What if we told you one type of telemedicine has the potential to help manage chronic diseases, allow older and disabled individuals to live at home longer, avoid prematurely moving those individuals into skilled nursing facilities (SNFs), reduce hospitalizations numbers, reduce readmissions, reduce length of stays in hospitals and so much more? Welcome to the power of remote patient monitoring, or RPM.
Remote patient monitoring is one type of telemedicine that has broad-reaching applications and impacts for many different types of healthcare specialties and facilities. Advocates for RPM monitoring programs cite its potential to help achieve the healthcare “triple aim”, through improving patient outcomes, improving access to care, and making healthcare systems more cost effective.
What is RPM and how does it work? Curious how your healthcare organization can incorporate it to solve challenges and accomplish strategic objectives? Keep reading for this month’s deep dive into the powerful telemedicine application of RPM.
Remote Patient Monitoring 101
Remote patient monitoring is a type of telemedicine that 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. RPM allows providers to leverage existing 21st century technology to expand into new forms of care for their patients who may have been unsuccessful in severe or constraining in-person treatment plans or struggled with adherence to treatment plans in the past.
RPM programs use “smart” health measuring tools and devices that can transmit data via the Internet such as smart scales, wireless smart glucometers, etc. These tools can collect a wide range of health data, including but not limited to:
- Vital signs (pulse rate, temperature, respiration rate, blood pressure)
- Blood pressure
- Blood sugar
- Blood oxygen levels
- Heart rate
Additionally, this data can then be transmitted to a variety of healthcare professionals in a number of healthcare facilities with monitoring centers for analysis, including:
- Primary care offices
- Intensive care units (ICUs)
- Skilled nursing facilities (SNFs)
- Off-site case management programs
Achieving the Triple Aim of Health Care
Recent studies on implemented RPM monitoring programs across the country are beginning to show evidence of its potential impact on the healthcare industry achieving its “triple aim”. The triple aim is a term to conceptualize healthcare’s three highest pursuits that are often challenging to achieve in tandem: improving the experience of care, improving the health of populations, and lowering costs. Often thought you must sacrifice one item to achieve the other two, this old triple aim stereotype is being put to the test by RPM monitoring programs.
A 2015 study that investigated acute care utilization outcomes during a 90-day period using a tele-monitoring program for underserved COPD and heart failure patients found encouraging results. According to the Center for Connected Health Policy, the study “found a 50% reduction in 30-day readmission and a 13-19% in 180-day readmission among patients who received the tele-monitoring intervention. Ultimately, they concluded that [RPM] has the potential to reduce long-term acute care utilization.”
Another 2015 study examined 269,471 patients who received pacemakers, implantable cardioverter-defibrillators, or cardiac resynchronization therapy, and noted their weekly use and all-cause survival following implantation. The study results found those who spent more time using RPM had higher survival rates than those who didn’t, providing evidence to suggest increased use of RPM can improve patient outcomes.
Managing Chronic Conditions with RPM
One of the most powerful applications of RPM is its ability to drastically assist patients challenged with managing and monitoring their chronic conditions. According to the CDC, chronic diseases are responsible for 7 of 10 deaths each year, and treating people with chronic diseases accounts for most of our nation’s health costs. While it’s quite clear chronic conditions are an enormous challenge for the healthcare system, many patients experience difficulty and frustration in managing or taking control of their health, particularly when their actions and vital readings outside their care setting can go unnoticed or unseen by their physician or care team. Combine these frustrations with studies showing healthcare consumers’ willingness to wear technology to track their lifestyle and vital signs, and you’ve got the perfect recipe for RPM success. RPM wearables and technology allow patients to not only become more educated on their conditions, but fosters greater engagement with their health care and encourages lifestyle choices resulting in better outcomes.
How would RPM work in a simple diabetic instance?
- A diabetic patient who’s struggling to manage their chronic condition could join an RPM treatment plan that includes taking blood glucose reading at least three times a day.
- The data would be collected and sent through an application to their physician’s or healthcare providers facility.
- With the use of real-time data, the patient’s care manager can notice trends in the patient’s blood sugar levels over time and develop strategies to amend the patient’s diet and activity.
Instances like the above example are just one of the many chronic conditions RPM can provide supported treatment on, including but not limited to:
Letting Seniors Age Gracefully
In 2011, the oldest baby boomers- Americans born between 1946 and 1964- started to turn 65. By 2050, the number of people ages 65 and older in the United States is projected to more than double from 40 million to 89 million, and consist of a whopping 1/5 of the total population. The healthcare industry has known for years it would face this challenge and RPM is proving to be an excellent tool for allowing seniors and the elderly age gracefully from the comfort of their homes.
One of the most challenging issues seniors face is the cost of their healthcare as they age since long-term care or skilled nursing facilities can be exorbitantly expensive. RPM devices, monitoring, and management provide a more affordable option for seniors to stay in their homes as long as possible, allowing them to stay rooted and connected to their communities and families. Studies also show RPM programs are cheaper and can reduce costly hospitalizations and custodial care. Using various sensors around the patient’s home, healthcare professionals can receive data on the patient’s restlessness during sleep, daily vital signs, data on monitoring the patient’s gait to help prevent falls and more. Sensors like these can help detect health issues or problems before the patient experiences symptoms or realizes something is going on. The integration of home tech devices, the Internet and healthcare professionals is revolutionizing and will continue to change the way we care for our elderly populations in the future.
Greater Access to Rural Patient Care
Rural populations currently experience significant health disparities compared to urban areas from higher incidence of disease and disability, to increased mortality rates, lower life expectancies and more. RPM, combined with other telemedicine solutions, can also provide greater access to healthcare among these remote, rural, and underserved communities across the nation. For example, electronic health units (e-ICU) are popping up allowing urban healthcare facilities to reach surrounding rural patients using health technology. One health system in Alaska is using e-ICUs to help treat patients in remote locations through monitoring stations. With real time tracking, nurses are able to see instant changes in patient’s breathing rates, blood pressure and oxygen levels, which allows the healthcare team to provide guidance on tricky and life-saving procedures. Since the system first started, the e-ICU prevented 17 patients from being transported to Anchorage, providing enormous health and cost benefits to patients.
It’s clear RPM technology has tremendous power to influence and enhance the way we monitor and treat patients moving forward but there are challenges the marketplace will have to face moving forward, including:
- Accessibility- RPM requires good broadband connectivity which can be difficult for rural facilities and small healthcare institutions to access and afford.
- Additional RPM software- Once data has been collected, health IT departments must redirect it from the RPM enabled devices into the system’s electronic health record (EHR). This usually requires one or more 3rd party applications which can be costly and unobtainable for budget-strapped healthcare providers.
- Reliability of data- Although wearable fitness trackers are popular, studies have shown them experience error margins up to 25% and even apps for detecting serious issues like melanoma have shown failure rates near 30%. Accuracy and reliability of the data is the most serious issue the industry must solve in the future.
What are your thoughts?
Has your organization implemented a remote patient monitoring program? If so, what best practices have you learned along the way? Tell us in the comments below!
- Center for Connected Health Policy’s Remote Patient Monitoring Research Catalogue
- C&M Health: New Reimbursement for Remote Patient Monitoring and Telemedicine
- HITEQ Center: Remote Patient Monitoring: A Toolkit for Success
- Center for Tech and Aging’s Technologies for Remote Patient Monitoring for Older Adult