diabetes s and other cardiovascular problems So the ability to manage our patients when we couldn’t see them directly really made a world of difference. And I think it actually emphasized the importance of making sure that your patients are connected in some way are If they use blood pressure monitors or apps on their phones that track sleep and activity, we can collect this data so that we as clinicians can make positive use of that information

Mintz: The most important thing is to keep in touch with your patients. In terms of the cardiovascular area, lifestyle change can be achieved very easily through telemedicine. Of course, you can see what the patient is eating in their home you know , I have patients walking around with a smart phone showing me their fridge, pantry and other things so you can see what they are doing, you can see how they are living, and you can really advise them, surely we can in the world of Lipid lowering accomplish all of this advice through telemedicine

Nowlan: No question about it, that was extremely helpful. If you had to choose a silver lining, the pandemic was that we had to turn in a cent and take it over. And I know that in our office we said within 24 hours: “We need telemedicine, we have to choose a service “And we did it the next day And so we could turn around really fast. Interesting is how good it is for some things

You mentioned lipid management and being able to see lab results, the patient has seen lab results and checked side effects. You don’t need hands-on exercises – although that’s nice – but you don’t need them to get 95% of that What you want to achieve there What I have noticed is that the visits to the office and the data we are receiving are starting to homogenize with what is happening as an outpatient. Assuming your blood pressure is high today. Well me will not pull the trigger and make a decision that you are hypertensive today instead we will monitor your blood pressure and you will contact me and document Why we don’t make another telemedicine appointment in two weeks and you give me the numbers? The two approaches are therefore complementary

Mintz: It also enables your health professional allies and nurses to take on a role in the telemedicine and telemedicine world within the practice

ME: What advice do you have for doctors trying to use telemedicine to remotely monitor patients to manage heart disease in their offices?

Mintz: If you are just starting out, you want to choose a safe platform first. You want to choose a platform that is easy. You need to educate the patient about its use. And of course, the staff needs to be trained on how to use it

It was quite a time when my staff set me up for a telemedicine visit and the patients muted their computers and I could see them and they couldn’t hear me and the telemedicine video conference became Let’s just talk on the phone So, all of this has to be found out

The other things we have matured into over time – and we asked our patients about them – we found that many patients do not have an ambulatory blood pressure cuff and so we recommended that they get one I recommend to them also to buy a pulse oximeter so that they can measure their O2 saturation and pulse

The other thing we recommended for certain patients who have arrhythmias or lots of palpitations during this COVID pandemic was the Cardia device that can put an EKG on their smartphone and then email it to us We also used home blood draw so patients never had to leave the home They were comfortable with someone coming home so make a laundry list of what we needed to get the patients home to do our job even better

Nowlan: I think there are all of these goals that can be achieved using remote patient monitoring. And you know we all think about improving health outcomes. And of course it’s very important that we want patients to have a better experience when they reach out to us And we either want to cut costs or improve sales The one aspect that I think is often ignored is that we as providers should have a higher level of satisfaction I think it’s very important that we take care of ourselves in our practice so that we can take good care of patients.And keeping an eye on all of these things, including our simple treatment of patients, is a good thing to always be in the foreground when you decide to whatever path you take to introduce this technology

It’s also about starting with the end in a hypothetical office, for example, treating high blood pressure is not very good We do not receive any data We’re not sure if the patients are measuring themselves So the goal is to have excellent blood pressure control that is measurable, that we can hold patients accountable for, and that is easy for me as a provider to deal with and I think if you clear those things up in mind, when choosing things like vendors and products rather than the next shiny toy that comes on your door, it can be very, very helpful

Novak: My practice was about holding the hand so we really tried to take the time to contact them and walk them through the steps they needed to take with the devices, especially our older ones Just knowing where the camera was on her phone, I was trying to get other family members to help. It Really Takes a Village

And I think when they found out they were very dedicated. At first we had a lot of patients who said, “Oh no, I’ll wait for the office to open” Everyone thought we would be closed until Easter and then we would hit them again”And that didn’t happen. When they realized this was the case and they grew increasingly anxious, they really wanted that connection with their health care provider and then learned how to do it.”

I will repeat what Dr Nowlan said, it is really important that when you use remote patient monitoring, you make sure that you carefully select a platform that is able to take the burden off of all that inbound and offloaded data from the requirements of how that data is monitored for you This is how you can get a refund There are some really good platforms out there that can do a lot of this for you It doesn’t do the clinician’s job, it doesn’t take away what you offer your patient, but it takes the screws and the Nuts away so you can practice more effectively and still make a profit on this additional service

I really recommend checking out the AMA Playbook on RPM They go through step-by-step recommendations on what to do for your practice, small or large, you can apply it and figure out how it works best for you

Nowlan: I think the future absolutely lives in a cloud-based data analysis with artificial intelligence and an analysis of the style of neural networks It does this in a very ingenious way, regardless of the condition, and provides this information to the clinician in a useful fashion

Novak: We will definitely see artificial intelligence and how it helps patients. With that in mind, computer-aided decision-making for clinicians to put all these pieces together How do you spot the risk? How do you identify therapies to best reduce this risk? All of these calculators are tied into some sort of algorithm that may be built into EHRs. And it would be great if we could have an EHR that is really universal and communicated

Telemedicine, Healthcare, Remote Patient Monitoring

News – PH – The role of technology in lipid management