Opening the conversation: your monitoring priorities

• To get started, tell me briefly which patient populations you are most focused on for remote monitoring
• In a typical month, how many patients in those cohorts would you expect to generate home-monitored readings you want reviewed Options: Under 100, 100–500, 500–2,000, Over 2,000, Not sure yet
• Walk me through the last time a home reading changed a clinical decision and prevented an escalation, what happened and who acted
• How do you currently define success for a monitoring program, for example reduction in admissions, improved condition control, or sustained patient engagement Options: Reduction in hospitalizations, Improved disease-specific metrics (BP, A1c, weight), Time to clinical response, Sustainable patient enrollment, Clear billing revenue
• Which clinical or operational roles on your team would be involved day to day in monitoring and follow up Options: Population health nurse, Care manager, Primary care clinician, Specialty nurse (cardiology, endocrinology), Clinical informaticist, Revenue cycle/billing

Where patients slip through the cracks

• If you had to point to the single monitoring failure that costs you the most in avoidable admissions, what would it be
• Describe the current monitoring cadence and which devices patients are asked to use at home Options: Daily vitals, Weekly scheduled checks, Symptom-driven only, Mixed schedule per cohort
• How often do incoming alerts exceed your team's capacity to respond within your target window Options: Almost always, Often, Sometimes, Rarely, Never
• When a critical reading arrives in your EHR today, who sees it first and how does it appear in their workflow
• Roughly what percentage of alerts do you consider false positives or non-specific today Options: Under 10%, 10–25%, 25–50%, Over 50%, Unknown
• What single operational constraint would make you stop a pilot before it completes

How alerts and thresholds shape daily work

• Imagine alerts were reduced by half overnight, what would change in your team's day and priorities
• Which readouts among blood pressure, glucose, weight, pulse oximetry, and activity create the most clinical follow up for your teams Options: Blood pressure, Blood glucose, Weight, Pulse oximetry, Activity/steps, Symptoms
• How are alert thresholds currently set, and which roles can change them Options: Set by device default, Set by clinical leadership, Set by informatics/IT, Clinician-level customization allowed
• Tell me about the last time adjusting a threshold reduced outreach volume, what rule changed and what was the result
• Estimate the average time a clinician spends handling a clinically significant alert from notification to resolution Options: Under 5 minutes, 5–15 minutes, 15–30 minutes, Over 30 minutes, Varies widely
• If your team could not receive monitoring data into the EHR within your daily workflow, would that stop the project Options: Yes, it would stop the project, It would delay the project, We could proceed without full EHR integration

Integration and data access are make or break

• If API approvals or data feeds take months to finalize, can your intended timeline still be met Options: Yes, timeline can absorb it, No, timeline would slip, Timeline would need review
• List the systems that must be integrated for monitoring to be operational in your environment Options: Primary EHR, Patient portal, Identity management, Lab system, Billing/RVU system, Care management platform, Other
• Who controls API access for those systems and what is their typical provisioning lead time Options: Internal IT team (under 2 weeks), Internal IT team (2–6 weeks), Internal IT team (6+ weeks), Third-party vendor manages access
• Do you have a dedicated technical owner who can commit time to integrations and pilot support Options: Yes, assigned owner, We can assign for pilot, No dedicated owner
• Which compliance or legal approvals must be completed before patient data can move outside your environment Options: IRB/ethics review, Legal contract and DPA, Privacy office approval, None beyond standard BAAs, Other
• What specific data or access failure would immediately stop the engagement

What keeps leadership awake at night

• Which single metric, if unchanged after six months, would make leadership pause or cancel the program Options: Hospitalizations, ED visits, Patient enrollment rate, Clinician time burden, Billing recovery
• How does uncertainty in RPM reimbursement affect your appetite to expand monitoring beyond a single pilot Options: Major constraint, Moderate constraint, Minor constraint, Not a constraint
• Have frontline clinicians pushed back on added monitoring tasks in previous pilots, and if so what were their main concerns Options: Alert volume, Workflow interruptions, Lack of training, No concerns raised, Other
• Tell me about patient adoption challenges you have seen with home devices, include the most common reasons patients decline or stop using them
• If enrollment remains below 60 percent of your target after three months, would you continue, pause, or stop the program Options: Continue and adjust, Pause to redesign, Stop the program

Alternatives you are weighing

• Who would you default to if you decided not to change vendors or partners today
• Please list the external vendors or internal teams you have evaluated so far and the current status of each evaluation
• Which internal build or staffing proposals has leadership suggested as an alternative to using an outside partner Options: Build internal platform, Hire additional nurses for monitoring, Contract with third-party clinical service, Other
• What would have to be true about your current approach for you to stay with it instead of changing
• Has anyone formally proposed solving this without an outside vendor, and who would lead that effort Options: Yes, IT would lead, Yes, population health would lead, No formal proposal, Other
• If an incumbent offered a lower price but no verified clinical outcome improvements, would that be enough for you to stay Options: Yes, No, Maybe with conditions

How you will know this is working

• If the pilot hits your target clinical impact, what would prevent a rapid rollout across other sites
• Which of the following metrics will determine pilot success for you Options: Admissions avoided, ED visits avoided, Percent of eligible patients enrolled, Average time to clinician response, Alert volume per clinician
• What is your current baseline for hospitalizations or ED visits in the target cohort, per 1,000 patients or as a percent
• What minimum percentage reduction in hospitalizations over six months would you require to proceed to a paid deployment Options: Under 5%, 5–10%, 10–20%, Over 20%
• Who must sign acceptance at pilot close and who will own ongoing outcome reporting Options: CMO/Chief Medical Officer, VP Population Health, Clinical Operations lead, Finance/CFO, Other
• If finance requires ROI within 12 months, is that a hard constraint or negotiable Options: Hard constraint, Negotiable with data, Not required

Deciding and next steps

• If your executive team asked for a single deliverable this quarter to support a recommendation, what would it be Options: Pilot results with outcomes, Detailed implementation plan, Cost model and ROI, Integration readiness checklist
• Which stakeholders must attend the next decision meeting to remove blockers Options: CMO, VP Population Health, IT/Integration lead, Legal/Compliance, Finance, Operational leadership
• What is your procurement timeline and who holds budget authority for this scope Options: Ready now, budget holder identified, 30–90 days, budget approval pending, 3–6 months, budget not allocated, Over 6 months
• Who will own patient enrollment and frontline change management on your side Options: Population health operations, Primary care clinic managers, Care management team, A shared task force, Other
• Realistically, when could you start a pilot Options: Immediately, Within 30 days, 1–3 months, 3–6 months, Unsure
• If the pilot demonstrates the agreed outcomes, can you commit to signing a multi-site roll out within 90 days Options: Yes, Maybe with conditions, No

• Solution Experience Session

• Confirm the current state and its cost
• You confirm that the demonstrated workflows would detect deterioration earlier for the shown scenarios and materially reduce manual triage time.
• Provide two de-identified representative patient scenarios and their typical vitals for the intended pilot cohort.
• Walk through a high‑risk hypertension patient scenario end to end
• You confirm that the proposed alert tuning and escalation protocol meets your staff capacity and clinical acceptance criteria.
• Share the list of EHR integration endpoints and any existing monitoring tools that the pilot must integrate with.
• Walk through a heart failure weight‑gain scenario end to end
• Deliver a draft alert tuning plan and a sample monitoring run using the provided scenarios within five business days.
• You agree on the evidence and artifacts needed to move from evaluation to pilot, including EHR integration checkpoints and pilot enrollment targets.
• Confirm pilot size, enrollment targets, and the outcome metrics you want tracked for the success review.
• Review alert tuning and enrollment flow with your staff constraints in mind
• Confirm integration behavior and acceptance criteria
• Forced validation, confirm this maps to what you asked for

• Solution Experience Session
• Solution Experience Deck
• Solution Brief

• meeting
• slides
• document

• Provision and Ship Home Monitoring Devices
• Activate Patient Onboarding and Device Setup
• Configure Device Data Ingest and Connectivity
• Configure Clinical Alert Rules and Thresholds
• Tune False-Alert Filtering and Alert Prioritization
• Deploy Care-Team Monitoring Dashboard
• Integrate Platform with EHR Systems
• Configure RPM Billing and CPT Coding Support
• Operate Clinical Monitoring and Triage Service
• Establish Escalation Protocols and Care Pathways
• Deploy Patient Engagement Messaging and Reminders
• Train Staff on Platform Use and Clinical Workflows
• Deliver Outcomes Reporting, Dashboards, and Exports

Provision and Ship Home Monitoring Devices

• Select device models to include (blood pressure cuff, cellular glucometer, weight scale, pulse oximeter, activity wearable). Options: Blood pressure cuff, Cellular glucometer, Weight scale, Pulse oximeter, Activity wearable, Other
• Estimate the number of devices by model to ship in the first 90 days. Options: Less than 100 total, 100-500 total, 500-2,000 total, More than 2,000
• Define patient eligibility criteria (for example heart failure NYHA class II-III, uncontrolled hypertension SBP >140) that determine device assignment.
• Describe logistics constraints for fulfillment (for example cellular activation pre-provisioned, consolidated clinic shipments, PO box exclusions).
• Assign ownership for inventory reconciliation and serial number tracking on your side. Options: Your supply chain team, Clinic operations, Shared responsibility (we/you), Other

Activate Patient Onboarding and Device Setup

• Choose the primary onboarding pathway: clinic pickup, mailed with phone support, in-home visit, or virtual self-setup with coaching. Options: Clinic pickup, Mailed with phone support, In-home visit, Virtual self-setup with coaching, Hybrid
• Estimate average time per onboarding session including device pairing and app authentication. Options: Under 15 minutes, 15-30 minutes, 30-60 minutes, Over 60 minutes
• List required patient consents or forms to collect during onboarding (for example RPM consent form, telehealth consent).
• Describe language and accessibility requirements for setup materials (for example Spanish translations, large-print, low‑literacy scripts).
• Identify who will provide first-line patient support for setup (your call center, clinic nurse, vendor helpdesk). Options: Your call center, Clinic staff, Vendor helpdesk, Third-party partner

Configure Device Data Ingest and Connectivity

• Select connectivity modes for devices: Bluetooth-to-phone, cellular LTE, or home Wi-Fi. Options: Bluetooth-to-phone, Cellular (LTE), Home Wi‑Fi, Bluetooth gateway (clinic), Other
• How many unique device serial numbers or models must be onboarded at go-live? Options: 1-10, 11-50, 51-250, 251-1,000, More than 1,000
• Specify the interface types your EHR exposes for inbound device observations (FHIR API, HL7 v2 ORU, SFTP bulk import). Options: FHIR API (Observation), HL7 v2 ORU, SFTP bulk import, Direct database feed, Other
• Define the minimum acceptable data delivery cadence and maximum tolerable data gap (for example at least one BP per day, maximum 24-hour gap).
• Assign responsibility for providing SIM activation or clinic gateway network access. Options: Your IT/network team, Clinic operations, Carrier/vendor, Shared

Configure Clinical Alert Rules and Thresholds

• What systolic and diastolic blood pressure thresholds should generate high-priority alerts for adult cohorts (provide numeric SBP/DBP values)?
• Specify glucose thresholds and measurement context (for example fasting vs random, units mg/dL or mmol/L) that should trigger alerts.
• Indicate SpO2 and weight-change criteria (for example SpO2 < 90%, weight gain >5% in 7 days) for heart failure cohorts.
• Outline alert severity levels and the clinician action required for each level (for example urgent RN triage, PCP notification, ED referral).
• Who will approve final alert logic and sign thresholds? Options: Chief Medical Officer, Population Health Director, Clinical governance committee, Other

Tune False-Alert Filtering and Alert Prioritization

• State baseline false-alert tolerance (acceptable false positive rate) for blood pressure and glucose alerts.
• Choose preferred filtering methods: rate-of-change suppression, outlier smoothing, or device-level QC flags. Options: Rate-of-change suppression, Outlier smoothing, Device QC flags (manufacturer), Patient-level averaging, Other
• How long should alerts be suppressed after a confirmed clinician action to avoid duplicates (for example number of minutes or hours)? Options: No suppression, 15 minutes, 30-60 minutes, 2-6 hours, 24 hours
• Explain rules that should escalate repeated low-severity alerts into higher-priority events (for example three elevated BPs in 7 days).
• Designate the owner for tuning cadence (weekly review, monthly optimization) and parameter change approvals. Options: Clinical operations, Vendor clinical lead, Joint governance committee, Other

Deploy Care-Team Monitoring Dashboard

• Pick required dashboard views: patient roster, alerts inbox, trend graphs, risk stratification heatmap, enrollment tracker. Options: Patient roster, Alerts inbox, Trend graphs, Risk stratification heatmap, Enrollment tracker, Other
• How many concurrent users require role-based access to the monitoring dashboard at go-live? Options: 1-10, 11-50, 51-200, 201-1,000, Over 1,000
• List the EHR context links or quick actions you want on a patient row (chart link, flowsheet entry, send message).
• Detail required visualizations (for example BP rolling average, weight trajectory with threshold bands) for clinical review.
• Do you require mobile-responsive dashboard access for field nurses? Options: Yes, No

Integrate Platform with EHR Systems

• Identify the EHR endpoints to receive device data (FHIR Observation write, HL7 v2 ORU, SFTP) and any version constraints.
• Provide the count of separate EHR instances (by hospital or clinic) that require unique API credentials or mapping. Options: 1, 2-5, 6-20, 21-100, More than 100
• Explain patient matching strategy for linking device observations to the chart (MRN, enterprise identifier, or demographic fuzzy-match) and required confidence thresholds.
• Provide the acceptance criteria for EHR integration cutover (for example 90% of test patients show observations in the flowsheet within 15 minutes).
• Who will supply API client IDs, OAuth2 credentials, test accounts, and a technical contact for integration testing? Options: Your EHR team, Integration vendor, Third-party integrator, Other

Configure RPM Billing and CPT Coding Support

• Indicate CMS RPM CPT codes you anticipate billing: 99453, 99454, 99457, 99458, or other codes. Options: 99453, 99454, 99457, 99458, Other
• Approximate the number of patients you plan to bill under RPM CPT codes in the first 12 months. Options: Under 100, 100-500, 500-2,000, More than 2,000
• What documentation workflow will capture monitoring time for 99457/99458 billing (for example time logs in EHR note, separate time-stamp export)?
• Do you plan to submit charges via the EHR charge capture or a separate billing system? Options: EHR integrated charge capture, Separate billing system, Hybrid
• Designate responsibility for claims appeals and payer-specific code mapping. Options: Your billing team, Vendor billing support, Shared responsibility, Other

Operate Clinical Monitoring and Triage Service

• Outline the monitoring model you prefer: nurse-led asynchronous review, continuous vendor monitoring, or hybrid on-call. Options: Nurse-led asynchronous review, Vendor continuous monitoring, Hybrid on-call
• State the number of clinical full-time equivalents (FTEs) you are allocating to RPM review at launch. Options: 0 (vendor only), 0.5-2 FTEs, 3-10 FTEs, More than 10 FTEs
• Declare escalation service level agreements required for high-priority alerts (for example RN response within 30 minutes, clinician notification within 2 hours).
• Which clinical documentation template should be used for triage encounters in the EHR (progress note, flowsheet entry, custom template)? Options: Progress note template, Flowsheet entry, Custom template, Other
• Designate who signs off on clinical protocols and delegation (standing orders) enabling RN triage of device alerts. Options: Medical director, Clinical operations leader, Quality committee, Other

Establish Escalation Protocols and Care Pathways

• Document stepwise escalation actions for an urgent hypoxia event (for example call patient, notify on-call MD, arrange ED transfer).
• Detail care pathways by cohort to embed in triage flows (heart failure decompensation, uncontrolled hypertension outreach, hyperglycemia action plan).
• Declare required documentation artifacts for escalation (nurse note, patient instructions, ED referral form) and specify where they are stored.
• Name the role authorized to change escalation thresholds during exceptional events (for example heatwaves or surge periods). Options: Medical director, Clinical operations, Incident command, Other
• Are automated routes to external services required and which endpoints should receive alerts (EMS, internal on-call, vendor triage line)? Options: Yes - EMS, Yes - Internal on-call, Yes - Vendor triage line, No

Deploy Patient Engagement Messaging and Reminders

• Choose patient communication channels for reminders: SMS, automated voice call, email, in-app push. Options: SMS, Automated voice, Email, In-app push, Postal mail
• How often should adherence or device-use reminders be sent (daily, weekly, only on missed readings)? Options: Daily, Weekly, Only on missed readings, Custom cadence
• Which message tone and literacy level do you require (for example plain language, Spanish translations, 6th grade reading level)?
• Are two-way messages required and how should patient responses route to the care team (clinical inbox, vendor chat, automated triage)? Options: Yes - route to clinical inbox, Yes - route to vendor chat, No two-way messaging
• Name the approver for patient message templates and opt-in consent language. Options: Clinical leader, Legal/compliance, Patient experience, Other

Train Staff on Platform Use and Clinical Workflows

• Give the number of clinician and non-clinician staff requiring training before go-live. Options: 1-10, 11-50, 51-200, 201-1,000, More than 1,000
• Pick training formats you prefer: live webinars, on-site workshops, recorded micro-learning modules, or blended. Options: Live webinars, On-site workshops, Recorded micro-learning, Blended
• Confirm the competency verification required for clinicians to independently triage RPM alerts (checklist sign-off, observed session, quiz). Options: Checklist sign-off, Observed session, Knowledge quiz, Other
• Report any union, credentialing, or scheduling constraints that affect staff training windows.
• Name the internal change champion(s) responsible for training adoption and post-go-live reinforcement. Options: Clinical lead, Operations manager, Site champion, Other

• Master Services Agreement (MSA)
• Statement of Work (SOW)
• Order Form / Subscription Agreement
• Device Purchase Agreement / Order Confirmation
• Data Processing Agreement (DPA) & HIPAA Business Associate Addendum (BAA)
• CPT Billing Support Addendum
• Service Level Agreement (SLA) & Support Terms
• EHR Integration & Interface Agreement
• Acceptance Criteria & Operational Handover
• Change Order Agreement

• Go‑Live Health Check (weeks 1-4)
• First Measurement Review (weeks 4-10)
• Acceptance Gate Review (day ~90)
• Quarterly Success Review (ongoing)

• Publish a prioritized enhancement backlog with expected delivery windows for the next quarter.
• Produce a validated data export for the acceptance meeting showing the three primary metrics over the onboarding window.
• Restate acceptance criteria and numeric targets
• Produce a documented pass/fail decision for each acceptance criterion recorded in Solution Scope.
• If any criterion failed or is conditional, agree remediation actions with target resolution dates and tracking steps.
• Confirm the incumbent system disposition and ensure no parallel production usage persists.
• Publish the acceptance decision record showing pass/fail per criterion and include the named buying signatory or the documented buying owner decision.
• For any failed or conditional criteria, create a remediation plan with explicit resolution dates and verification steps.
• Finalize incumbent system decommissioning actions: archive or retain-read-only, confirm data migration completion, and close any remaining access paths.
• Outcomes review vs. targets
• Confirm whether adoption and alert-burden metrics remain on track relative to Solution Scope targets and note corrective priorities if not.
• Ensure high-priority operational issues are on a path to resolution with clear dates and verification steps.
• Agree the prioritized enhancement list and next delivery window for items that materially affect acceptance criteria or operations.
• Publish the quarterly outcomes report with trend charts for adoption, alert burden, and hospitalization rate.
• Close or re-scope high-priority operational tickets and document resolution verification steps.
• Reconfirm success criteria and targets
• Confirm deployment completed and essential integrations are passing basic health checks.
• Establish baseline device activation rate and enrolled active patient count as the early-adoption baseline.
• Document high-priority blockers with remediation actions and target dates for closure.
• Collect and share device activation logs and enrollment roster covering days 0-14.
• Produce a short integration health summary showing EHR endpoint status, error rates, and recent successful transactions.
• Create a remediation task list for any open blockers with proposed resolution dates.
• Present first-period outcomes
• Determine whether adoption and alert-burden signals are trending toward the Solution Scope targets or require remediation.
• Document specific corrective actions with resolution dates to address the highest-impact gaps before the acceptance gate.
• Confirm telemetry and reporting needed for the acceptance gate are in place and validated.
• Adjust alert thresholds or rules for the identified cohort and publish expected impact before the acceptance gate.
• Update patient outreach and re-enrollment scripts to improve device activation and weekly monitoring frequency.
• Present outcome data against each criterion
• Deployment and integration validation
• Operational issues burn-down
• Root-cause analysis for gaps
• Alert quality and triage review
• Early adoption signals and usage patterns
• Document pass or fail per criterion
• Enhancement requests and prioritization
• Process improvements and guardrails
• Formal acceptance decision and signatory
• Operational blockers and billing capture
• Open issues and blockers
• Agree corrective actions and timeline to acceptance gate
• Immediate remediation plan
• Incumbent system wind-down confirmation