The increasing importance of remote patient monitoring (RPM)

Remote Patient Monitoring

Remote patient monitoring (RPM) uses digital technologies to collect medical and other forms of health data from individuals in one location and electronically transmit that information securely to health care providers in a different location for assessment and recommendations. These patient monitors help physicians to reduce the amount of hospital readmissions, and also maintain stability for patients who suffer from a chronic illness, by maintaining constant communication between patient and physician.

Remote patient monitoring (RPM), also called homecare telehealth, is a type of ambulatory healthcare that allows a patient to use a mobile medical device to perform a routine test and send the test data to a healthcare professional in real-time. Trending data is superior to less frequent snapshot data because it can alert a clinician to worsening levels before the situation becomes severe enough to prompt a return to the hospital. Upon noticing any worsening of symptoms, the patient or caregiver can immediately call or text the monitoring center to receive instructions and answers to questions.

Remote patient monitoring requires following components

Input device

This may be a sensor clipped onto a patient’s clothing physically attached to a patient by one or more leads embedded in a watch, shoe, clothing, mattress, etc., or placed in a home (such as a motion sensor). Other forms of input devices include smart phones, computers, or landline telephones. These are either used for patients to enter data themselves, or as local data storage devices into which there is a wireless communications feed from the input device.

Local data storage

is used to capture and retain the data locally. This data may be held by the patient or submitted to a central data repository.

Telecommunications

is needed to transmit the data from the input device/local data storage device to a central data repository. Telecommunications may include a variety of home hub devices that capture short range signals (e.g., Bluetooth) and move them over a cellular network to the central data repository. They may also be less sophisticated forms: Patients may be required to use an intermediary local data storage device (e.g., a USB drive) and literally carry the data to the provider or insert it into their own personal computer to store the data or use the computer and WiFi, cable or other means to send the data through the Internet.

Central data repository

may include a provider’s Electronic Heath Record (EHR), a Patient Health Record (PHR), a Health Information Exchange (HIE) organization, or (less commonly) other Health Systems in Transition (HIT) such as a registry, e-prescribing system, laboratory information system, and others depending on the nature of the data being monitored.

Diagnostic application software

helps the patient, provider, or other person interpret the data captured through the device. This may be a smart phone app that compares data to normal values and provides an alert to contact the provider or take other action. Smart phone apps may provide some graphing functionality so the patient can see positive change or observe concerns, upload data to a PHR, and may recommend links to educational information on the web.

Remote patient monitoring achieves this effective communication through a specific series of functions:

Collection – RPM technology includes daily monitoring devices such as glucose meters for patients with diabetes and heart or blood pressure monitors for patients receiving cardiac care. Once the user activates the patient monitor, information is collected, stored on internal systems, and formatted for transmission to the patient’s healthcare physician.

Transmission – The data collected is then transmitted to the healthcare facility through the internet, phone, text, or other form of communication.

Evaluation – Internal algorithmic software and healthcare professionals will examine the data and indicate any areas of concern. Information regarding these concerns is then sent back to the patient or the patient’s healthcare team.

Notification – In the event that the physician finds a discontinuity in the data that requires immediate attention, alerts will be sent to designated emergency responders.

Action – An emergency medical team will provide immediate assistance to the patient and will even explain what happened and ways to prevent another similar incident in the future.

The technology involved in this communication has improved drastically within the last several years. In fact, recent remote patient monitors are now able to transmit precise data more efficiently, take medical readings through less invasive methods, and analyze real-time data to identify abnormal readings faster and more accurately .

Application of Remote Patient Monitoring

In the healthcare IT market, remote patient monitoring devices had greatly decrease the burden of patients and delivered high quality of care with lower risk. Beyond the patient interface, the technology platform is being enhanced in every corner and solve all medical related problem of the patient at remote locations. The most widespread and promising application of patient monitoring devices are:

(i) Maintain diabetes:

For controlling diabetes, the patient has to take care of its blood pressure, blood glucose, weight etc. For this purpose, these monitoring devices facilitate the real-time delivery of blood pressure & blood glucose level & alerts healthcare provider to treat when needed.

(ii) Reduces Risk of Heart failures:

Due to hectic lifestyle, lots of people are suffering from heart devices. To reduce the risk of heart failure, technology has brought devices like cardiac resynchronization therapy, pacemakers etc in the market which indicates that RPM improves the quality of life, decreases mortality rate and shortens the duration of stay in hospitals.

(iii) Prevent Dementia and Falls:

When we are growing old, we are at a risk of dementia and falls. To prevent these risks, remote monitoring technology prevents harm & promote safety through continuous surveillance. Different types of sensors are attached to the mobility devices such as walkers and canes of the patient which indicate alert in case of fall & lost. To locate or track elders, GPS or wifi or radio frequency technologies are used.

(iv) Infertility:

A Recent study proves that a six-month remote monitoring program had the same pregnancy rate as a cycle of IVF (In-Vitro Fertilization). Remote patient monitoring service & product used for Infertility treatment had a very low cost as compared to IVF treatment cycle cost.

Remote patient Monitoring Benefits

With the increasing demand, most of the countries adopt this technology and use devices to provide quality of care to patients. Following of benefits of remote patient monitoring for patient & providers are:

Patients:

Timely & Proper treatment at an early stage.

Multiple doctors can evaluate the condition from the remote locations.

Proximity to home and community.

Reduced travel and wait time.

Rapid diagnosis & fast intervention by the doctor.

Doctors:

Real-time visualization of patient health and medical parameters.

Increase operational efficiency, planning & compliance.

Live streaming of patient data even in 2G network.

Reduces the workload, clinical productivity solution.

Save Time & Resources.

Healthcare organizations, particularly hospitals, can use remote monitoring to limit associated healthcare cost, and cut down on the use of more expensive services. These facilities can expand their scope of service — and rest assured that patients are maintaining a healthy status.

Value-based care, which revolves around clinicians getting paid according to the quality of care patients receive instead of the traditional fee for service payments, is the new payment strategy in healthcare. RPM will play a major role in value-based care by increasing ongoing interactions between patients and clinicians via digital messaging and transmission of biological data.

In short, remote patient monitoring will allow continuous tracking of both healthy and at-risk patient vital signs in order to prevent emergent conditions, predict if and when an intervention will be necessary, and develop baseline outcomes for various conditions. All of this, presumably, should reduce healthcare costs and improve health outcomes, particularly for those patients managing chronic illnesses, but it remains to be seen how and when remote patient monitoring will go mainstream.

The continued advancements in new technology and the declining number of healthcare workers as compare to population, ensure that RPM will become a valuable care option for more and more patients.

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