Remote Patient Monitoring Brings mHealth Care Management Into the Home

With mHealth tools and platforms, remote patient monitoring programs have the potential to extend care management and coordination outside the doctor's office or hospital and into the patient's home.

Remote patient monitoring programs have the potential to reduce chronic care costs and hospital readmissions and improve clinical outcomes by moving care out of the hospital or doctor’s office and into the home.

Most of these programs focus on the collection of patient-generated health data from the home, through devices and mobile health platforms that connect to the primary care provider or care team. That data can either be collected and sent by the patient or gathered by connected devices and sent to the provider without the patient’s participation.

In this manner a provider can keep track of a patient around the clock, gathering data on health, activity, diet and exercise, the environment, even social determinants, thus filling out a health record that would otherwise focus on the patient’s visits to the doctor or hospital. By creating a more complete record, the provider can gain a better understanding of a patient’s overall health and develop a care plan that more closely adheres to a patient’s life.

A provider can also use the platform to push health and wellness advice, care management tips and other resources to the patient, based on trends spotted in RPM data. A diabetic patient consistently showing high blood sugar levels, for instance, might be urged to exercise more or alter his or her diet – or change his or her daily insulin intake to bring those readings down.

The path to acceptance for RPM devices and platforms hasn’t been easy. Providers have long been wary of remote monitoring technology for two reasons:

1. Most of the technology hasn’t been proven reliable, leaving the doctor or nurse to wonder whether the data coming in from the patient is accurate enough to support a diagnosis or treatment plan.
2. Devices and platforms that capture too much data threaten to overwhelm the provider with useless information.

Payers have been slow to reimburse providers for using the technology, as well, primarily because they haven’t seen proof that RPM is improving clinical outcomes. Researchers at Cedars-Sinai Medical Center reinforced that notion with a 2018 study pointing to a lack of data indicating that RPM produces long-term results.  

“Despite anecdotal reports of RPM efficacy and growing interest in these new health technologies by researchers, providers, and patients alike, little empirical evidence exists to substantiate claims of its ability to improve clinical outcomes, and our research indicates many patients are not yet interested in or willing to share RPM data with their physicians,” the study concluded.

Ironically, Cedars-Sinai is one of several health systems across the country actively engaged in RPM pilot programs, so it may not take long for that earlier study to be revised.

USE CASES FOR RPM

There are several potential use cases for remote patient monitoring. They include:

Chronic care management

Primary care providers can keep tabs on patients with chronic conditions in between office visits, promoting care management and intervening if data indicate a pending health issue.

Post-discharge care

Health systems are eager to keep track of patients after they’re discharged to make sure they follow their care plans and don’t experience setbacks that could lead to rehospitalization. In this scenario, the provider can also connect the patient with physical therapists and other specialists involved in rehabilitation.

Senior care

The growing numbers of seniors aging in place are putting pressure on providers to develop programs that connect to their older patients in their homes.

Workmen’s compensation cases

Payers, businesses and providers are all interested in tracking patients who have been injured on the job and are rehabilitating at home. All want to make sure they’re adhering to their care plan and are on a path to returning to work.

Behavioral health and substance abuse

.Providers treating these populations want to keep track of their patients outside the office to gain a better understanding of the social and environmental challenges affecting their health. An RPM platform can help providers identify health concerns and step in to address a potentially harmful issue, and they can be available in times of crisis. In addition, providers treating substance abuse issues can monitor their patients for relapses and ensure compliance in medication-assisted therapy (MAT) programs.

While hospitals and health systems generally view RPM as a means of engaging with a selected population of patients outside the hospital, smaller practices and even solo physicians can find value in the service to reduce unnecessary in-person visits, cut traffic in the waiting room, improve patient engagement and make sure patients don’t have to visit the hospital or doctor’s office for some emergency that could have been avoided.

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