Quest Health Solutions for Diabetes RPM using CGMs
Life can be challenging, but managing your diabetes shouldn’t be. Our partners at Quest Health Solutions with Mozzaz as the underlying technology have combined Continuous Glucose Monitoring (CGM) with Remote Patient Monitoring (RPM) to improve the management of diabetes.
Whether your patients are pre-diabetic, type one, or type two - listen in on Quest Health Solution’s unique offering and discussion surrounding CGM device eligibility, CMS reimbursement and more.
Learn how Quest Health Solutions can help augment your practice with their on-staff medical support for your RPM program, leaving you able to focus on those who need your care most.
Blog Overview
What are we seeing in the market for CGM’s as it relates to Remote Patient Monitoring (RPM)?
Are both Type I and Type II Diabetes Patients Eligible for CGMs?
Technology Evolution and Mozzaz Partnership with Quest Health Solutions Defined
Trending Towards Virtual Care and Closing the Healthcare Data Loop
Who is Quest Health Solutions?
[Adam Nadler, CEO at Quest Health Solutions]
Quest Health Solutions is one of the leading providers of continuous glucose monitors (CGMs) in the United States. We service patients across 48 states, and we have been in business since April of 2019 – as a result we've really seen this market grow.
What are we seeing in the market for CGM's as it relates to Remote Patient Monitoring (RPM)?
[Adam Nadler, CEO at Quest Health Solutions]
Sure. Well, it's actually a very exciting time right now with CGM's.
Ever since the beginning of COVID, there were a lot more restrictions on continuous glucose monitors and their access to people with diabetes. A lot of the studies got accelerated quickly with how it (CGMs) could benefit people with type two diabetes and type one.
So we've seen Medicare, which is really the standard for allowing access to patients and people with diabetes, kind of take down the barriers to entry.
For example, when we first got into this business, to qualify for CGM, you had to be testing four times a day and injecting insulin three times a day. As time progressed, they took away the four time a day testing. Now as of April 16th, they've moved away from the three times a day injecting, and it just has to be that you are prescribed insulin.
So, for our industry and for people with diabetes, this really is a great opportunity for people to get access to these devices that are life changing and so we're very excited!
Are both Type I and Type II Diabetes Patients Eligible for CGMs?
[Adam Nadler, CEO at Quest Health Solutions]
That's a great question. During COVID, they (Medicare) actually relaxed some of the coverage criteria and allowed type two patients to get access if it was medically necessary for their patients.
So, a doctor would prescribe (a CGM) to their type two patients if they had severe hypoglycemic events, but inside the Medicare coverage determination, it wasn't written into regulation.
One of the things that came out on April 16th, which was really a breakthrough for Medicare patients and for private insurances to follow suit, is now type two patients with diabetes if they experience a level two hypoglycemic event, which means that their blood sugar drops below 54 or a level three with a change in their regimen with their physician they'll now have access to these (CGM) devices.
It's going to be great to see these type two patients clinically get approved for these devices.
Technology Evolution and Mozzaz Partnership with Quest Health Solutions Defined
[Rini Gahir, CEO at Mozzaz]
We are seeing a lot of evolution in terms of technology, both on the hardware side and on the data side, and just the ubiquity in terms of patients having access to various technologies.
And so it's definitely an exciting time, especially in areas of complex care diseases.
Mozzaz, as you know, has been working on clinical programs, interventions and connected devices over the last few years, but seeing the advancement in some of the CGM data and the ability to collect data almost real time on a high frequency type basis gets you some very interesting insights into an individual's glucose levels.
In addition to that, having the ability to collect some extra metadata around an individual, such as maybe their physical activity, their sleep patterns, their diet and nutrition patterns, and aggregating that data, correlating it with the glucose data, becomes really powerful.
When we started working with Quest (Health Solutions) a few years ago and Quest being a strong partner with Abbott, Dexcom and in the CGM space. It seemed like a powerful and good fit. There was a lot of synergy there.
Through our partnership we were able to implement and wire up the technology underneath, fairly quickly and cost effectively that enabled us to go to market, show value and prove value to a number of clinics, but then also to Abbott and Dexcom themselves.
Adam, what do you think about that?
[Adam Nadler, CEO at Quest Health Solutions]
I do agree. I can tell you that in the beginning, several years ago, I don't think a lot of these providers, endocrinologists or primary care physicians that were managing patients’ diabetes were really looking that intently into the data.
One of the things that changed were the RPM codes in the end of 2019 early 2020 that allowed clinical staff outside of the physician to work with these patients, and the codes that came out that Medicare introduced allowed more interactions between the patients and the staff of the doctor under their supervision.
So, we found that there was a need for this, and we believe that accelerates the CGM - RPM type of integrations that people are looking for. One of the unique things I can say, and what makes our partnership unique with Mozzaz, is the fact that we went to Abbott and pitched to them this idea that RPM is the future of CGM right there.
They're collecting cloud data constantly with Abbott's LibreView product, with Dexcom’s Clarity product, but in particular with our very good partnership with Abbott being a direct supplier I saw the vision of being able to integrate RPM and CGM and the only way we can do that was to have this HL7 integration.
As a DME supplier we're not a software company, right - so the beauty with Mozzaz is that they assisted us in the entire integration and the implementation process with Abbott's team.
So, taking Mozzaz’s expertise and the ability that Abbott gave us to have this agreement really kind of propels us and puts us in a different category than other RPM providers that are just your typical blood glucose meter finger stick because we're moving away from that right. You don't want to sell an RPM product when CGM is now the new standard of care.
So from there, you have your blood pressure cuffs your pulse oximeters but no one really had the Abbott connection so that's where really this becomes a unique offering and it's a win-win for us because we have the patients that we can monitor.
But we now go to the physicians that are sending us prescriptions for their patients for referrals and we're going back and saying listen, we can offer this program that no other company in the country can offer - and that's what makes this partnership so special.
How We Make the Data Actionable for Care Teams
[Rini Gahir, CEO at Mozzaz]
Yeah, I mean, there's a lot of data that we're collecting through the system and through the platform, so the trick is how do you make it meaningful, relevant, and actionable at the right time for proper clinical care?
What we've done is create a number of dashboards, various rules and thresholds and paired it with logic in order to surface the overall data in a more meaningful way to create a holistic view of your patients.
The last thing you want to do is create an alert storm for clinicians and patients. So, filtering the data, making it usable, making it structured in a way that is meaningful and actionable by clinical teams is the goal.
We have progressed there quite a bit and we're seeing some really good results. You don't want people just living in the data and trying to piece it together - the data should tell a story, and it should be accurate, relevant, and timely to the individual.
Adam, what do you think?
[Adam Nadler, CEO at Quest Health Solutions]
I do agree. One of the other things that is also important is the patient satisfaction and the patient care.
In the case of our clients, we get that data for a lot of practices might be overwhelming. One of the beautiful things about our service is that we are not just giving the tech to a practice and saying, here you go. We have MAs, we have diabetes educators on staff that are going to work in conjunction with that practice and take a lot of the burden off them.
When we go to them initially and say we have this RPM program, then they say, well, we don't have the staff to handle it. We want to be the first line of defense and triage that patient.
A lot of times, what we see is a patient might call because their sensor might fall off, or they have a question about their food, or any other question such as if they just went hypo a couple of times, and they could really inundate a doctor's office.
What we do well from a supplier side and from a patient satisfaction and customer service side is, we know how to service the patient. We work with that doctor’s office and discuss them letting us take those initial phone calls.
If there's an issue, we could then escalate it to the practice, but you know, 90% of the time the patient just wants that extra handholding. In addition to doing that and giving them assistance with their health, with their exercise, with nutrition and with their numbers, this all becomes a billable event also for that doctor’s office.
It doesn't have to be done within the physician's office. The physician can give us the directives to say, okay, if a group of patients or a segment of patients get to this level over a certain period of time then we could even schedule a point for the patient to come in.
So, we're really elevating that patient care and that touch point between maybe visiting the doctor only every six months or three months and looking at that data in retrospect. It isn’t helpful pulling down an AGP report from three months ago, what is happening now for that patient?
Most importantly we want to keep that patient out of the hospital. We want to create better outcomes and we want to have a better patient experience, not only for the doctor’s office, but for the devices to show that they actually create a value compared to the old way of sticking your finger.
[Rini Gahir, CEO at Mozzaz]
I think it's also valuable for the patient to see a better picture of themselves. They see all this data that is being collected and is relevant to their personal health. So, as they make decisions or lifestyle choices while part of an RPM program, it becomes measurable and it becomes really effective in that sense.
Trending Towards Virtual Care and Closing the Healthcare Data Loop
[Rini Gahir, CEO at Mozzaz]
Over the last few years in the COVID era, there has been a definite trend towards virtual care. A lot of organizations have tried to implement something at different levels, some work, some didn't work, but there's a lot of learning still that's taking place. Best practices have started to evolve out of virtual care. So, I think in terms of patient satisfaction and labor shortages on the clinician side which is a huge problem all over the place.
These are big problems to solve, and they haven’t been solved yet. So, I think what we're doing with Quest and with Adam's team is hitting the mark and has relevance in terms of excellent continuous clinical care and patient activation overall.
[Adam Nadler, CEO at Quest Health Solutions]
The physicians already trust us, we're servicing their patients already so they're giving us the prescription for that CGM, which is the hardest part to do in the first place right.
They're sending us scripts; they want us to take care of their patients. So now we're just adding an extra layer for them to say listen, now that they have the device let us show you how we can even improve above and beyond just giving them the device for you.
Let us show you how it can make their lives better and let us show you how we can help your office become a better conduit with that patient, with Quest being an extension of your practice as well and not just a supplier of a unit.
[Rini Gahir, CEO at Mozzaz]
I think the other important aspect from the data perspective is collecting all this data from the patient level - aggregating, consolidating, crunching all the numbers, and providing meaningful visual dashboards. Then sending that data back and updating that patient's chart on the EHR in the back-end system for the clinical team.
Ensuring that the data has the full round trip is vital to avoid siloed databases and systems which we know can be an issue for care teams already.
Closing Remarks and Next Steps
[Adam Nadler, CEO at Quest Health Solutions]
I truly believe that the future of continuous glucose management and monitoring is also overlaying itself with a remote patient monitoring program. That is the purpose of all this data, and it is a very important initiative of mine, dating back almost a year and a half when coming together with Rini.
I would love to have the opportunity to speak with people directly, you can reach me at my personal email at adam@questhealthsolutions.com. I'd be happy to discuss the RPM codes, tell you a little bit more about our platform, where I think the market is going with RPM and how to get you started with your practice. It would be my pleasure.
[Rini Gahir, CEO at Mozzaz]
I think technology can be scary to some – especially with all this data, the evolution of RPM, patient engagement, and virtual care. Those are a lot of big buzzwords.
What we've done at Mozzaz and with Quest is we try to take that complexity away from implementations and rollouts of such systems. There's a lot of things to think about when getting an RPM program off the ground - there's interoperability, security, compliance, data integrity, data updates among many others!
If you have any questions about an RPM solution for your organization, feel free to talk to Adam or myself. We have been doing this for a long time and are happy to address any of the issues you might be facing.
