RPM Device Logistics: Shipping, Activation and Returns Without a Spreadsheet

RPM device logistics is the work of getting the right monitor to the right patient, getting it switched on, and getting it back when the patient leaves. Every step depends on one thing: knowing which device, by serial number, is where and with whom. A spreadsheet can hold that for a few patients. Past that, it falls behind the carrier, the warehouse and the clinical team at once. This guide walks through each stage of a device's life and what to record at each one.

The life of an RPM device, step by step

Each device in a monitoring program goes round the same loop:

1. Received into stock, with its serial number recorded.
2. Ordered for a patient, once the patient has consented.
3. Packed, with the device's serial number tied to the parcel.
4. Shipped and tracked to the patient's door.
5. Activated by the patient, so readings start arriving.
6. Monitored, and replaced if it breaks or goes missing.
7. Returned when the patient leaves the program.
8. Checked in and either put back in stock, kept aside or retired.

A device goes missing in the gap between two of these steps, where it changes hands and nobody writes it down.

Receiving devices into stock

Logistics starts before any patient is involved. When a delivery of devices arrives, record each one on its own.

• Scan the device, not the box. A barcode on the outer carton is usually the product code, not the device's own number.
• Use the right identifier. A device without a SIM is tracked by its serial number. A device with a SIM card, such as a cellular monitor or hub, is usually known by its IMEI, a 15-digit number.
• Count the consumables. Cuffs, batteries and chargers do not need serial numbers, but they still run out. Count them in and set a reorder point.
• Keep stock per practice if you serve more than one, so a practice's orders draw on its own shelf.

Our medical device inventory checklist covers counts, reorder points and stock logs in more detail.

Placing the device order

A device should only leave the shelf for a patient who is ready for it.

• Consent first. Do not place the order until the patient's RPM consent is recorded. Shipping first and asking later leaves you with a device in a home and no basis for the service.
• Confirm the address. Check it with the patient, especially if they spend part of the year somewhere else.
• Get the first order right. Decide what a new patient's first box must include, such as the monitor and the right cuff size, so nobody has to remember it each time.
• Leave a short window for corrections. A delay of a few hours between placing an order and packing it lets someone fix a wrong address or item before it ships.
• Call before it ships. A short pre-ship call tells the patient a box is coming and that it is not junk mail.

Packing and shipping

When the box is packed, tie each device's serial number to the parcel and the patient. That one record is what later lets you match readings to a patient, find a device during a return, and answer "which monitor does this patient have?"

• Scan each device into the box as it is packed.
• If an item is out of stock, ship what you have and send the rest in its own parcel when it arrives, rather than holding the whole order.
• Follow every carrier scan, not just "shipped" and "delivered". A delivery problem reported early can be fixed before the patient calls.
• Treat the shipping label as patient information. It carries the patient's name and address, so keep the print area private and shred spare or misprinted labels.

From delivered to the first reading

Delivery is not the finish line. A device that is in the patient's home but not switched on produces nothing.

• Watch the gap between delivery and the first reading. A patient who has the device but no readings needs a call.
• Call soon after delivery. Walk the patient through setup while the box is still on the table.
• Check that readings arrive from the device itself. Medicare expects RPM data to be transmitted automatically from the device, not typed in by the patient. This is general guidance; confirm with current CMS guidance and your payers.
• Escalate setup problems fast. If the device will not connect, decide quickly between talking the patient through it and sending a replacement.

Our comparison of cellular vs Bluetooth RPM devices explains why setup looks different for each kind.

Replacements

Devices break, get dropped and go missing in the post. Decide in advance how a replacement works.

• Record the reason: not working, damaged, lost in transit, never arrived or the wrong item.
• Decide what ships first. For a broken device you may wait until the old one is on its way back; for a parcel that never arrived, nothing has to come back, so ship at once.
• Keep the link between the two devices. The replacement and the device it replaces should sit on the same patient record.
• Include the return label in the replacement box when the old device should come back in it.

Returns and check-in

A device that is not returned is a device you buy again. Make the return a process, not a favour you ask of the patient.

1. Start the return when the patient leaves the program, at the same moment as the disenrollment, so it is never forgotten.
2. Make it easy for the patient: a prepaid label in the box, a label sent by text, or a drop-off option.
3. Send reminders, and set a date after which a return counts as late.
4. Check every device in when it arrives, by its serial number or IMEI, so it closes the right return.
5. Decide where it goes: back in stock, kept aside, or retired. Before a device goes to another patient, follow the maker's cleaning and testing instructions and your own policy.
6. Handle the box that matches nothing by recording what the label says, so the office can find the patient later.

A returned box shows the patient as the sender, so remove or black out the old label before you reuse or throw away the box. Our guide to RPM device returns goes further into reminders and late returns.

Frequently asked questions

Do we need our own warehouse to run RPM?

No. A practice can keep devices on its own shelf and pack them itself, or have a fulfilment partner store and ship them. What matters is that both work from the same record of which device went to which patient.

What should happen to a device when a patient disenrolls?

Start a return at the same time as the disenrollment, cancel any order that has not shipped yet, and follow the return until the device is checked in. A parcel already on its way will still arrive, so plan for that return too.

Can a returned RPM device be sent to another patient?

That depends on the device and on your policy. Check it in, follow the maker's cleaning and testing instructions, and only then put it back in stock. Retire a device that fails those checks.

How do we know which device a patient has?

Record the device's serial number, or IMEI for a device with a SIM, when it is packed into the patient's box. That link, kept on the patient's record, answers the question at every later step.

Sources

• Telehealth & Remote Monitoring (MLN901705), CMS
• Billing for remote patient monitoring, Telehealth.HHS.gov