All authors contributed to, reviewed, revised, and approved the final manuscript, which represents the consensus recommendations of all authors (in this publication, referred to as the panel). After the in-person meeting, follow-up surveys were distributed to obtain more details on best practices regarding the frequency of monitoring, clinically relevant metrics, which metrics should trigger notification to the care team when outside an acceptable range, the timing for this notification, and reimbursement considerations. The in-person discussion was driven by presurvey results (questions developed by the cochairs) in addition to presentations on the remote management of CIEDs, the unmet needs in the field of SCS, the history of remote monitoring reimbursement codes, and the billing requirements for remote physiologic monitoring (RPM) and remote therapeutic monitoring (RTM) reimbursement. Recommendations detailed in this manuscript are based on the authors’ clinical experiences and skill, owing to the relative lack of previous publications on remote management, and were refined using in-person discussions, survey responses, and correspondence. These recommendations are offered with the assumptions that appropriate patient selection, surgical technique, and postoperative care are observed Recommendations are based on available literature, the opinions of 15 expert interventional pain physicians and neurosurgeons, and input regarding SCS device remote functionalities from experts in remote monitoring of medical devices. It is directed to physicians and other healthcare providers, in addition to third party health plans, to provide preliminary guidance on the potential value and implementation of remote device management in the field of SCS, including the recommended frequency of remote follow-up, the limitations of remote device management, methods to address reimbursement issues, the roles and responsibilities of all involved parties, methods to address ethical and privacy issues, and future research needed to support remote SCS device management. This manuscript summarizes expert consensus and recommendations for remote spinal cord stimulation (SCS) device management. Both existing and needed clinical evidence were covered, including outcomes of interest for future studies. The guidelines were developed in consideration of reimbursement processes, privacy concerns, and the responsibilities of the care team, industry professionals, manufacturers, patients, and caregivers. Such periodic reviews of remote monitoring metrics would occur separately from automatic monitoring system notifications (if key metrics fall outside an acceptable range). Recommendations were made for frequency of reviewing remote monitoring metrics, although providers should tailor follow-up to individual patient needs. The panel identified metrics for remote monitoring and classified them into three categories: device-related (eg, stimulation usage) measurable physiologic or disease-related (eg, patient physical activity or pedometry) and patient-reported (eg, sleep quality and pain intensity). Major goals of remote SCS device management were identified, including prompt identification and resolution of SCS-related issues.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |