Give Your Device Clinic a Check-Up

Thursday, October 25, 2018 | Nicole Knight

Remember the “old” days when you would put the telephone receiver into a transmission dock and receive pacemaker data through the phone line? Clearly—we have come a long way since then.

Today’s automated, remote management (RM) technologies are far less clunky and they deliver far more data. Add to that the need for in-person visits, the complexity of patient compliance, and capturing charges for these services and it’s understandable that the deluge of data has put so many practices on tilt.

During the recent CV Transforum Fall’18 conference, I heard a lot of questions and concerns about device clinic management: What’s the best way to minimize lost-to-follow patients? How can we provide fast access to patients with urgent needs? How do we make sure we are capturing all the billing? And how can we staff all of this when we’ve got 5,000 device patients who need four RM visits and 1 in-person visit a year, and there are multiple data systems and processes to deal with?

These are just a few of the things practices are grappling with. Let’s face it: reorganizing device clinic operations and staffing to meet all of these needs can feel like turning a cargo ship that’s barreling across the high seas at 300 mph.

Yet, from a patient care and outcomes standpoint, optimizing the device clinic is essential. So if you are one of the many programs looking for ways to improve the infrastructure, staffing, and make sure you are properly reimbursed, now is a good time to ask yourself these questions:

  1. Do you have a device clinic optimization plan? If not, it’s time to start looking at your clinic. There are 4 key areas to focus on: access, staffing, adherence, and reimbursement.
  2. Are you optimizing the features of your device management system? Many practices purchase a good platform, but it’s not used effectively by everyone. Are all staff fully trained to use the features? Are alert and other settings configured correctly? Are the right people reviewing the right reports? If the answers are no, review best practices, tips, and the need for additional training.
  3. Are you capturing all the patients who need to be seen or remotely followed? In many programs we visit, not all patients have been been registered in the device management system or have not followed up as scheduled. It’s usually a manual process, and gets put on the back burner when staff are busy. Do you have a good process to make sure registration happens?
  4. When was the last time you reviewed your lost-to-follow process? Without a solid process there is no good way to track patient non-compliance, follow up with those who don’t show up, or cancel scheduled appointments. Map out your current process and understand the staffing necessary to complete this process. Review it for gaps and opportunities.
  5. Do you have a remote data alert protocol in place for the device clinic? How do you escalate patients whose data comes back at risk? Is there a clear procedure? When was the last time you discussed it? A well-designed protocol includes a decision tree for each type of alert, specific condition or necessary physician review needed.
  6. Is outsourcing an option? Engaging a third party is becoming a viable option as new device clinic management companies hit the market. These companies combine integrated software platforms with support services that include performing your RM and following up on alerts and patients whose quarterly reviews need attention. Yes, you may lose the technical revenue. But you still get paid for physician interpretation. The net financial result may actually be positive considering the potential reduced staff, software, and other expenses. Additionally the potential improvements in patient compliance and satisfaction are a huge benefit to evaluating these options if they meet your needs.
  7. Have you considered getting an assessment of your device clinic? Opportunities are always identified in the device clinics we visit. Are you capturing all reimbursement? Do you have the right staff doing the right things? And finally, are you identifying opportunities for improvement in your processes?

The importance of device clinics will continue to increase as the volume, new technology and variety of data streams grow. Create a device clinic optimization plan now so your organization is prepared for the risks and rewards of these opportunities.

MedAxiom’s blog post is published every Thursday at



Illustration: Lee Sauer

About the Author
Nicole Knight

Nicole Knight, LPN, CPC, CCS-P, ACS-CA, is Vice President, Revenue Cycle Solutions and Consulting at MedAxiom. Her decades of hands-on health care experience includes cardiology and neurology practice operations, clinical management, business office management, and consulting for coding and compliance. Nicole maintains her LPN licensure in Louisiana and Florida. She is a member of the American Academy of Professional Coders and the American Health Information Management Association. She received her Advanced Coding Certification with the Board of Medical Specialty Coding. Nicole is a certified AHIMA ICD-10-CM Trainer and completed a Lean Sigma Healthcare training course at Johns Hopkins University. She also serves on the Physician Practice Council for AHIMA.

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