Lightbeam Health/CareSignal CTO Evan Huang
Photo: Evan Huang
Some telehealth and remote patient monitoring experts believe that in order to scale chronic care and value-based care opportunities, healthcare provider organizations need to meet patients where they are in terms of technology – with phones and texting. They refer to this as "deviceless" remote patient monitoring.
With messages written at or below a sixth-grade reading level to enhance accessibility and reach, deviceless RPM can support multiple condition-specific monitoring programs – for example, CHF, COPD, diabetes and depression – using self-reported data to flag high-risk trends, said Evan Huang, CTO of the CareSignal division of Lightbeam Health Solutions, a health IT vendor whose products include RPM and data management.
Even patients with limited minutes or text can still participate. It automates outreach to relieve care manager workload and helps providers intervene earlier by alerting when patient responses indicate risk, Huang explained.
Lightbeam Health achieved 93.2% in KLAS Research performance in the limited-data RPM segment and achieved $59 million in client savings for the Medicare Shared Savings Program, the company reported.
Healthcare IT News sat down with Huang to discuss deviceless RPM and the ramifications it can have on healthcare – and to hear about one clinic's success story.
Q. What do you mean by deviceless RPM? How does this work?
A. When we talk about deviceless RPM, what we mean is an approach to monitoring patients that doesn't require shipping or managing specialized, connected hardware like Bluetooth blood pressure cuffs or Wi-Fi-enabled scales.
Traditional RPM programs rely on these devices – such as for weight, glucose levels or blood pressure – to automatically capture and transmit biometric data. While that technology can be useful, it also introduces barriers. For instance, patients may struggle with setup, need troubleshooting or require retraining. And clinicians can end up acting like IT support.
Deviceless RPM removes these barriers by meeting patients where they already are. Instead of mailing out new hardware, we use communication channels patients are already comfortable with – simple automated text messages or phone calls – to prompt them to share self-reported metrics and symptoms for whatever program they are listed in.
Most patients already own and know how to use a basic blood pressure cuff, glucose monitor or scale. So, by asking them to simply report those readings via text or voice response, we collect the same biometric data, and often more – we can capture symptom information the devices wouldn't provide.
What's powerful is this model drives higher adherence. People reliably respond to a text message or a phone call in a way that feels natural. That consistent stream of data allows us to filter the patient panel: surfacing those who need immediate attention while automatically reassuring clinicians that the majority are doing fine.
In turn, care teams can focus their time on the small subset of patients who actually need an intervention, rather than trying to monitor everyone equally.
Ten years ago, there was skepticism that text messaging or phone calls could serve as a viable data collection mechanism in healthcare. Today, it's clear this approach not only works, but in many cases, it works better because it eliminates friction for patients and clinicians.
Deviceless RPM isn't about cutting corners on technology – it's about using the simplest, most accessible tools to drive engagement, compliance and outcomes at scale.
Q. How does deviceless RPM specifically help with chronic care management? Why do you believe deviceless RPM is better than other approaches with this type of care?
A. One of the most pressing challenges provider organizations face today is navigating the shift from fee-for-service to value-based care. Traditional reimbursement rewarded volume. But under VBC, success depends on proactively managing chronic conditions, preventing avoidable utilization, and capturing long-term improvements in patient outcomes.
That shift requires new tools that make population health scalable and sustainable. This is where deviceless RPM plays a critical role.
Unlike device-based approaches that are costly, complex and limited in reach, deviceless RPM flips the care management model from outbound to inbound. Instead of nurses and care managers making check-in calls – a model that drains staff time while still missing patients in need – patients engage through simple text messages or phone calls.
This creates an inbound flow of real-time data, allowing care teams to focus on the 5%-10% of patients who are high-risk, high-cost patients before diseases flare up and they go to the emergency department. For overstretched teams and growing patient populations, this makes chronic care management far more sustainable while also improving patient satisfaction by removing the technical barriers of connected devices.
Ease and simplicity remove technical barriers, while serving care teams well. Deviceless RPM ensures care teams have scripts readily set and a process for patient alerts to be reviewed and resolved within the existing EHR workflow.
Just as important, deviceless RPM extends beyond biometrics to include symptom-level and qualitative data, such as behavioral health concerns, post-discharge challenges and social determinants of health. That broader visibility is critical to managing chronic diseases effectively – and it's something traditional device-reliant RPM systems simply cannot collect.
The benefits of this model show up both immediately and over time. In the short term, deviceless RPM enables FFS provider organizations to scale chronic care management programs and capture more CCM revenue.
Longer term, this approach enables FFS provider organizations to fully embrace VBC models by making it easier to manage larger patient panels without hiring additional staff, and to reduce avoidable utilization by catching problems before they escalate.
Q. How can deviceless RPM help care managers and clinicians in ways other approaches cannot, or cannot do as well or efficiently?
A. Deviceless RPM changes the game for care managers and clinicians because it directly addresses the dual challenge of operational efficiency today and readiness for VBC tomorrow. In a value-based environment, inefficiency becomes unsustainable.
Deviceless RPM bridges both challenges by automating outreach, turning manual outbound calls into actionable inbound signals – and giving care teams a scalable way to focus only on patients who need intervention.
The operational benefits of near real-time patient health data are immediate. Care managers no longer guess which patients might need help. Deviceless RPM continuously collects patient-reported data, categorizes it by risk, and triggers timely alerts when trends point in the wrong direction.
Equally important, the type of data captured goes beyond what devices alone can provide. Deviceless RPM incorporates symptom-level inputs – like swelling or shortness of breath in a CHF patient – alongside behavioral health and social determinants of health.
That longitudinal view creates a richer clinical picture, supports proactive outreach by care managers, and ensures patients trending toward instability are addressed before crises occur. That not only prevents avoidable utilization in the short term but also enables more efficient pre-visit planning and chart reviews, making every office visit more productive.
Over time, this continuous feedback loop supports not just physical health programs but mental health and social care as well, areas where device-based RPM has traditionally fallen short.
With care manager-to-patient ratios expanding five to 10 times, often going from one to 100 to as many as one to 1,000 patients per care manager, organizations can manage much larger populations without adding staff.
Ultimately, what makes deviceless RPM unique is its ability to align day-to-day care management with long-term value-based goals. In the short term, it eases staff workload and improves patient engagement. Over the long term, it equips provider organizations to manage broader populations at scale, and deliver the kind of whole-person, proactive care that is essential to succeeding under value-based contracts.
Q. How is deviceless RPM being used today? What kinds of outcomes are being seen?
A. We've seen strong impact and outcomes in healthcare organizations, specifically Mankato Clinic, which deployed Lightbeam's deviceless RPM program to better engage its high- and rising-risk ACO and Medicaid populations.
The clinic focused on six chronic and mental health conditions – depression, hypertension, diabetes, asthma, heart failure and COPD – and chose deviceless RPM because it required no new devices, apps or downloads. Patients were monitored through simple text messages and phone calls, with data automatically categorized by risk and triggering real-time alerts to care managers.
The results speak to the full spectrum of cost, quality, operations and satisfaction outcomes:
Financial. $1.5M in cost savings; CCM billable instances grew from 3% to 17%.
Operational. Care manager caseloads scaled from 1:100 to 1:1,000 patients without compromising quality.
Clinical. 122 ED visits averted; 10.5% reduction in high-risk PHQ-9 depression patients; 20.77 mmHg average drop in systolic blood pressure; 2.3-point average drop in HbA1c for diabetes patients.
Satisfaction. Patients strongly agreed the program improved communication with the clinic, with one noting, "These texts help me keep a closer eye on my mental well-being and understand what I actually need to tell my doctors when I need help."
By leveraging deviceless RPM, Mankato was able to extend care to the 20% of rising-risk patients it previously struggled to reach, while simultaneously building a stronger financial and operational foundation for VBC.
Mankato's experience demonstrates that deviceless RPM is not just a tactical system for patient engagement, but also a strategic enabler of population health management, whole-person care and long-term sustainability while transitioning under VBC.
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