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Enhancing COPD Care with Chronic Care Management and Remote Patient Monitoring


Chronic Care Management for COPD

COPD, or Chronic Obstructive Pulmonary Disease, requires vigilant, ongoing care to manage symptoms and improve patients’ quality of life. Many healthcare providers, however, often find themselves without the resources or specialized staff to provide the hands-on support that COPD patients need. Fortunately, innovative approaches in Chronic Care Management (CCM) and Remote Patient Monitoring (RPM) are helping bridge this gap by enabling continuous engagement and support for COPD patients outside of traditional clinical settings.


Why Patient Engagement Matters in COPD Management

Consistent patient engagement is essential to managing COPD successfully. A proactive approach to care can make a significant difference in achieving the following critical goals:

  • Smoking Cessation: Vital for preventing disease progression.

  • Medication Adherence: Ensuring patients take their medications correctly for optimal effect.

  • Pulmonary Rehabilitation: Guiding patients through exercises and therapies that support lung function.

  • Symptom Management: Educating patients on avoiding and responding to flare-ups.

For many providers, adopting a CCM program has become a practical solution for addressing these priorities. These programs not only promote patient engagement but also allow providers to capture reimbursement for covered services, making it a win-win for patients and practices alike.


The Role of Chronic Care Management and Remote Patient Monitoring

When COPD patients leave the clinic, maintaining their health can be challenging. Here, CCM programs have proven to be instrumental in slowing disease progression. According to a study published in the International Journal of Chronic Obstructive Pulmonary Disease, a comprehensive disease management program, which included patient education, case management, and regular follow-up, reduced hospital admissions and length of stay (LOS) by 30%.


CCM supports COPD patients with:
  • Personalized Care Plans: Tailored to individual needs and health goals.

  • Lifestyle Education: Guiding patients in self-management and healthier living.

  • Preventive Care: Coordinating timely vaccinations and screenings.

  • Treatment Navigation: Assisting patients in managing complex medication regimens and other therapies.


For instance, care managers can ensure that COPD patients receive essential flu, pneumonia, and COVID-19 vaccines annually, a crucial measure in maintaining health and preventing complications.


RPM technology complements CCM by providing continuous, real-time monitoring of key health indicators. With devices like peak flow meters and oscillometers, RPM allows clinicians to track physiological metrics and receive alerts when readings deviate from target ranges. Clinical studies have demonstrated RPM's potential to significantly enhance COPD outcomes:

  • 65% Reduction in Unplanned Hospitalizations: Fewer emergency visits per patient annually.

  • 63% Reduction in Cardiopulmonary Hospitalizations: Decreasing hospital admissions for related conditions.

  • Shorter Hospital Stays: Reduced length of stay by 1.28 days for cardiopulmonary issues.


How ChronicCare Supports Comprehensive COPD Management

ChronicCare’s care management platform empowers providers to deliver integrated, patient-centered care by streamlining essential tasks and processes. Our platform is designed specifically to support COPD patients with CCM and RPM, providing:

  • Seamless Enrollment and Care Planning: Efficient onboarding and individualized care plans.

  • Device Management: Ordering, registering, and managing RPM devices for easy use.

  • Data Capture and Alerts: Tracking real-time patient data and notifying care teams when metrics fall outside safe ranges.

  • Automated Documentation: Simplifying claims processing for time- and device-based documentation.


ChronicCare’s evidence-based workflows are aligned with industry standards, making COPD care efficient, scalable, and cost-effective. By combining CCM and RPM, our platform enables a holistic approach that keeps patients healthier, reduces hospitalizations, and ensures providers can capture reimbursements effectively.


With ChronicCare, COPD patients gain continuous support while providers gain the tools they need to offer high-quality, proactive care management.


Offer Chronic Care Management To Your Patients With ChronicCare

ChronicCare partners with Physicians, Hospitals, Payors, and Employers to offer Chronic Care Management Services to their patients. We are dedicated to helping people improve their health and quality of life by maximizing their healthcare outcomes. We bridge the gap between healthcare visits, in order to ensure patients are continually care for each month.


Click here to connect with our team, we'd love to discuss potential benefits to your patients, staff, and practice.

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