Remote patient monitoring
RPM involves the constant remote care of patients by their physicians, often to track physical symptoms, chronic conditions, or post-hospitalization rehab.
[1] Incorporating RPM in chronic-disease management may significantly improve an individual's quality of life, by allowing patients to maintain independence, prevent complications, and to minimize personal costs.
[4][5][6][7] While technologies are continually being developed to tackle this type of health care, physicians may utilize basic communication methods such as Zoom, Snapchat, or even landline phones.
[8] Literature related to Remote Patient Monitoring suggests that interventions based on health behavior models, care pathways, and personalized coaching lead to the best outcomes.
By 2025, the Remote Patient Monitoring industry is expected to double, due to factors such as the COVID-19 pandemic and increased at-home care.
[18][22] The FDA has given emergency authorized use of RPM technologies for the purpose of decreasing the spread of COVID-19 and to prevent overload for healthcare resources and personnel.
[4] Furthermore, tracking capabilities via Wi-Fi, global positioning system (GPS) or radio frequency enables caregivers to locate wandering elders.
[32][33][34] The randomized study, conducted by PJ Devereaux and Micheal McGillion, split 905 patients between a standard of care group and a RPM group, which used at-home clinical grade vital sign devices to transfer their vital signs to a Clinician Portal where they were monitored remotely and could communicate through text, chat, or video calls.
[40] The Veterans Health Administration (VHA), United States' largest integrated healthcare system, is an early adopter which became highly involved in the implementation and evaluation of RPM technologies.
VHA's findings indicate improvements in a wide range of metrics, including decrease in emergency department visits, hospitalizations, and nursing home admissions.
It is the largest randomised control trial of telehealth and telecare in the world, involving 6191 patients and 238 GP practices across three sites, Newham, Kent and Cornwall.
In the UK, the Government's Care Services minister, Paul Burstow, has stated that telehealth and telecare would be extended over the next five years (2012-2017) to reach three million people.
The continuous flow of patient data requires a dedicated team of health care providers to handle the information, which may, in fact, increase the workload.
[17] Debate surrounds the potential cybersecurity issues of RPM, including the likelihood of hacks which could pull personal medical data.
[44] Additionally, most remote monitoring devices are limited to single-user applications, and could be expanded in the future for better inclusion of multi-user technologies.
[45] Cigna, Humana and UnitedHealth Care are among the large private U.S. private health insurance companies that offer members to track certain health data, such as blood pressure, glucose values and other metrics, and send them to their virtual primary care providers who can review the data during patient visits.
[49] Published by the New England Journal of Medicine, a randomized controlled trial involving congestive heart failure patients concluded that the use of telemonitoring failed to provide a benefit over usual care.
[50] The telemonitoring patient group was instructed to call a designated number daily, and answer a series of questions about their symptoms using a keypad.
[50] Clearly, the process described by Chaudhry et al. (2010) differs from the RPM methodology illustrated in the overview, which involves actual collection and transmission of physiological data through point-of-care devices.
With articles[51][52] from Forbes associating RPM with the negative findings by Chaudhry et al. (2010), it may be difficult to clear the misconception that telemonitoring is synonymous with remote patient monitoring.
[53] The lack of standardization of RPM nomenclature and definition makes it difficult to differentiate between different forms of patient monitoring involving technology.
Different forms of RPM have varying effectiveness, with researchers supporting more resources going towards developing technologies which counter the pitfalls of these methods.
