Remote Patient Monitoring: Uses and Challenges

Telehealth, supported by remote patient monitoring (RPM), continues to expand in use.  The global remote patient monitoring device market is expected to grow by 18.9% to $101.02 billion by 2028. Through RPM, providers can manage both acute and chronic conditions, and patients can reduce travel costs and infection risks.  RPM technology is quickly evolving which brings challenges in implementation and data integration.

Types of Remote Patient Monitoring Programs

According to the U.S. Department of Health and Human Services, the most common conditions currently tracked through RPM include:

  • High blood pressure
  • Diabetes
  • Weight loss or gain
  • Heart conditions
  • Chronic obstructive pulmonary disease
  • Sleep apnea
  • Asthma

In a recent webinar presented by healthleaders, a panel of experts[i] discussed their experiences in implementing and managing RPM programs.  These experts note that chronic disease management, including hypertension, COPD, and congestive heart failure, is the typical focus of home-based RPM programs.  Patients in need of episodic care, such as high-risk pregnancies and some oncology specialties, are also frequent candidates for RPM.

[1] Khang Nguyen, MD, Diego Ortega, MD, Ruchi Tiwari, PharmD, MS, and Beth Wharton served as the expert panel on Remote Patient Monitoring in the January 2023 healthleaders webinar.


Measuring Success of RPM Programs

Remote patient monitoring programs measure success through various analytics, including readmission rates, emergency department visits while on the program, outcome-based data (such as decreases in A1c levels), comparisons of actual clinical data to actuarial data, decreased length of stay if readmitted, compliance with therapy regimens, patient satisfaction, and total cost of care.

Authors of a recent Harvard Business Review article believe that RPM could improve clinical quality, increase access to care, and reduce health care spending by up to 20% in the U.S.  This would be accomplished by reducing unnecessary ED visits, reversing chronic diseases, addressing disparities in health care, making specialty care faster and more efficient, and providing access to the best doctors.

Challenges in Home-Based RPM Programs

Types of remote patient monitoring programs vary by organization.  Some include in-home nursing visits in conjunction with data gathered by RPM devices.  Other programs have 24-hour “command centers” which can react in real time to changes in patient status.  Virtual visits are common in most RPM programs.

The expert panel in the webinar discussed many challenges in implementing successful remote patient monitoring programs.  These challenges include, but are not limited to:

  • Investments in technology
  • Payment issues with CMS and private insurers
  • Cultural transformation for both providers and patients
  • Training of patients and providers on the use of devices
  • Interoperability of technologies
  • Connectivity issues, particularly in rural areas
  • Integration of documentation into electronic health records

A recent article in Nature focusing on surgical home hospital programs outlined similar challenges in both wearable and ambient technologies (sensors, video), including:

  • Signal fidelity
  • Data interoperability among devices and into the EHR
  • Integration into clinical decision-making workflow
  • Quality and accuracy of data
  • Frequency of monitoring
  • Separating true alerts from false alarms

Future of RPM

The webinar panelists anticipate expansion of RPM programs to smaller hospitals with limited resources and to more at-risk populations.  They also expect more integration with community healthcare programs.  As programs continue to gather data, predictive modeling can be used to improve and expand RPM offerings and facilitate buy-in from employer and union health insurance plans.  Experts also agree that there will be an increase in the use of artificial intelligence in remote patient monitoring programs.  As long-term care facilities experience rising acuity of residents and ongoing staffing shortages, the use of remote patient monitoring will allow for enhanced access to specialized care and increased staff efficiencies.

Excelas continues to monitor advancements in telemedicine, with a special interest in integration of data from remote patient monitoring tools and the electronic medical record.  Excelas can assist your facility in a documentation review to ensure timely and complete integration of RPM data into residents’ medical records.  This comprehensive and complete medical record data is critical not only to patient care, but to reimbursement, compliance, and risk management.

[1] Khang Nguyen, MD, Diego Ortega, MD, Ruchi Tiwari, PharmD, MS, and Beth Wharton served as the expert panel on Remote Patient Monitoring in the January 2023 healthleaders webinar.

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