Rimidi CEO Discusses Innovative Partnership With Brighter Day Health Foundation to Tackle Chronic Care in Underserved Communities

Rimidi has partnered with the Brighter Day Health Foundation to bring chronic disease management to underserved populations through church-based wellness clinics, providing remote patient monitoring supported by Medicare reimbursement and insurance coverage. 

Please share your name, title, and your professional experience. 

I am Lucienne Ide. I'm the CEO and founder of Rimidi and a physician by training. I trained to become an OBGYN but also had a career in technology before going into health care as a physicist and working in venture capital investing and mobile and communications technology. My experience has led me to the intersection of health care and technology. I left clinical medicine about 12 years ago to start Rimidi. 

Why are underserved populations the most at risk for developing chronic diseases?  

Disproportionately chronic diseases aren't well managed in underserved populations. Chronic cardiometabolic diseases are all interrelated. If you are obese, you have a higher chance of having diabetes, or you have a higher chance of having high blood pressure or fatty liver disease. Underserved populations also may not have access to affordable, healthy food, and that increases their likelihood of obesity. Some individual conditions like hypertension or diabetes tend to be more prevalent in different racial and ethnic groups, and then those groups intersect with medically underserved areas. It's the constellation of all those factors that leads to a higher prevalence of poorly managed chronic diseases in underserved communities. 

Please share a brief overview of the details of Rimidi’s new partnership with Brighter Day Health Foundation, which was created to help address the chronic care needs of vulnerable populations through church-based wellness clinics.  

Since certain populations that are medically underserved may have a harder time with access to and control of medical resources to help support their needs with chronic health conditions, it forces the question of how you think creatively about reaching those individuals. Because if you're only going to reach them through the medical establishment and the medical establishment doesn't serve their community, it becomes a problem of circular logic.  

One thing I love about this partnership is taking care of people where they are and not limiting care access to traditional medical outlets like clinics. While some awesome free, charitable clinics and federally qualified health centers often serve medically underserved communities, it's not enough. 

The Brighter Day Health Foundation reaches people through their churches. These are centers of community where people have already formed relationships of trust. Many churches view this as mission-based work for their congregations. Brighter Day already has experience in church-based wellness programs, and we have partnered with them to bring specific access to care for chronic disease management to these communities. We are extending the foundation they have built to offer screenings in churches. For example, after church, someone can get their blood pressure checked or basic fingertip labs to check their cholesterol levels. Once someone is identified as having high blood pressure or diabetes and needs help, Rimidi is the next step in care. That way, we aren’t providing the screening without follow-up assistance and resources.  

Trying to distribute vaccinations during the pandemic highlighted the need to provide care where patients are. If we only went through traditional channels such as the Department of Health clinic or the pharmacy, we would not be able to reach and serve everybody in the population equally. That was an amazing learning opportunity. A silver lining of the pandemic was seeing a lot of creativity around taking health care to people where they are, such as churches.   

Please explain what remote patient monitoring is and how it will improve access to chronic disease management?  

People live with chronic diseases and conditions that require management daily. If I have high blood pressure, I might only see my doctor once or twice a year, but I have high blood pressure every day of the year. However, the one day I am in the clinic may not be the day my blood pressure misbehaves. This mismatch of the burden on the individual living with the chronic condition and when they have an appointment with their health care provider means the health care provider only has one data point. The concept of remote patient monitoring has developed over the past 5 years to provide a more continuous data stream of information about that patient.  

We can remotely monitor blood pressure when a patient checks it at home and then transmit the data to a cloud-based system the clinic can access. This creates a continuous, ongoing relationship with that patient with better blood pressure monitoring control so clinicians can offer advice or intervene as needed. That's the general concept of remote monitoring: patients have a medical device at home to self-monitor their chronic condition, and the data automatically transmits to a clinical team providing oversight. The team can interact with that patient virtually via phone calls, texts, emails, etc, and more proactively assist the patient in controlling their condition. We want to support patients when they need support versus only being able to support them when they happen to have an appointment. 

How does Rimidi ensure both short- and long-term support for underserved populations?  

In 2019, Medicare started offering a payment model for this care. For remote monitoring to work, somebody needs to provide that patient with a connected medical device such as a scale, blood pressure cuff, and glucose meter. Someone else needs to be paid to monitor the transmitted data, too. Medicare’s reimbursement model has expanded dramatically over the past 5 years, and many commercial insurance companies and Medicaid plans also pay for it. 

That same reimbursement model can apply to a project where we’re talking about engaging and supporting patients through a church-based wellness program. Brighter Day Health Foundation and their clinicians can bill to Medicare or a patient's insurance. This is how the system becomes self-sustaining, both short-term and long-term. And long-term sustainability is important. Historically, programs like this might be grant-funded, and, after a year or 2, when the grant money runs out, they can't keep offering the program. That's disappointing to patients who have benefited.  

An anecdotal example of why this kind of program is important is that a patient who didn't realize their blood pressure is much worse at their clinic appointment than at home. Through remote monitoring, they could identify this difference and change their medication to hopefully prevent an adverse outcome. I think those individual-level stories are just as important and impactful as the population-level stories where clinics can say that because of remote monitoring, instead of one nurse supporting 40 patients, they can now support 250 patients.  

Is there anything else you would like to share? 

To put me in the health care establishment bucket for a minute, it's our job and our burden to bring care to patients and not place the blame on patients that their health isn't well managed. We need to meet patients where they are, through church-based programs, school-based programs, or other community institutions that people trust. I hope other organizations with communities they want to support will think about how to take advantage of a creative model like this to better support their members, their congregation, and their community.