Contributed: The opportunities and challenges for remote patient monitoring – What We Know!

Dr. Liz Kwo

Digital well being and telehealth have been round for a while, however it’s solely with the COVID-19 pandemic that their adoption has made an enormous leap ahead.

Used initially of the pandemic primarily within the type of videoconferences and telemedicine, distant affected person monitoring (RPM) is at present adopted by an elevated variety of physicians and sustained by a number of reimbursement insurance policies issued by entities similar to Facilities for Medicare and Medicare Companies (CMS).

Though at present experiencing accelerated improvement, RPM nonetheless has some challenges forward that may be overcome by efforts from a number of gamers concerned within the healthcare system, similar to federal authorities, huge tech firms, suppliers, physicians and sufferers.

What’s the present standing of RPM?

A report launched in November 2020 indicated that by 2025 the RPM market is estimated to succeed in $117.1 billion in comparison with $23.2 billion final 12 months. A survey from 2019 confirmed that 88% of the suppliers had been analyzing or already implementing RPM options in their companies.

The curiosity in and demand for these options have elevated previously two years, additionally attributable to pandemic, which prompted CMS to vary its reimbursement insurance policies in an effort to flip RPM right into a extra accessible resolution.

A newer survey, dated Could 2021, indicated that 43% of clinics and hospitals interviewed imagine that within the subsequent 5 years in-person monitoring will likely be matched by distant affected person monitoring, whereas 35% suppose RPM will surpass in-patient monitoring in the identical timeframe.

RPM options suppliers are creating easier-to-collect knowledge from trendy gadgets and functions. Sensible wearables, tablets or smartphones are outfitted with software program that makes use of gadget sensors to ship physique knowledge (similar to coronary heart price or sleep patterns) on to remote-monitoring platforms.

By connecting objects similar to blood glucose screens or weight scales via Bluetooth expertise to those platforms, a affected person’s knowledge is transmitted mechanically, relatively than measured and entered manually within the platform by the affected person.

These latest applied sciences allow suppliers to maintain updated with a affected person’s situation, with the adjustments that may happen of their illness evolution, and to make interventions that may lower the variety of visits to ER, cut back the charges of readmissions, and even save the lives of monitored sufferers.

Wi-fi medical gadgets similar to sensible stethoscopes are additionally utilized in RPM. In Europe, any such stethoscope, despatched to sufferers enrolled in telemedicine companies, is used to detect, label and analyze pathological sounds current within the lungs throughout assisted self-examinations by sufferers.

These findings are then despatched to a health care provider, who evaluates them and decides if these sufferers can proceed to be remotely supervised, or in the event that they require an in-person go to to the physician’s workplace. These sensible stethoscopes allow the detection of early indicators of respiratory points in adults and youngsters. On this approach, these gadgets assist forestall hospital overcrowding, lower the danger of illness transmission and supply sufferers the care they want.

As for sufferers, their place relating to digital care, RPM and well being monitoring via tech gadgets has modified in contrast because the COVID-19 pandemic. A survey revealed in 2020 indicated that, though sufferers are nonetheless involved relating to using their private knowledge and don’t have a lot belief in tech gadgets that monitor their well being, 57% of respondents would comply with obtain “distant monitoring of ongoing well being points via at-home gadgets” whereas 52% “would select digital for routine appointments.”

The confirmed advantages of RPM

The advantages of distant affected person monitoring have been confirmed by a number of research and sustained by many surveys performed lately.

1. Bettering supplied care and lowering readmissions to hospitals

In response to a examine performed in 2019 on 2,004 American adults, RPM supplied higher well being outcomes for 49% of the respondents, and it prompted 42% of them to take possession of their well being. From the 100 physicians additionally included within the examine, 68% acknowledged they intend to make use of RPM sooner or later and 50% acknowledged they imagine expertise has facilitated sufferers’ wider entry to well being and health.

Lowering the variety of hospital readmissions is one focus for a number of RPM platforms, and a few of them handle to attain vital milestones on this regard.

2. Impacting scientific trials

Very important to the drug-development course of, scientific trials are generally confronted with recruitment challenges. Individuals don’t all the time meet the in-person go to necessities for periodic check-ins.

Distant affected person monitoring would have the ability to acquire extra constant knowledge and allow trials to comply with via. Information acquired regularly from individuals via RPM could be extra correct and fewer dangerous than in-person visits to areas the place the trials are being performed.

Correct knowledge can have a constructive influence on the pharmaceutical business, whereas distant assortment of this knowledge would maintain the individuals secure from COVID-19 hazard.

3. Supporting telemedicine

Telemedicine visits could be complemented by distant affected person monitoring, so enabling physicians to step within the second a affected person’s well being reveals regarding adjustments. For instance, adjustments like coronary heart price oscillations after a brand new remedy is taken might require a direct telemedicine go to to verify the affected person’s wellbeing, to regulate remedy, or to suggest one other remedy or a distinct set of actions.

The one draw back noticed thus far is that this mixed utilization of RPM and telehealth may enhance the physicians’ or the suppliers’ workloads, a problem that must be addressed earlier than going full scale with this method.

4. Lowering dangers

Distant monitoring of well being indicators similar to blood sugar or coronary heart price can forestall sufferers affected by severe circumstances from being hospitalized. By remotely monitoring adjustments in necessary physique indicators, physicians and suppliers can take actions that lower the dangers of hospitalization.

One examine revealed in August of final 12 months and performed for an eight-month interval in 2020 indicated that, within the case of low-intensity monitoring of sufferers, a “multisite RPM program for administration of acute COVID-19 sickness is possible, secure and related to a low mortality price.” 

What are the principle challenges for RPM?

Among the challenges most cited by physicians, clinicians and suppliers concerned or excited by distant affected person monitoring are:

  • Funds charges are too low. In response to some physicians, implementing RPM expertise and conducting corresponding administrative duties in lots of instances requires hiring extra workers, which will increase their overhead.
  • Many claims formulated by suppliers are rejected attributable to unclear specs present within the RPM reimbursement guidelines. The principles say, for instance, that two healthcare suppliers can not invoice the identical distant affected person monitoring codes on the similar time for a similar affected person. However based on well being suppliers, these conditions happen fairly steadily with sufferers receiving distant care for various medical points from completely different clinicians.
  • The reimbursement guidelines are usually not structured sufficient to help the self-recording and transmission of important indicators and different physique parameters by sufferers to RPM options suppliers, which signifies that at the very least part of the prices for these companies is transferred to the affected person. This makes sufferers reluctant to enroll in any such service.
  • The fee-for-service reimbursement mannequin can’t be utilized to all RPM instances, as a result of the worth of any such care is usually seen over time, and never throughout the body of the episode acknowledged by the mannequin.
  • The excellent news is that, in comparison with earlier intervals, new classes of reimbursement for digital healthcare companies have change into out there or clearer.

What tech firms and entrepreneurs can do to extend RPM’s adoption

Tech firms can present correct instruments for illness administration and disease-burden monitoring. They will do that via biomarker-based and research-supported medical options in addition to via revolutionary applied sciences that might acquire FDA approval and would offer assist to sufferers sooner relatively than later.

Product managers and entrepreneurs have the instruments and capability to advertise a RPM-ready mindset and tradition by granting a “human face” to sufferers’ digital experiences. They will additionally have interaction in outside-of-the field partnerships that might allow them to develop new applied sciences and launch cost-effective, revolutionary options to deal with sufferers’ wants for high quality distant care.

Conclusion

Distant affected person monitoring success requires a shift in sufferers, suppliers, payers and tech builders’ mindsets in an effort to create extra cost-efficient options. What essential gamers within the healthcare business have to do subsequent is ensure that these options are absolutely and correctly understood by sufferers.

Doing so allows sufferers to enhance their well being outcomes by taking possession of their monitoring, whereas feeling absolutely assured within the distant applied sciences and sensible gadgets that acquire and ship their knowledge to clinicians or physicians through RPM platforms.


Concerning the Creator

Dr. Liz Kwo is Chief Medical Officer of Everly Well being and a Harvard Medical College college lecturer. She acquired an MD from Harvard Medical College, an MBA from Harvard Enterprise College and an MPH from the Harvard T.H. Chan College of Public Well being.