Remote patient monitoring is gaining momentum as healthcare providers strive to deliver more services on tighter budgets.
With the population aging and facing greater health issues, the pressure on healthcare services is rising and will continue to do so. Providers are grappling with lower reimbursements and a significant trend toward payments for value rather than volume.
To cope with these challenges, the industry is embracing new healthcare delivery models that emphasize more outpatient and at-home services. To enable these new models, providers are increasingly embracing remote patient monitoring. Traditionally, RPM has meant taking existing medical monitoring devices and putting them into the home. A finger pulse oximeter. A scale. All requiring manual entry by the patient or even wired into some kind of central hub before being transmitted through a phone line.
This presents numerous operational and patient experience challenges, but is also of questionable clinical utility. Numerous studies have found that spot measurements, once or twice a day, are of limited clinical efficacy and adherence is poor.
By moving to wearable devices for passive RPM, the amount of clinical data captured massively increases. By then taking that day, applying machine learning and generating actionable insights that enable earlier healthcare to be delivered, a truly valuable RPM model can be delivered. The government has recognized the potential: The Centers for Medicare & Medicaid Services (CMS) recently approved incentives to healthcare providers using RPM and other telehealth systems.
RPM-enabled models allow patients to be treated in hospitals for a shorter period of time and discharged to continue their recovery at home — the care is still managed and readmission less likely. Without RPM, that transitional stage can be a vulnerable one for many people. Patients often have little or no medical support once they’re home on their own and don’t always know when to call a doctor. Connected devices take that burden off the patient. These wearables continuously communicate vital data to healthcare staff, enabling them to detect and address problems as soon as they arise.
It’s also important to recognize that health systems manage patients with a wide range of pathologies, each with a different suite of vital signs and metrics. Until now, we’ve often expected the patient to manage many different devices and self-report but ubiquitous use of Bluetooth Low Energy and near field communication technologies allow a single device to act as an on-body hub, integrating with a range of devices around the patient, such as for spirometry or for glucose.
Armed with this information, doctors can get an early warning of potential problems and provide earlier attention and care to patients in a remote setting. The ability to intervene quickly addresses a huge problem: costly hospital readmissions. If patients don’t report problems and get prompt treatment, they can wind up back in the hospital.
Currently, hospital readmissions within 30 days of discharge are associated with more than $40 billion a year in healthcare costs. Besides placing a burden on the system, this imposes a financial and emotional strain on patients and their families and often leads to poor patient outcomes. Government and healthcare providers alike have made it a top priority to reduce readmissions, imposing financial penalties on hospitals with higher-than-average readmission rates.
RPM can help in this effort, and it’s poised to take off thanks to advances on a number of fronts.
The populations most in need of an effective alternative healthcare service often lie in rural, underserved communities. Internet access and Wi-Fi penetration is low, but with the spread of 4G and the impending rollout of 5G, connectivity is a far lower barrier than it historically was.
Next, the availability of low-cost, high-volume cloud storage and computational resource has significantly increased thanks to companies like Amazon and Microsoft. This allows machine learning to be used at scale to generate early warnings. Presenting large volumes of data to healthcare staff is not valuable, presenting salient data that allows earlier action is.
Lastly, the shifts of payers to begin reimbursing for RPM, largely driven by CMS, will likely lead to an explosion in implementations as healthcare providers and home health agencies vie to deliver the best and most competitive healthcare in their local markets.
Though RPM relies heavily on technology, it doesn’t cut out the human element. Far from it. With this real-time, accurate data on patient health, care managers can prioritize patients and their needs. Apps allow patients to report symptoms, receive medication reminders, review educational material and even visit with their doctor via video. Studies have shown that this approach has a positive impact, empowering patients and leading to better outcomes.
RPM is already moving to the forefront of the industry, and given current and projected future trends, it clearly has significant upside potential for the coming years.
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