Remote Patient Monitoring (RPM) has become a central component of chronic disease management in the United States, particularly following the rapid expansion of telemedicine during the COVID-19 pandemic. Remote patient monitoring programs commonly capture physiological data in the home and transmit it to clinicians to support ongoing care decisions outside of traditional office visits. While adoption has accelerated, questions remain about sustainability, integration into clinical workflows, reimbursement stability, and long-term outcomes.
A 2025 review published in the Journal of Medical Internet Research examines the current state of RPM for chronic disease management in the United States. The article synthesizes evidence on stakeholders, available RPM technologies, regulatory oversight, coverage and reimbursement, implementation challenges, and persistent knowledge gaps shaping the future of RPM in routine clinical practice.
Why RPM Matters for Chronic Disease Management
Chronic diseases such as diabetes, hypertension, heart failure, and chronic kidney disease account for a significant proportion of health care utilization in the United States. The Journal of Medical Internet Research (JMIR) review notes that telemedicine and RPM expanded rapidly during the pandemic, supported by temporary policy changes and emergency use authorizations. Evidence cited in the paper shows that higher use of telemedicine has been associated with improved medication adherence and changes in utilization patterns, including fewer emergency department visits for some chronic conditions.
RPM is positioned as a tool that helps bridge the gap between virtual visits and continuous care by enabling clinicians to monitor patients between encounters and respond to changes in clinical status.
Key Stakeholders in RPM Programs
The article identifies several stakeholder groups whose interests shape RPM adoption and sustainability.
Patients
For patients, RPM can increase convenience, engagement, and communication with care teams. It allows individuals to participate more actively in monitoring their health outside the clinic. However, the paper also highlights financial considerations, including device costs and cost-sharing, which may affect participation and equity.
Health Systems and Payers
Health systems and payers are primarily focused on whether RPM improves quality, outcomes, and efficiency, particularly in value-based care environments. A major challenge identified is uncertainty around long-term reimbursement, which can limit investment and scalability.
Policy Makers and Regulators
Federal and state policy makers must balance innovation with patient safety, equity, and sustainability. The review emphasizes the importance of reimbursement models that account for the clinical work required to review and respond to RPM data, not just device deployment.
Digital Tools Used in RPM
The JMIR review provides a detailed overview of RPM technologies used for chronic disease management, categorizing tools by frequency and type of data collection.
Intermittent Monitoring Devices
These include:
- Blood pressure monitors
- Glucometers
- Pulse oximeters
They are commonly used for conditions such as hypertension, diabetes, chronic kidney disease, and heart failure.
Continuous or High-Frequency Monitoring Devices
These include:
- Wearable activity trackers
- Continuous glucose monitors
- Remote ECG systems
- Fall detection sensors
These tools are increasingly used for higher-risk patients and conditions requiring closer surveillance.
All RPM devices discussed in the article are regulated as medical devices by the U.S. Food and Drug Administration, many of which transitioned from emergency use authorization to standard regulatory pathways after the pandemic.
Implementation Challenges in Clinical Practice
The review identifies several recurring challenges that health systems face when implementing RPM.
Workflow and Staff Burden
RPM often increases asynchronous messaging and data review responsibilities, requiring new workflows for “in-basket” management and non-visit care. Without redesign, this can contribute to clinician workload and burnout.
Technology Access and Equity
Patients may face barriers related to device access, broadband availability, digital literacy, and language. These challenges disproportionately affect rural and low-income populations and can exacerbate disparities if not addressed intentionally.
Cost and Sustainability
RPM programs involve upfront and ongoing costs related to devices, staffing, and infrastructure. The review highlights that cost-sharing requirements may limit access for economically disadvantaged patients.
Coverage and Reimbursement Landscape
In the United States, RPM services are covered by Medicare as communication technology–based services. The article notes that, as of late 2023, 37 state Medicaid programs also reimbursed RPM in some form.
The Centers for Medicare and Medicaid Services (CMS) requires:
- An established clinician-patient relationship
- At least 16 days of physiological data per month
- Use of FDA-approved devices with secure data transmission
Reimbursement includes CPT codes for device setup, monthly monitoring, and clinician time. However, the review emphasizes that variation across payers and states creates uneven access and uncertainty for long-term program planning.
Regulatory Considerations for Quality and Safety
RPM devices and platforms are regulated as medical devices, with oversight based on risk classification. In 2023, the FDA issued updated guidance reinforcing enforcement policies for non-invasive RPM devices beyond the public health emergency.
The article underscores the need for:
- HIPAA-compliant data platforms
- Secure integration of multiple data streams
- Quality management systems for device manufacturers
Regulatory clarity is critical to ensuring patient safety as RPM becomes more deeply embedded in routine care.
Knowledge Gaps and Opportunities
Despite rapid adoption, the review identifies important gaps:
- Limited long-term outcome data for sustained RPM use
- Insufficient evidence on cost-effectiveness across conditions
- Gaps in understanding patient and provider experience
- Ongoing challenges with interoperability and administrative burden
The authors highlight opportunities to use artificial intelligence to reduce clinician workload, improve triage, and manage increasing data volumes, while emphasizing the need for careful implementation.
How DrKumo Aligns with the Evidence
The JMIR review emphasizes that RPM is most effective when it is integrated into clinical workflows, supported by appropriate reimbursement, and designed to account for care team workload and patient equity. These principles align with how DrKumo approaches remote patient monitoring.
DrKumo supports RPM as part of structured care management by providing secure, HIPAA-compliant platforms that enable clinicians to receive, review, and act on patient-generated health data within established workflows. Rather than positioning RPM as a standalone solution, DrKumo focuses on supporting care teams as they integrate remote data into chronic disease management programs consistent with regulatory and reimbursement requirements.
Takeaways
The 2025 JMIR review shows that RPM has moved from a pandemic response tool to a sustained component of chronic disease management in the United States. Its future depends on resolving reimbursement uncertainty, improving workflow integration, addressing equity barriers, and strengthening evidence on long-term outcomes. RPM’s value lies not in devices alone, but in how technology, policy, and clinical practice are aligned to support ongoing care.
To learn how DrKumo supports secure, HIPAA-compliant remote patient monitoring aligned with evidence-based chronic care workflows, contact us today. Our team is ready to support organizations implementing RPM responsibly and sustainably.
Disclaimer: This article is provided for informational and educational purposes only and does not constitute medical, clinical, legal, or policy advice. The information summarized reflects findings from a peer-reviewed publication and may not apply to all patient populations, care models, or regulatory environments. Organizations should consult qualified clinical, compliance, and regulatory professionals before implementing or expanding RPM programs.
