“RPM Only Works When the Data Changes a Decision” — Dr. Maya Krishnan, VitalLoop Health

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Remote patient monitoring crossed a threshold this year: Medicare RPM spending has passed the half-billion-dollar mark, and CMS has proposed the biggest overhaul of remote monitoring billing since 2019. We sat down with Dr. Maya Krishnan to talk about what happens after the sensors are deployed.

You've said most RPM programs are "data-rich and decision-poor." What do you mean?

Hospitals have gotten very good at collecting signals — blood pressure, glucose, weight, rhythm strips from a patch. What most programs still lack is the last mile: a workflow where an abnormal trend reliably reaches the right clinician, with enough context to act, before it becomes an admission. Monitoring only works when the data changes a clinical decision. Otherwise you've built a very expensive dashboard.

"The next wave of RPM is about closing the loop, not adding more dashboards. Every alert should have an owner, a protocol, and a measurable outcome."

CMS has proposed consolidating RPM codes and requiring directly employed staff. What does that do to the industry?

It forces the question the industry has avoided: who is actually delivering the care? Programs built on outsourced monitoring staff need a Plan B by January 2027. The compliant service model — not the hardware — was always the real product.

What should health systems look for when buying RPM technology in 2026?

Three things. First, evidence that the vendor reduces total cost of care, not just engagement metrics. Second, true interoperability — if the data doesn't land in the EHR where clinicians work, it doesn't exist. Third, a billing story that maps cleanly onto the codes CMS will actually pay. The reimbursement scaffolding is finally there; use it.

What excites you most right now?

On-device intelligence. The cardiac patch work coming out of the University of Chicago — arrhythmia detection at 99.6% accuracy processed on the body, with no cloud round-trip — points at a future where the device itself is the first responder. For cardiac events, those seconds matter.