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Connected Health Technology

The Complete Comprehensive Guide to Remote Patient Monitoring

Successful implementation of Remote Patient Monitoring requires the right information and best practices.

Introduction

In terms of advancement of technology, healthcare is one of the rapidly evolving industries, especially when the COVID-19 pandemic started. Remote Patient Monitoring (RPM) is a recent breakthrough in this sector that offers various benefits in an aging and diverse world population with increasing health problems.

There are important things to consider and to learn if you are planning to deploy an RPM program in your clinic. It is one of the tools that you can use for better health outcomes and lower cost. Later on, we will discuss more benefits for you and for your patients, and some of the best practices to deploy a successful RPM program.

What is Remote Patient Monitoring?

Remote Patient Monitoring (RPM) or remote physiologic monitoring is the use of electronic equipment or digital technologies to gather and monitor patient-generated health data and transfer it to their healthcare provider for diagnosis, assessment and recommendations.

For example, a patient tests his or her blood pressure on a regular basis using a blood pressure monitor at home and submits the results digitally, usually automatically, to their clinician. Providers can use RPM application outside of the hospital or clinical context to monitor, report, and analyze their patients’ acute or chronic diseases.

How does Remote Patient Monitoring work?

In a basic sense, RPM connects patients and clinicians anytime and anywhere. Using digital technology and available medical devices at home, patients monitor themselves by taking measurements and then electronically submitting the information to their clinicians or care coordinators.

The information received through a mobile application or computer dashboard is then analyzed by medical professionals, usually with the aid of Artificial Intelligence and Machine Learning engine, to make daily, or in some cases, hourly, recommendations. AI/ML streamlines and automates clinical workflows through data analytics, and empower healthcare providers with actionable insights. The applications of AI and ML in healthcare will be discussed later. The healthcare providers can also send out alerts to modify treatment or medications or refer patients to the emergency room if needed.

RPM is also utilized after a patient is discharged from an ER or a care facility in specific instances. RPM devices allow clinicians to keep track of their patients’ progress and make modifications to their treatment plans, reducing the need for the patient to be readmitted.

The bottom line: Using technology, doctors can collect data more frequently and reliably than they could during typical in-office patient sessions. They can monitor weight, blood pressure, blood sugar, blood oxygen saturation, heart rate, and electrocardiograms from any point of care. This real-time data transmission could be life-saving.

Overall Benefits of Remote Patient Monitoring

Everyone wins in remote patient monitoring— not only healthcare providers and patients but the entire healthcare system as well.

Benefit to Providers

1. Improved productivity
RPM increases the efficiency of clinical process. It can act as a conduit for better prioritization of care delivery, triaging each case, and improving communication by gathering, storing, and using patient data for better medical decision-making. These tools can help improve performance and patient satisfaction.

Furthermore, by reducing waiting room congestion and devoting more time to patients who require immediate attention, healthcare providers can boost productivity by seeing more patients, resulting in increased revenue for their practice.2.

2. Increased practice revenue streams
The US government supports the implementation of RPM so that both patients and providers can benefit from it. The US Centers for Medicare and Medicaid Services (CMS) is boosting telehealth and RPM with CPT Codes, which allow healthcare providers to bill for remote patient interactions. RPM can also help providers achieve a competitive advantage by using innovative treatment models to attract and keep more patients. *More discussions on billing and reimbursement below.

3. Increased patient engagement and satisfaction
Thanks to RPM, patients feel that someone is “watching” them and caring about their health as data is sent to their clinicians. This empowers patients to play an active role in taking measurements at home or anywhere they are, knowing that a provider could be contacted if their vital signs go out of their normal range.

Clinicians can now teach patients how to care for themselves in between virtual clinical appointments as part of proactive treatment. With the rising number of chronic illnesses, remote monitoring is one option for medical professionals to enhance outcomes while increasing patient engagement.

Trust is very important when it comes to patient-doctor relationship. The more a doctor trusts his/her patients to take in charge of their own illness and treatment, the more patients will trust the doctor’s advice, and become more involved in their care. As a result, remote monitoring in healthcare improves patient participation, which leads to better health outcomes and satisfaction.

4. Greater access to care and more patient reach
During the COVID-19 pandemic, when patients and doctors wanted to reduce in-person contact for routine appointments, telehealth became a more significant means of providing healthcare. Telehealth enables small rural hospitals and clinics to provide high-quality healthcare services closer to home and at lower costs, benefiting underserved patients by eliminating the need to travel great distances for specialty care.

Moreover, we are all aware of the growing physician shortage, and RPM has the potential to help extend provider networks in new and innovative ways, hence improving access to care. RPM can be used to link people who live in rural locations or who are unable to access traditional healthcare. Owing to RPM’s ease of use, it also bridges the digital divide in healthcare, allowing senior people who are less tech-savvy to manage their own health.

5. Reduced patient no-shows
No-shows and same-day cancellations can occur for a variety of reasons, including individuals forgetting about their appointments, logistical challenges such as transportation or childcare, inability to take time off work, excessive wait times at physician’s clinics, fear of cross-infections, and so on. No-shows cost money, waste staff time, cause artificial access issues, and have a detrimental impact on patient care.

With RPM, patients can send information to their doctors, almost real-time, via a linked health platform from the comfort of their homes or offices. Patients can save time not just during their real consultations, but also on travel and waiting time, by using remote monitoring or virtual visits.

Patients with chronic conditions who need to see their doctor on a regular basis to monitor their health may face issues if they miss their appointments. By recording and delivering patient data to providers via connected monitoring devices, remote patient monitoring with disease management protocols (DMPs) can assist eliminate the need for in-person visits. RPM and DMPs allow doctors to do normal check-ins while also allowing them to respond quickly if RPM values surpass predetermined thresholds.

Benefit to Patients

1. Improved chronic disease management
Chronic diseases account for 90% of healthcare costs in the United States, however many of them are avoidable or better controlled by patient behavior change. Medical providers can manage their patients outside of the typical hospital setting with remote patient monitoring. In other words, patients don’t need to go to the doctor’s office to check their vital signs and other parameters such as blood pressure, blood sugar levels and body weight because RPM allows care providers to do it remotely.

Through RPM, clinicians can now manage a wide range of chronic conditions from the comfort of their patients’ homes, including type 1 and type 2 diabetes, hypertension, heart failure, and chronic obstructive pulmonary disease (COPD).

2. Reduced emergencies, hospitalizations and readmissions
Chronic diseases cost the US more than $3 trillion per year, yet better chronic illness management can prevent or delay a number of costly occurrences like ER visits, hospitalizations, and readmissions. The risk of serious and costly emergency situations is reduced when RPM assists patients in maintaining normal values for parameters such as blood sugar and blood pressure.

3. More control over personal health
Patients can get a holistic health analysis with Next-Generation RPM solutions, which come with a user-friendly mobile-enabled application. This improves the patient’s lifestyle, diet, and medication and treatment plan adherence.

4. Fewer physical visits to the practitioner’s office
RPM allows patients to stay home while being monitored by their doctors. This means they are less likely to contract COVID-19 and other illnesses, and they spend less time and money traveling.

5. Better support and education
Due to this constant, instantaneous communication between patients and their physicians, RPM also provides patients with enhanced levels of education, support, and feedback as compared to traditional healthcare models. Providers can provide better personalized and individualized support since they have access to comprehensive and timely information about a patient’s health condition.

6. Better quality of care
Patient health data provides valuable insights to healthcare providers that they would not have otherwise, giving them better tools for evaluation, diagnosis, and treatment prescription. Furthermore, rather than waiting until their condition becomes serious before scheduling and managing a visit to their care provider’s office, patients can engage in real-time monitoring and symptom analysis with their clinicians through remote patient monitoring.

Benefit to Health Systems

1. More focus on effective prevention and well-being
RPM allows healthcare systems to focus more on preventive care as the costs of chronic disease management rise. Effective prevention is one of the best ways to cut healthcare costs and increase patient well-being, but it’s tough to focus on when so many people in the United States are already chronically ill.

2. Lower national healthcare costs & significant annual savings
RPM improves access to treatment by reducing trips to the ER, hospitals, and readmissions, as well as increasing physician productivity. Furthermore, despite the continuing shortage of medical practitioners, remote patient monitoring benefits the US healthcare system by allowing more patients to be treated at home. Other types of office visits will have more capacity, however appointments for people with chronic conditions will be limited. These advantages could result in significant annual savings.

Types of Remote Patient Monitoring (RPM) Devices

RPM devices are wearables and medical devices that are capable of measuring and transmitting the health data collected from the said device to a cloud storage, where the healthcare provider can access anytime and anywhere.

1. Blood pressure monitor
Connected blood pressure monitors are beneficial to patients, especially those with hypertension and heart disease. A blood pressure monitor is a common medical device that measures the systolic and diastolic blood pressure of the user. Traditionally, the cuff of a blood pressure monitor is mounted on the arm of the user. However, with today’s innovation, a blood pressure monitor cuff may be mounted on the wrist of the user. Some blood pressure monitors are even integrated into smart watches making it very accessible and convenient to carry around.

RPM uses a connected blood pressure monitor to track and monitor their patients’ blood pressure remotely and continuously. With this, healthcare providers are able to provide better heart care to their patients. In fact, according to the American Heart Association, remote and continuous cardiac monitoring has significantly lowered patients’ blood pressure as compared to traditional care and self-monitoring. Connected blood pressure monitors allow healthcare practitioners to accurately diagnose and treat their patients by eliminating false readings, which usually occur when the result is higher during clinic visits as compared to readings done in different settings, such as their homes.

2. Pulse Oximeter
A pulse oximeter is also a common medical device that measures blood oxygen saturation and pulse rate. For patients with chronic obstructive pulmonary disease and other pulmonary health issues, including those with COVID-19, monitoring their blood oxygen levels continuously is important.

Blood oxygen saturation is measured by inserting a finger into a pulse oximeter. Traditionally, patients would use a stand-alone pulse oximeter and record their readings in a book, which they would bring to their provider during a clinic visit. Often, the time interval between taking the readings and meeting their providers in person is rather long, and their health may deteriorate during that time.

With RPM utilizing a connected pulse oximeter, providers can monitor their patients continuously and provide care despite distance. Using a connected pulse oximeter also allows providers to intervene without significant delay during emergencies, preventing complications and even death.

3. Glucose Meter
A blood glucose meter is a medical device that measures blood glucose by pricking one’s finger with a small needle called a lancet to get a drop of blood. Then, placing the drop of blood on a disposable test strip, which is inserted into the glucose meter. The glucose in the blood will react with the chemicals in the test strip to give the result of one’s blood sugar levels.

A glucose meter is usually given to a patient with diabetes. Diabetes is a complicated illness that may not manifest symptoms until it is already at its worst stage. As such, patients with diabetes are turning to RPM to continuously monitor their blood sugar levels and prevent complications such as hyperglycemia and hypoglycemia from happening.

With a connected blood glucose meter, healthcare providers are able to monitor their patients’ blood sugar levels without in-person clinic visits. Utilizing RPM and the data collected through the connected blood glucose meter may aid healthcare providers to better understand their patients’ health conditions and to adjust treatment plans immediately to avoid risks and complications.

4. Smart Scale
A smart scale is a device that measures not only the user’s weight but also the BMI, body fat, body water, muscle mass, bone mass, and others. These body parameters are measured by simply stepping on the smart scale. This device is usually given to patients with obesity.

For patients with obesity, continuous weight monitoring is vital, especially for those who are trying to lose weight. Losing weight is not just about body mass. An overweight patient may have the same body weight as a body builder. As such, it is also important to consider other body parameters, such as body fat and muscle mass.

With RPM, providers can keep an eye on their patients’ health conditions from anywhere and may change their diet or treatment plan if needed.

5. Electrocardiography (ECG) Device
An electrocardiography device is a medical device that measures the one’s heart electric activity. An ECG is usually given to patients with heart problems.

RPM utilizing ECG devices to assess heart function may deliver a plethora of information about a patient’s health. This data will allow healthcare providers to diagnose and treat their patients. Patients enrolled in RPM may benefit from connected ECG devices since it provides continuous patient monitoring. Additionally, for patients at risk of cardiac disease, the connected ECG allows for greater freedom and reduces the need for clinic visits and in-home nursing.

6. Smart watch
A smart watch is an all-in-one wearable device. Traditional smart watches are usually used to measure calories burned during workouts. However, as technology advances, smart watches are now being utilized to monitor patients remotely.

Connected smart watches do not just measure calories burned, but also heart rate, blood pressure, respiratory rate, blood oxygen saturation, and even ECG. With the connected smart watch’s functions, healthcare providers are able to monitor and track their patients’ overall health conditions.

Remote Monitoring for Chronic Disease Management Programs

1. Hypertension Management
Remote patient monitoring makes a demonstrable difference for patients living with hypertension in the gap between convenience and consistency of monitoring. RPM plays an important role in hypertension by allowing healthcare providers to intervene more quickly and avoid a controllable illness from becoming a health emergency requiring hospitalization. RPM helps people and healthcare providers control hypertension by allowing them to make informed decisions based on facts and trends. RPM can send notifications in real time if the blood pressure reading deviates from the recommended range. Because RPM for hypertension also saves data on a regular basis, it aids medical experts in detecting any unusual blood pressure. These trends are used to figure out how a given treatment plan works and whether or not existing prescriptions need to be modified. This eliminates the tediousness of regularly logging and reporting readings in the traditional at-home manner, while also reducing emergencies.

2. Cardiovascular Diseases Managament
The use of RPM to manage cardiovascular disease (CVD) has proved to enhance patient outcomes significantly. RPM devices have been shown to lower blood pressure, forecast heart failure decompensation, and detect arrhythmia early enough to allow for faster intervention. Data collection from those who have or are at risk of cardiovascular disease can now be done remotely. A number of stand-alone devices can assess symptoms, body weight, activity, blood pressure, pulse rate and regularity, heart sounds, respiratory rate, an electrocardiogram, oxygen saturation, and sleep quality. RPM has already been shown to be effective in the treatment of various cardiovascular diseases. Patients’ compliance has increased as a result of the shift from manual to automatic remote monitoring. Furthermore, RPM’s ability to send data directly to healthcare providers leads to better management and treatment of cardiovascular diseases.

3. Diabetes Management
Diabetes is one of the most prevalent chronic diseases afflicting people worldwide, and in the U.S., about 1 in 10 Americans have diabetes according to the CDC. Good blood glucose control is the cornerstone of diabetes management, and is crucial to decreasing the risk of long-term complications and adverse events. In this capacity, remote patient monitoring can definitively make an impact in improving the lives of people with diabetes.

People with diabetes are often advised to monitor blood glucose levels regularly, ranging from several times a week to several times a day. This monitoring is tailored to individual needs, level of glycemia, and type of treatment regimen. When remote patient monitoring is applied to diabetes management, either using a capillary blood glucose meter or continuous glucose monitor, patients can monitor their blood glucose more regularly and consistently, as the RPM platform reminds them to do so. Tracking patient progress and maintaining vigilance for adverse events is also made possible, as health care providers can view patient data in real-time and will be notified about any adverse event based on customizable alerts. This leads to better glucose control for patients and better coordination with health care providers, ultimately resulting in better health outcomes.

4. Obesity and Weight Management
Obesity represents a significant health burden in the US, with around 4 in 10 Americans being overweight or obese. A myriad of health problems are associated with obesity, including cardiovascular disease, fatty liver, diabetes, and even cancer. This being the case, weight loss is strongly recommended to improve health outcomes and prevent complications and additional risks to one’s health. Remote patient monitoring can also play an important role in aiding the weight loss process.

Integral to weight loss programs is the ability to measure weight and track one’s progress. A simple weighing scale can provide information on weight, but a smart scale with body impedance analysis can provide more metrics like fat mass, bone mass, lean body mass, and visceral fat. This is important because in some instances, fat may be lost while an equivalent amount of muscle was gained, leading to no change in weight. A regular weighing scale would not be able to tell the difference, but a smart scale would show the improvement. And since patient data are stored and summarized within the platform, health care providers can also track their patients’ progress and better streamline weight loss efforts and strategies.

5. COPD management
Chronic obstructive pulmonary disease necessitates close monitoring because it has been shown to improve the patient’s quality of life. A coordinated care approach that includes oxygen support, tailored maintenance and rescue medications, and patient rehabilitation that is current and partnered with remote patient monitoring and pulmonary function tests will greatly improve patient adherence and may even prevent the occurrence of potentially life-threatening respiratory diseases like COVID-19.

6. Asthma management
While many factors contribute to the causes of asthma, such as smoking, genetic factors, and presence of respiratory infections, preventive measures are welcomed as an effective means of controlling asthma and delaying progression to COPD. By monitoring signs and symptoms, providers will better detect and intervene promptly.

7. Management of other respiratory diseases
The advantages of remote patient monitoring have extended to less common pulmonary diseases such as cystic fibrosis and bronchiectasis.

Best Practices for Providers

Choosing the best RPM Partner

The system must be simple to use for everyone across the board. Logging in, getting into the session, taking measurements, and using the features should all be quick and straightforward for both patients and providers.

For providers: You should be allowed to test and receive brief orientation before you get into the contract. The platform should give you more freedom to work efficiently. Its platform should support automation of alert systems, billing and reimbursement calculation, and with rich visualizations of data analytics.

For patients: Telehealth program should give patients confidence to utilize. The monitoring devices should be easy to operate and connect to a mobile application even without too much assistance from their family or caregiver.

1. Seamless clinician workflow
RPM powered by AI that delivers a complete picture of a patient’s health status aids clinical workflows. DrKumo, a leader in massively scalable remote patient monitoring (RPM), uses artificial intelligence (AI) to analyze patient-generated health data acquired by sensor fusion-equipped medical devices.

2. Patient data security (HIPAA-compliant)
Patient data must be on top security first. This requires creating and deploying technology platforms that make use of the most recent technological and data-transfer security improvements, such as a variety of data encryption techniques, extensive system testing, and other relevant variables. Choosing a security-focused and HIPAA-compliant RPM provider necessitates developing a healthcare delivery system that involves patient data protection, ensuring patients’ sensitive data is kept private.

3. Continuous Real-time Support
Goals should be making care accessible to people who live in isolated or rural areas; making services readily available and convenient for people with limited mobility, time or mode of transportation from their place; improving communication and care coordination among members of a health care team and a patient; supporting self-management of diseases.

Like health monitoring devices that record and transmit information such as heart rate, blood glucose, oxygen level, or blood pressure continuously in real-time allow clinicians to provide timely medical intervention when necessary. Continuous Real-time Remote Patient Monitoring can act as a conduit for faster prioritization of care delivery, triaging each case, and improving communication by gathering, storing, and using patient data in real-time for better medical decision-making.

Introducing RPM to your patients

Remote patient monitoring (RPM) provides and offers a lot of benefits to healthcare systems and care providers and encouraging patients to embrace remote patient monitoring usually requires patience and careful consideration. Let’s have these three vital factors.

1. On-boarding education and continual support
You have to demonstrate how to operate RPM medical devices and the mobile application. Highlight the ease of use, educate them about their roles in the care process, and continuously provide support. You need to have multiple lines of support for some technical problems. Just get your vendor involved with the process of troubleshooting issues and educating the patient.

2. Setting clear goals
You need to start with clear goals for both short and long-term goals. Short-term care involves post-acute care management, either after surgery or after temporary care in the home of the patient, while long-term / chronic care, the illness is expected to continue for the remainder of the patient’s life. You can start with some baseline metrics, then set the target endpoint. For example, if you are introducing RPM to a patient with diabetes, the example goals could be: to reduce HA1c from 8.5% (1.7% SD) to 7.4% (1.3% SD); to reduce the average HA1c by 0.5% in patients with type 2 diabetes; and/or to reduce HA1c in 3 and 6 months.

3. Well-designed RPM technology
It must be built around ease of use of software, have data-driven credibility, and be cost-effective. RPM solutions equipped with sensor fusion medical devices are excellent as they provide a holistic and accurate representation of patient-generated health data, promoting patient education and patient adherence. Patients must know their disease to embrace rpm and multicast continuous real-time data streaming gives patients peace of mind, knowing that their condition is being monitored anytime and anywhere.

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