Nephrology Specialists, P.C. RPM & CCM Customer Story

Reducing the Incidence of Uncontrolled Hypertension and Improving Chronic Kidney Disease Outcomes with RPM & CCM

“HealthSnap made the whole implementation process so easy, their portal is both robust and easy to use, the patient data is easily accessible, and HealthSnap went above and beyond to interface with our EMR for billing and clinical purposes.”


Nephrology Specialists, P.C. (NSPC) physicians have been treating Richmond, VA area patients for over twenty years, and currently work across 5 office locations. All NSPC physicians are Board Certified in Nephrology and have completed fellowship training in renal medicine. 

Stuart West MSN, RN – Nurse Manager, and Julie Whited – Controller, at NSPC shared that the practice initially decided to implement Remote Patient Monitoring (RPM) and Chronic Care Management (CCM) programs because they were looking to improve patient outcomes related to hypertension across the 5 practices. Because Chronic Kidney Disease is often caused by uncontrolled hypertension, they have found that many of their patients are not aware that their uncontrolled hypertension has affected their kidney function.

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Historically, all NSPC patients have been tasked with keeping a daily log of their blood pressure so that their doctor can determine how well hypertension is controlled. However, in many cases, patients were non-compliant with their logs. Due to inconsistencies with home readings and the tedious task of remembering to log blood pressure, a Remote Patient Monitoring (RPM) program sounded like a great solution to the team at NSPC.

A few years ago, the practice implemented an Ambulatory Blood Pressure monitoring program to identify patients affected by White Coat Hypertension. However, these particular monitors were difficult for patients to use, and patients began to complain about the number of times the machine was taking their pressure during the day and night. In addition, patients would turn the machine off at different times during the 24 hours. As a result of these inconsistencies, accurate data was difficult to obtain. In addition to the Ambulatory Blood Pressure Monitor, patients were coached about keeping a daily blood pressure log at home and were instructed to bring the readings to their appointments. Once again, there was poor compliance with this strategy.

NSPC’s initial efforts to set up a Chronic Care Management (CCM) program coincided with the onset of the COVID-19 pandemic: “As a small practice, there simply was not enough staff to enroll patients and make monthly patient calls to ensure compliance with the CCM program,” explained Julie. The team also felt frustrated with certain quirks present in the first CCM platform they had chosen, and it simply wasn’t a fit for the staff.

Program Highlights

Stuart shared, “HealthSnap has been a pleasure to partner with for improved patient care and outcomes. Every question we have asked has been promptly answered. Every problem brought to the HealthSnap team’s attention has been handled. Their portal is both robust and easy to use. The patient data is easily accessible.” She is also pleased that the HealthSnap staff documents every interaction with NSPC patients and communicates well with the practice.

NSPC shared that HealthSnap was highly recommended by Virginia Cardiology Specialists (VCS) with whom they share many mutual patients. HealthSnap was cognizant of working with the team at NSPC to help ensure that their mutual patients with VCS were not enrolled in the program at both practices at the same. 

Stuart also shared that in selecting HealthSnap, “We liked that their nursing team would be dedicated to our practice. In addition, HealthSnap’s Care Navigator Nurses assigned to us are located in our local area. It was important that our patients would feel like they were speaking to someone as an extension of our office and not someone across the country.”

She also stated, “HealthSnap made the whole implementation process so easy. They created brochures for our patients, helped us set up a line for our automated attendant to go directly to their staff, sent out letters from our practice to introduce the new program, and worked with us to implement a telephone campaign to enroll patients. HealthSnap was willing to interface with our EMR for billing and clinical purposes as well.”


In terms of results and outcomes, NSPC shared that their practice has more easily been able to identify patients who have uncontrolled hypertension at home, which has enabled them to intervene earlier to help control their hypertension. They believe earlier intervention will contribute to improved outcomes for patients with chronic kidney disease. Many NSPC patients also have shared feeling more informed and proactive with respect to their uncontrolled blood pressure. 

Finally, in terms of reimbursement, NSPC shared that the RPM and CCM reimbursements are in line with what the practice projected. The NSPC team also shared that the program will continue to have a positive impact on their overall practice and in terms of ROI.

Watch Below for a Comprehensive Video Detailing these Patient Outcomes