Remote Monitoring

Imagine if you prescribed a new glaucoma drop to a patient and were able to get 4 IOP readings per day for the next month.  

We have all treated a glaucoma patient whose “numbers” all looked good, yet they continued to lose vision.  We wonder about the IOP diurnal variations.  What if we could track that?

Do we really have to get an ambulance to bring that patient from the nursing home for an IOP check every month?  

The American Telemedicine Association states defines Remote Patient Monitoring (RPM)  as:  including home telehealth, uses devices to remotely collect and send data to a home health agency or a remote diagnostic testing facility (RDTF) for interpretation. Such applications might include a specific vital sign, such as blood glucose or heart ECG or a variety of indicators for homebound consumers. Such services can be used to supplement the use of visiting nurses.

iCare now offers a home tonometry unit that has been approved by the FDA for home use and measurements of IOP by the patient in their home.  It is safe, easy and highly accurate.  The measurements can be uploaded to a portal in your practice and the patient can keep the unit as long as need for you to get the needed data.  

There are newly recognized CPT codes for remote monitoring and they can be billed monthly.  So this begs the question if it is better for a patient to come into the office every 3 months for an “IOP Check” or a monthly evaluation of 30 days of multiple IOP readings?

Eye Care Live promotes a visual acuity test that can track the VA of a patient undergoing myopia management.  When reliable testing of VA can be done, is that comparable to in-office refractive testing for the purposes of tracking progress?  (Remote monitoring of VA does not qualify for billing purposes as remote monitoring.)

Both of these methods require patient training and rely on proper technique, but they data received allows significantly improved ability to decide when intervention is needed.