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How a Family Practice Used Technology To Overcome Barriers To Chronic Care Management

Doctor Holding Patient's Hand

About: Barry J. Liberoni, M.D., P.A.

Dr. Barry J. Liberoni’s internal medicine practice in South Texas has a patient population that includes adults with chronic conditions such as hypertension, obesity, and heart disease. Most of the practice’s patients over 40 have multiple chronic conditions. 80% of seniors have at least one chronic condition and Dr. Liberoni notes that “South Texas is the diabetic capital of the U.S.”

Goal: Improve patient experience through remote patient monitoring

Dr. Liberoni’s practice faced the same challenges many small practices face, treating a senior population with chronic conditions who have many barriers to receive timely care. Trying to manage seniors with telemedicine alone was a challenge because they didn’t have the necessary homecare technology at home.

To solve these challenges, the practice turned to telemedicine and remote patient monitoring — reaching patients at home.

The practice aimed to provide patients with at-home tools including a digital scale, blood glucose monitor, and automated blood pressure cuff so that they could remotely monitor vital signs. This would allow the practice to provide care to their patients by monitoring and treating their chronic conditions in real-time. Dr. Liberoni explains, “If our patients’ chronic conditions become unmanaged it may result in potentially catastrophic and expensive outcomes further stressing the healthcare system.”

Decision: choosing a remote patient monitoring solution

Once Dr. Liberoni’s practice had decided to move forward with remote patient monitoring, they set their requirements for a solution that doesn’t make providers or patients download an app or learn complicated tech to use it. Prior to finding 100Plus, the practice couldn’t find a suitable solution and considered building one themselves. After doing more online research and learning more about 100Plus, they began enrolling patients in the program. Dr. Liberoni found the email alerts for patients whose health data was out of normal range and the intuitive web interface of the 100Plus Provider Portal helpful immediately: “It gives me good oversight about
what’s going on with my patients’ conditions at home.”

Results: the benefits of 100Plus

“100Plus remote patient monitoring devices assist physicians and our staff to monitor patients by providing informative data virtually,” said Dr. Liberoni, “This data can be relied on to make informed clinical decisions throughout our patients’ course of care. The additional revenue has been invaluable to our practice, but the data from these devices has enabled our practice to care for our patients when they are at risk and that’s what matters most to our practice.”

100Plus devices all use cellular technology, so they don’t require any setup. Dr. Liberoni notes that all of the technology works well together and having the ability to provide more than one device to each patient has been a positive aspect of choosing this solution. A diabetic patient may also have hypertension and congestive heart failure. 100Plus enables Dr. Liberoni to see that patient’s pulse, daily weight, and blood glucose levels. Dr. Liberoni says he has very few patients who are using only one device — most of his patients are using multiple

Examples of patient intervention enabled by 100Plus

Hypertensive crisis

One patient had changes to his medication by the rheumatologist which affected this patient’s blood pressure and caused a hypertensive crisis. Dr. Liberoni received a patient alert notifying him that this patient’s blood pressure was out of the normal range and was able to reach out to the patient by phone to address. The patient then came into the office for a follow-up appointment at a later date. Dr. Liberoni was able to
adjust the medications and follow the impact of the adjustments using RPM.

Uncontrolled hypertension

Were able to pick up issues earlier vs waiting for the patient to come in with a problem. Started medication
adjustments prior to the patient coming in – avoided ER visits or hospital admissions. Having an accurate device enables the doctor to adjust medication remotely vs waiting for the patient to come into the office. Similar experience with a glucose monitor.

Engaging patients by using the 100Plus platform

Dr. Liberoni’s office began enrolling eligible patients when they came into the office and now has over 1000 patients using 100Plus remote patient monitoring devices. Dr. Liberoni calls the devices his “eyes and boots in the house,” giving him a better understanding of how patients are doing on a daily basis — while they live their lives. With this new data-backed understanding of their patient population’s day-to-day health, they’re able to pick up earlier on symptoms of health crises and prevent the need for emergent care.

They’re able to engage with their patients during telemedicine visits armed with information and health trends particular to that patient. This facilitates a much more productive telemedicine visit and better overall outcomes.