How patients and providers benefit from remote patient monitoring solutions

14.01.2020
8 min.
title

The traditional healthcare system requires patients to visit a clinic or a hospital if they need to consult a doctor. This appointment consumes both the patient’s and the doctor’s time, and is costly for the patient as they need to travel to the healthcare facility and pay for the appointment. Unless it’s an emergency, this face-to-face meeting can often be avoided.

Another drawback of the traditional healthcare delivery system is that the patient might not deem it necessary to contact a healthcare facility in case of a health issue until this issue aggravates. There is hardly any way to detect this other than through an appointment.

The situations above can be improved using remote patient monitoring (RPM) solutions. Remote patient monitoring together with the internet of medical things is changing the healthcare model by turning it from ‘hospital-centered’ into ‘home-centered’, and making it more affordable and accessible for all social groups.

Many healthcare software development companies aspire to innovate in the area of remote patient monitoring software for managing various conditions. Notably, they find support among clinical stakeholders. The proof of this is the global RPM equipment market growing to $2.7 billion by 2022, up from $1.5 billion in 2018, according to ResearchAndMarkets.

Inside remote patient monitoring

RPM uses digital technologies to gather patient health data outside of traditional clinical settings and transmit it to a healthcare facility for assessment and analysis. Technically a part of telehealth technologies, RPM offers the convenience of receiving continuous medical care from a professional while remaining at home. An example of healthcare data that can be monitored is heart rate, blood pressure, blood sugar level, weight, etc.

RPM can be beneficial for the following groups of users:

  • Patients with chronic illnesses
  • Elderly patients
  • Patients with limited mobility
  • Patients from rural areas with limited access to healthcare facilities
  • Post-surgical patients

According to the 2019 Spyglass Consulting Group study, 88% of US-based healthcare providers surveyed are investing into remote patient monitoring apps. The main goals of introducing this group of technologies are to track a patient’s well-being outside of the hospital, help them maintain control over their conditions, ensure timely interventions from providers, and avoid emergencies. Altogether, RPM contributes to reducing the number of hospitalizations and readmissions as well as the length of stay.

Remote patient monitoring uses an array of technologies that vary according to a particular condition and tracked metrics. Despite this variety, there is a common architecture for each solution that comprises the following elements:

  • Sensors are placed on wearables and portable medical devices to measure a patient’s vitals (blood pressure, weight, temperature, blood oxygen levels, heart rate, sleep, ECG, and more). Sensors can also be placed on invasive medical devices such as implantable cardiac defibrillators.
  • Local data storage stores the data acquired from sensors on the patient’s side and communicates with the centralized repository on the provider’s side.
  • Centralized repository aggregates and stores data from different sources, such as EHR, patient devices, and analytic systems.
  • Data analysis software generates insights from a centralized repository and pushes alerts to providers, caregivers, and patients as needed.

The diversity of RPM applications

Integrated remote monitoring systems have multiple applications ranging from disease prevention to their detection and management.

Managing diabetes

Diabetes is a chronic condition that can lead to severe complications if not managed well. Diabetic patients continuously experience peaks and troughs in their blood glucose levels, which should be regularly balanced to avoid hyper- and hypoglycemia. Also, patients need to be aware of their blood pressure, temperature and weight. Additionally, these patients can develop other complications such as diabetic foot ulcers, which can result in amputation if not treated timely.

For this reason, the Department of Veterans Affairs adopted a wireless RMP technology to catch diabetic foot ulcers among veterans at the outset. If not diagnosed in time, this condition can result in limb loss. One in four veterans has diabetes, and as the Health Data Management Journal reports, 80% of non-traumatic amputations among veterans are caused by diabetic foot ulcers.

Podimetrics SmartMat uses clinical decision support tools and thermal imaging to collect foot temperature scans. Veterans place their feet on the mat for 20 seconds per day, and the obtained data is sent to a diagnostician for analysis. If feet temperature exceeds the allowed threshold, doctors communicate with the veteran prescribing an appropriate care.

When tested, SmartMat was able to detect 97% of diabetic foot ulcer risks five weeks before the symptoms appeared.

SmartMat

Avoiding heart failure

Remote patient monitoring telehealth applications allow decreasing the risk of heart failure in patients prone to this condition with the help of cardiac resynchronization devices and smart pacemakers that can send patient health information to a central repository. This information can be analyzed to derive patterns and help providers keep patients stable, improving their life quality and decreasing overall mortality rate.

Eko, a California-based startup, developed two devices similar to a stethoscope. The CORE device delivers sound amplification 40 times larger than a traditional stethoscope. The DUO device combines sound and electrocardiogram recording. DUO comes as an at-home device that patients can use to monitor their heartbeat.

Complex AI and machine learning algorithms analyze cardiac health using electrocardiogram and the sound of heartbeat. The sound analysis is based on capturing a specific sound caused by the turbulent blood flow. This sound interferes with the cardiac beat, so a human ear cannot detect it using a regular stethoscope.

Eko Home cardiac application

Preventing falls

With age, individuals develop risks of dementia. Remote patient monitoring tools help the elderly stay safe while being more independent from their caregivers, taking walks whenever they feel like it and still being under supervision.

Researchers from the University of Malaga (Spain) have developed an innovative cane that can transmit a range of relevant data about the elderly person using the cane. This data includes the elderly’s weight-bearing while walking. The data is generated by the pressure sensors embedded in the cane and captured by a smartphone via Bluetooth. Data transmission occurs without any additional effort from the elderly.

We seek a minimal interaction with patients, to avoid any cognitive load and prevent any impact on their daily routine.

Cristina Urdiales

Real-time health monitoring

Remote monitoring can be used as a preventive measure that implies using mobile devices and sensors to swiftly detect any changes in the human body before it shows visible symptoms, helping avoid costly treatment.

Researchers at the University of Wisconsin-Madison and the Morgridge Institute for Research are developing a smart toilet system that analyzes urine to extract important metabolic data.

Urine contains metabolic links to over 600 human conditions including cancer and kidney malfunctioning. Continuous analysis of urine metabolites gives a real-time indication of a patient’s health. Patients can access the results and receive recommendations using a mobile app.

Smart toilets

Summing up the patient’s benefits of RPM

As remote patient monitoring systems are still far from reaching their ultimate potential, further innovations will bring more and more advantages for patients. The following three benefits will most likely be the major reasons to supply patients with RPM solutions.

More convenient access to medical assistance

Reaching a doctor’s office for routine check-ups can be difficult because patients have to find time to travel, wait in a crowded hospital setting, and then return back home. This is the easiest scenario, which however becomes much harder for elderly and disabled patients as well as for those living in rural areas. Sometimes, a regular check-up visit is just for confirming that a patient is feeling fine and is on the right track to faster recovery. Reaching a doctor’s office for this purpose only is often a waste of time that can be avoided.

RPM solutions help patients stay connected with their care team from the comfort of their homes without the need to travel to the healthcare facility for routine checks, which saves time and costs.

Early symptom detection and timely intervention

Remote patient monitoring can help patients maintain a balanced health status at every point of care cycle—from an arising concern to a preliminary diagnosis to ambulatory treatment to post-discharge recovery. Continuous remote supervision ensures control over the patient’s response to medication and spots disturbing patterns before health deterioration.

Due to its proactive nature, RPM leaves more time for providers to make well-weighed decisions. This positively impacts patients’ health outcomes in both the short and long term.

Increased patient engagement

An established relationship between a patient and their care team improves patient engagement rates on several levels. RPM supports patients 24/7 and makes them more disciplined as well as confident in their successful recovery. Individuals feel that they have a greater control over their health by following the treatment plan and receiving reminders to stay on track. At the same time, patients get informed advice and feedback on the collected vitals, and feel supported along the way.

The engaged patient is the blockbuster drug of the century.

Eric Topol

The value of RPM for providers

Providers will have to adopt remote patient monitoring sooner or later if the value-based care environment is to evolve. But committing to RPM requires a certain investment of time, budget, and effort in exchange for the following benefits.

Optimized operational efficiency and planning

Medical emergencies put a huge burden on healthcare organizations, overloading emergency departments (EDs), disrupting utilization management plans, and forcing clinical staff to overwork regularly.

Providers can reduce ED workload by adopting an emergency-preventing approach with RPM. Prevention and real-time health tracking would help keep health-related issues under control and maintain clinical settings organized.

Reduced costs and maximized reimbursements

In a perfect world, every healthcare organization manages to keep costs low, provide high-quality care, and receive reimbursements doing everything the old way. But since this perfection is unattainable, providers can turn to remote patient monitoring solutions to eliminate out-of-control expenses and achieve peak performance.

The key is to build a network of providers, payers, and patients, making care transparent and straightforward. RPM solutions bring together all the care cycle parties and keep everyone in the know about patients’ health and current needs. This makes communication instantaneous and can result in preventing crises as well as reducing hospitalizations and readmissions. When critical issues are controlled, costs go down and reimbursements go up.

Improved HEDIS scores

The Healthcare Effectiveness Data and Information Set (HEDIS) is a tool that US health plans use to evaluate performance and service quality. HEDIS comprises 94 measures across six care domains, addressing multiple chronic conditions. The tool also allows patients to take surveys and identify how satisfied they are with care delivery, claims processing, and customer service.

By introducing remote patient monitoring, health systems can increase their HEDIS quality score, influence their ranking, and get more incentives from both health plans and government payers.

Challenges surrounding RPM

The introduction of RPM depends on the availability of a reliable and secure internet connection. Otherwise, there is no way to transfer patient data from sensors to the physician. Any interruption in connectivity would result in data loss and undermine the real-time aspect of RPM. Cyber-security is another major concern for this healthcare delivery method.

Apart from that, some people are worried that elderly patients may run into difficulties handling RPM-related communication via smartphones. In reality, though, this shouldn’t present a problem, as 53% of people over 65 living in the US own a smartphone, while 40% of them have continuously used YouTube in 2018 according to the Pew Research Center.

However, this new healthcare model does come with new challenges:

  • Inability of some patients to adhere to the instructions remotely: as soon as patients leave the clinical settings, they may think the control is loosening and feel tempted to skip medicine intake or violate dietary restrictions.
  • Lack of technical support: while doctors have access to IT support, this is more complicated for patients if they experience malfunctioning of their RPM devices at home.
  • Data accuracy: even if all devices are functional, there is still a question about data reliability. If the data arriving to the monitoring physician is corrupted, it will not be of much value to the patient.
  • Security and privacy: like all systems operating over connected networks, RPM is prone to hacking and other forms of privacy breaches unless properly protected.

Remote patient monitoring is the present, not the future

With more technologies emerging and evolving in healthcare, such as precision medicine, data analytics, blockchain, and others, the message is clear—the patient becomes the central point of care. Providers should put more effort into accelerating the transition to this patient-focused realm and adopt the customer-centric approach common to retail companies. Winning patient loyalty now means safeguarding the relevance of providers’ services for years to come.

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