Time for Better
Even before the COVID-19 pandemic, health systems faced numerous challenges. Burdensome EHRs contributed to clinician burnout, chronic disease rates were continuing to rise, there were inadequate funding mechanisms for many systems to move to more proactive, value-based care, and poor interoperability between EHRs and other systems limited flexibility to meet evolving care needs. COVID-19 further highlighted existing issues with clinician efficiency and patient care. Thankfully, broad government mandates in the past few years have made interoperability a reality and the pandemic catalyzed an expansion of funding for tools that enable value-based care delivery, making 2021 the opportune time to adopt more robust, flexible, integrated care delivery platforms like Rimidi. The Rimidi platform was built as an enhancement to the EHR, not a replacement, and is designed to support quality improvement, workflow optimization, and patient engagement objectives all within the existing EHR workflow. Rimidi uniquely brings remote patient monitoring, chronic care management, clinical decision support, and patient reported outcomes together in one highly composable platform. Specifically, the Rimidi platform supports: (1) proactive management of patients with chronic conditions and other high-risk patient groups to avoid costly and dangerous complications and interventions, (2) optimization of treatment decisions based on personalized recommendations to get patients to goal more quickly and avoid prescribing unneeded medications (3) improved clinical efficiency within practices by driving workflow optimization and virtualization of care, and (4) incorporation of the Social Determinants of Health and Patient Reported Outcomes.
Rimidi’s platform optimizes clinical workflow and virtualization of care with four core capabilities. (1) Integration into the workflow: Leveraging SMART on FHIR APIs, Rimidi provides clinical data integration, single sign-on and a unified onscreen user experience. Many platforms operate as stand alone solutions requiring separate login and duplicate data entry, limiting utility and scalability for busy physicians. (2) Remote patient monitoring: With integration to multiple devices via APIs and Bluetooth as well as a FHIR-based Patient Reported Outcomes engine, Rimidi offers patients a frictionless means to share their data, symptoms and sentiments with their healthcare team. The PGHD is integrated with clinical data and displayed in the same user interface. By offering cellular-enabled devices and browser-based PRO reporting, Rimidi’s solution is accessible to more patients and is more affordable for clients versus other kit-based RPM solutions. (3) Risk Stratification and Reporting: The Rimidi platform allows each client to configure alerts, risk scores, and triage status to support their specific protocols, care team structure, and clinical priorities. Rimidi provides visibility of outcomes at the aggregate population level, in various patient registries, and detailed individual patient views. (4) Clinical Decision Support: Rimidi has built the most advanced implementation of CDS Hooks on the market in anticipation of broad adoption of the standard by EHRs over coming years. Currently, the CDS Cards surface in the Rimidi interface and support almost any insight or intervention a client wants: RPM data alerting and interventions, referral management, lab or medication recommendations, clinical trial identification, and more.
Rimidi: Supports multiple disease states and use cases: The Rimidi platform has specific views for Type 2 Diabetes, Heart Failure, Nonalcoholic Fatty Liver Disease, Cardiovascular Disease, Obesity, and Epidemic Management. Care teams can seamlessly switch between the views if a patient meets criteria for more than one. Additionally, Rimidi has created SMART on FHIR apps for both improving the patient journey for Deep Brain Stimulation and tracing surgical outcomes for Orthopedic Surgery. Integration to existing systems: The platform is integrated to leading EHRs as a SMART on FHIR application to facilitate streamlined data exchange. It also integrates with a variety of cellular or Bluetooth connected devices such as glucometers, blood pressure cuffs and scales. Rimidi’s technology is flexible enough to support each client’s existing protocols and clinical priorities. Connects Data to Action with Clinical Decision Support: Configurable clinical decision support cards bring practice guidelines to life at the point of care in the context of each individual patient. Leveraging the Clinical Decision Support (CDS) Hooks standard, the CDS Cards provide information, gaps in care, laboratory ordering and suggested prescribing actions within the workflow. Incorporates Virtual Collection of Patient Reported Outcomes: The Rimidi platform includes a PROs engine to send patient surveys via text message, patient portal, or email to virtually collect and display responses within the existing workflow. Patients receive surveys based on upcoming appointments, following treatment changes, or other configurable rules. The PROs tool is integrated to existing disease views, but can operate stand-alone to support additional use-cases.
For one client, Rimidi demonstrated a 2.8 point improvement in hemoglobin A1c in a randomized controlled study of patients with Type 2 diabetes, and with fewer ER and SNF visits, cost savings were $12,700 in the Rimidi cohort. Years after the initial study, we are still observing fewer acute admissions and few acute bed days in patients with diabetes that were using remote diagnostics versus those without remote diagnostics. Average acute admissions of 0.25 vs 0.31 per patient/year and 0.65 vs 0.96 acute bed days/patient/year. Patients in this program are satisfied, too. In a survey of 250 remotely monitored, mostly Medicare patients, 70% of respondents believed remote monitoring enabled them to better manage their health conditions, and 91% said the celluar-enabled devices provided were somewhat easy or very easy to use. Separately, with a safety net hospital, Rimidi launched a remote blood pressure monitoring program within a few weeks of the Public Health Emergency declaration in 2020. This has not only protected new mothers and new born babies from COVID-19 risks but also allowed for continuity of care for a very high-risk group of patients. The client had previously sent visiting nurses to patient homes for postpartum blood pressure checks which was not financially sustainable for patients who had copay implications and then COVID-19 eliminated availability of visiting nurses for this program. To date, the client has served over 800 patients with this program using the Rimidi platform.
Rimidi’s sweet spot is at the intersection of clinical and technical expertise. The platform was built by clinicians with clinical workflow top of mind. Rimidi uniquely integrates several components of care delivery into a comprehensive, composable clinical management platform including problem oriented views and extensive Clinical Decision Support capabilities.