Two years ago, the remote patient monitoring platform Luscii and ChipSoft set off on a journey to enable remote patient monitoring from the EHR. With remote monitoring, patients do not always have to come to the hospital. This saves care staff precious time, which they can use for patients who really need it. This turned out to be the perfect solution during the COVID-19 pandemic. Virtual COVID-19 nursing wards were set up, and creative doctors and nurses created remote monitoring programmes for dozens of syndromes. Since its start in 2018, it has developed into an ecosystem. Now, we're taking the next step: starting remote patient monitoring from HiX, with a single, easy click.


From a small beginning to a huge impact

The remote patient monitoring functionality started small, but has already made a huge impact. In 2018, the interface between the Luscii home monitoring app and ChipSoft's EHR HiX was made. This integration had been a long-cherished dream of many care providers. The integration of remote monitoring in the EHR allowed them to quickly and easily register patients without having to manually copy data. It also allowed them to receive remote monitoring reports directly on their task list in the EHR and to process actions for remote monitoring directly from HiX.


From waiting room to living room

This step turned out to be crucial for the expansion that followed. More and more hospitals realised that patients could do or prepare at home various things that would have otherwise required a visit to the outpatient department. On their Luscii app, the patients can see what they have to do. These actions can vary: it may be measuring something with one of the more than 100 linked wearables, or answering a questionnaire about how they feel, or watching an animation about how to live with a specific condition, or reading self-care tips like a COPD exacerbation action plan. Algorithms in the Luscii app analyse all the data, and the care staff will receive an alert on their task list in the EHR if their attention is required. They can easily contact patients with an appointment request in the patient portal, or with a video call, or they can simply send a message.


Each euro invested saves eight euros in healthcare expenses

The new remote patient monitoring option in HiX changed a lot. Where care staff first had to log in to a separate application, they could now process remote measurements directly with all other patient data. What were the benefits? The University Medical Center Utrecht (UMC Utrecht) analysed the data from HiX and Luscii as part of its research on the effects of remote monitoring for women with gestational hypertension or preeclampsia. The results were convincing: fewer visits to the outpatient department, fewer and shorter admissions, and fewer diagnostic procedures. What's more: patients were happy and care providers saved a lot of time. For every euro invested, 8 euros in healthcare expenses were actually saved, calculated Dr. Hans van den Heuvel in his PhD research on this subject, supervised by professor Mireille Bekker.


A pandemic that boosted the creativity of health staff

More hospitals followed. Then, the COVID-19 pandemic started, and changed everything. Hospitals closed for non-essential healthcare, and remote patient monitoring was often the only way to keep a remote eye on the patient. Projects scaled up rapidly and the ecosystem of remote monitoring programmes and healthcare applications continued to grow. Last year, medical specialists and nurses developed more than 40 remote monitoring programmes: from oncology to surgery, from paediatrics to ophthalmology, and from gynaecology to internal medicine. It turned out to be a great solution for patients with diabetes, asthma, atrial fibrillation, and even for pre- or post-surgery surveillance or cancer treatments.


Insurance coverage for remote patient monitoring

As remote patient monitoring scaled up, the question of who would pay for this form of healthcare arose. Many hospitals managed to make agreements about using remote patient monitoring for various patient groups. Healthcare insurer CZ, for example, started a special programme to help hospitals make the switch. Insurer Zilveren Kruis concluded contracts to move 10 to 20 percent of health care to home situations. Doctors and nurses developed remote patient monitoring programmes and looked into how remote monitoring could help them and the patients. And last week, word got out that, upon recommendation of the OLVG hospital and Zilveren Kruis, the Dutch Healthcare Authority has determined the compensation for remote monitoring of patients with COPD, asthma, chest pain, atrial fibrillation, and hypertension. This turns this type of digital care into normal care.


Starting remote monitoring with a single click

'So, you're a developer and you just wrote this amazing app, and what is your dream? Your dream is to get it in front of as many people as possible in order to make a huge impact.' With words similar to these, Steve Jobs launched the App Store in 2008. This was the beginning of an enormous ecosystem. Why wouldn't that be possible in healthcare as well? With this vision, Luscii founder and digital health professor Daan Dohmen revealed the Luscii Library on 14 October 2021, to the 200 physicians and nurses attending the first Luscii Medical Developer Conference that Luscii organised in partnership with ChipSoft


Cooperating and sharing proven remote patient monitoring programmes

Healthcare staff can search for remote patient monitoring programmes in this app library. They can see which physician developed a programme, what patients think about that programme, which hospitals use it, and what the most important functions are. If they're interested, they can directly start a programme themselves. In hospitals that offer Luscii through the Care Platform, the Library is available directly from HiX, using modern (international) FHIR standards. In this way, ChipSoft and Luscii work together to expand the ecosystem that was started in 2018, while allowing every health provider to share their creation with other hospitals. After all, cooperation to improve healthcare is the future.


More room for care, scaling up faster

The integration with Luscii has demonstrated how certified apps, using specific use cases from healthcare facilities, can contribute to the healthcare of tomorrow. The way for other digital health apps to integrate with the EHR has opened up. In fact, the way has already been paved and is waiting to be trodden. If the cooperating parties make clear agreements about the value that the solution adds, it will be a fantastic journey. The more care professionals can use the app to benefit from each other's knowledge and network, the faster healthcare as a whole can scale up the use of solutions that reduce the registration burden.

Luscii believes, as does ChipSoft, that an open ecosystem is the way to get there. 'It's time that other healthcare apps also look into the possibilities of integrating with the EHR,' Dohmen says. 'The results with the Luscii app shows that integration and cooperation are worth it, and lead to better and modern healthcare for the patient, while creating room for care for the health providers. I encourage providers of certified health apps to look into integration with HiX as well! This way, we can diversify the HiX ecosystem and improve healthcare together. Who's next?' 


< Check out the Luscii Library >