Date of Award

January 2013

Document Type

Open Access Thesis

Degree Name

Master of Public Health (MPH)

Department

School of Public Health

First Advisor

Judith H. Lichtman

Abstract

Background: The PREDICt-RM study found that Remote Patient Monitoring (RPM) was used by less than half of eligible patients with implantable cardioverter-defibrillators (ICDs) between 2006 and 2010 despite guideline recommendations. We investigated whether the addition of new Current Procedural Terminology (CPT) codes for RPM in January 2009 had impact on utilization of RPM technology and whether the impact varied by race or geographic region. Methods: We used multivariable logistic regression to determine whether subjects in the PREDICt-RM study cohort receiving an ICD post-coding change were more likely to enroll in an RPM program or activate RPM (transmit RPM data) within 180 days of implant, versus those implanted pre-coding change. Rate differences between the post and pre-coding change periods were calculated overall and for racial and regional subgroups. Results: Subjects implanted after the 2009 coding change were less likely to enroll (OR 0.76) and more likely to activate (OR 1.27). Enrollment rates in the Post period were significantly lower than the Pre period in most regions and among all races. Activation rates were higher in most regions, but only among white subjects. Conclusion: The 2009 CPT coding change was not associated with an appreciable rise in RPM utilization, and minorities continue to underutilize the technology to a greater extent than white patients. There is a need for the professional community to standardize the implementation of RPM technology in routine practice, and further studies should examine patient and provider motivations for utilizing RPM.

Comments

This is an Open Access Thesis.

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