When it comes to innovation, the phrase “thinking outside of the box” is a cliché. But when it comes to using a “big box” retailer to extend health care beyond the walls of a hospital, clinic or doctor’s office, the highly effective collaboration between integrated health system Geisinger and retail giant Best Buy elevates the idea to a new level.
Since 2022, Geisinger has leveraged Best Buy’s Geek Squad to deliver, install and activate remote-care management devices from the health system. The devices include blood-pressure cuffs, body weight scales, thermometers and glucose meters to monitor patients’ health at home and transmit data back to their care team at Geisinger.
“We saw improvement as far as our patient engagement and time to activation on the devices, and saw the importance of getting the devices to them—not just through UPS—but hand-delivered, creating a new level of customer experience,” said Emily Fry, MHA, vice president of innovation operations for the Steele Institute for Health Innovation at Geisinger.
In an early pilot with 300 patients, researchers found that using the Best Buy Geek Squad led to:
- 50% faster time to activation of devices.
- 19% higher rate of patient adherence to using wearable device.
- 18% reduction in technical issues reported.
“Geisinger is utilizing Best Buy Health to build out a care continuum model with the enabling technology of remote-patient monitoring—but it is more than that,” Fry said at the Healthcare Information and Management Systems Society (HIMSS) Global Health Conference in Orlando, Florida.
First and foremost, it’s about building a care model and adapting the technology to support it is secondary, Fry said.
“The support services make this possible,” she added.
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Data transmission can be alarming
Geisinger has cared for more than 27,000 patients using remote technology since 2010, including 3,000 using the Best Buy—formerly Current Health—platform.
ConnectedCare 365 is being used by 14 clinical programs for patients in acute care episodes, those in pre-surgical or post-acute transition, and those receiving low to complex management of their chronic conditions.
“Our goal is to manage, in a care model, all of these different patient population sets and deploy remote patient monitoring technologies across the organization,” Fry said.
Some patients require continuous monitoring, others only intermittent monitoring, and others self-report using the scale or BP cuff.
The more monitoring there is, the more data comes in. It is important to understand what data is important to respond to, what is clinically relevant and what is not, Fry said, so getting it right is part of the learning process that Geisinger is still going through.
Fry added that Geisinger has had to acquire much of this knowledge through its own experience as “there’s not a ton of scientifically backed studies around the use of these devices in poly chronic populations,” except for BP cuffs, which she encouraged everyone to use.
“There’s a lot of data on the use of BP cuffs in chronic hypertension: Use the remote blood-pressure cuff,” Fry said. “It is proven to help.”
Geisinger is researching what volume of “touches” patients need, what level of health professional needs to deliver them and what do patients prefer.
“The key here is the personalization through the mode you want to be communicated with on the Best Buy Health app—they have the notifications,” Fry said. If needed, a nurse can call or text you, but it is also not needed all the time because there are automatic notifications to tell you to take your blood pressure or step on the scale.”
AMA MAP™ Hypertension is an evidence-based quality improvement program that provides a clear path to significant, sustained improvements in BP control. With the AMA MAP program, health care organizations can increase BP-control rates quickly. The program has demonstrated a 10% increase in BP control in six months with sustained results at one year.
Patients’ conditions affect expenses
Billing and return on investment (ROI) are still unclear also. Traditional fee-for-service billing won’t cover all expenses and there is no raw number of patients that will create a tipping point, Fry said, noting that it is patients’ conditions that affect expenses and revenue, not the volume.
Fry was joined by Benjamin Zaniello, MD, MPH, chief medical officer for Best Buy Health, who added that what may drive ROI is being able to discharge someone faster or letting them go home rather than to a skilled nursing facility. Caring for someone at home also boosts capacity by freeing up hospital beds or time for primary care office visits.
Geisinger’s bottom line is boosted by having its own health plan and by participating in an accountable care organization, Fry said.
“We are incentivized to keep patients healthy and keep them at home,” she explained.
Leveraging Best Buy’s logistics
There is skepticism, noted Dr. Zaniello, from some about the retailer’s entry into health care.
“One of the questions we always get—and I have gotten it pretty much every hour on the hour, if not more, at HIMSS—is: ‘Who are you in health care? You have big box stores and sell retail items,’” Dr. Zaniello said.
“But,” he noted, “we have a huge logistics network that is often delivering items—sometimes related to health care, sometimes yes, the TVs that are associated with us—into the home.”
The “ultimate goal” for Best Buy is to make the process of receiving care at home easier by bringing in the needed technology, helping patients use it, and making sure it works inside their homes.
In separate remarks at the conference, HIMSS CEO Hal Wolf welcomed untraditional players into the health care arena. Retailers and banks, for example, are often considered way ahead in their use of IT.
Health care “has to learn from other industries,” Wolf said.
