Federal award allows UMMC to reach more telehealth patients

Published on Monday, January 25, 2021

By: Ruth Cummins

Every day, Stephen Dawkins adds a tech twist to a routine check of his blood pressure from the comfort of his rural Warren County home. 

Dawkins puts on his blood pressure cuff, and the reading registers on a computer tablet with a Bluetooth connection. The data is transmitted from the tablet to his University of Mississippi Medical Center electronic health record.

“It goes straight to the tablet and Telehealth,” said Dawkins, a retiree who’s spent most of his life in the Vicksburg area. “Telehealth” is UMMC’s Center for Telehealth, where a team of nurses review the health data of hundreds of Medical Center patients with chronic conditions.

If something’s amiss with his reading, Dawkins will get a call from a Telehealth nurse, and they’ll discuss reasons why it’s out of kilter and remedies to get it back within a normal range. The nurses are the backbone of the program, and they coach the patients throughout their time in the program so that they’re not in it alone.

“They’ve been trying to adjust my blood pressure a little bit. It jumps,” said Dawkins, who takes medication for his hypertension. “The tablet is a really good tool, I guarantee you.”

Dawkins is grateful for the chance to take part in remote patient monitoring, and thousands more patients like him will get that opportunity, thanks to a $2.3 million federal award. The award will allow UMMC to ramp up remote patient monitoring, or RPM, for those living in rural areas or who are veterans, with emphasis on those who are low income, uninsured or underinsured.

Money will go toward areas such as providing the bandwidth that the tablets need in order to transmit the health data to UMMC. In addition, the money will go to defray the cost of the RPM platform used by UMMC.

“We are a rural community, and many patients live in underserved areas, with poor access to health care,” said Dr. Saurabh Chandra, UMMC chief telehealth officer. “This form of telehealth takes the benefit of remote patient monitoring directly to the patient’s home.”

The funding from the Federal Communications Commission, announced earlier this month, is part of a “Connected Care” pilot project that impacts telehealth patients in 11 states. It allows UMMC to take advantage of broadband Internet access in expanding RPM programs and to increase synchronous, face-to-face telehealth visits between Medical Center providers and patients.

The goal for the RPM program is to serve an additional 6,000 patients; more than half will be low income, UMMC estimates. Remote patient monitoring also provides critical health education to patients so that they can better manage their diseases.

“The University of Mississippi Medical Center has been on the leading edge of providing telehealth services to rural areas,” U.S. Sen. Roger Wicker, R-Miss., said in a statement announcing the funding. “This award … will be a major boost to our state’s efforts to provide quality care to residents who lack easy access to in-person care.”

“The events of the past year have highlighted that connectivity is critical to address current and future health challenges in this country, from chronic disease to COVID-19, in particular for our nation’s veterans and low-income Americans,” FCC Chairman Ajit Pai said in a statement. 

The Center for Telehealth, one of just two federally designated Telehealth Centers of Excellence, was a national trailblazer for remote patient monitoring. UMMC’s 2014 Diabetes Telehealth Network provided secure tablets to Mississippi Delta patients with diabetes to help health care providers remotely manage chronic conditions that come with the disease.

The Center’s use of RPM gained added impetus in January 2020, when Dr. Donald “Trey” Clark, assistant professor of cardiology, became that program’s medical director.

In 2018, Clark led a pilot telehealth study to manage hypertension patients that has the potential to be just as far-reaching as the diabetes pilot. Clark and the research team tracked and analyzed data from about 120 patients that included medication therapy and when it’s intensified; safety of the protocol; and patients’ blood pressure change from baseline. Safety metrics tracked included self-reported adverse events such as emergency room or clinic visits that could potentially be attributed to the protocol.  

The goal was to produce a telemonitoring protocol for managing patients’ blood pressure more efficiently, and for better controlling it.  “We had great success in monitoring these patients from home,” Chandra said.

“The unique thing about our RPM program is that we have a dedicated multidisciplinary team of outstanding nurses, clinical pharmacists, data analysts and project managers under the clinical leadership of Dr. Clark, who is a cardiologist by profession,” Chandra said. “You have a specialist who’s seeing patients in clinic and in the hospital.” Clark and other specialists, including Dr. Vishnu Garla, assistant professor of endocrinology, “are always coming up with the latest evidence-based, state-of-the-art protocols on treating our patients,” Chandra said. “That just makes our program so much more robust.”

In the years since RPM was first used, Clark said, “we’ve done a lot of work developing protocols around how to manage the incoming data. The nurses assigned to the patients have parameters they are looking for, and if a patient falls out of that parameter, the nurse knows what to do.” 

That treatment is done in partnership with the patient’s primary care provider. “An essential component of this program is that the patients have a well-established relationship with their primary doctor,” Clark said. “We want to facilitate better care for them with the person who knows them best.”

That’s the case with Dawkins, whose UMMC cardiologists are in close touch with the RPM program. “I can’t say enough about that whole group,” Dawkins said.

The Center has an agreement with Memorial Hospital at Gulfport to offer RPM services to qualifying patients and is in discussions to do the same in North Mississippi, Chandra said. “We’re expanding our outreach beyond our backyard to other rural communities,” he said.

At the end of the day, Chandra said, it’s all about helping patients with chronic conditions who face obstacles, from access to health care to the inability to pay for it.

“We are very excited about what we can do with this funding,” Chandra said. “We want the benefits to go down to the patient living in the rural community. This funding will offset costs so that we can provide those benefits.”