Effectiveness of managing conditions with remote patient monitoring | Viewpoint

Remote patient monitoring has experienced substantial growth in recent years, driven by technological advancements and a growing recognition of its ability to improve outcomes across various health conditions.

More hospitals and health systems are finding encouraging results from remote patient monitoring to track patients with chronic conditions, Arun Chandra writes.

From managing chronic illnesses like diabetes and hypertension to addressing mental health concerns and post-surgery recovery, RPM has proven effective in empowering patients and enhancing clinical decision-making.

Amid this trend, a plethora of literature has surfaced, highlighting the advantages of RPM in managing different medical conditions. This column delves into the rising momentum behind RPM adoption, exploring research findings published in recent months that underscore its transformative impact on patient care.

From cutting hospital readmissions and healthcare costs to boosting patient engagement and treatment adherence, RPM's benefits are increasingly apparent, thus making the care management service more likely to help shape the future of healthcare delivery.

Post-Implementation Outcomes of a Remote Patient Monitoring Program After Emergency Department Discharge

This article, published in Studies in Health Technology and Informatics, focuses on an RPM program introduced for patients discharged from emergency departments across 10 hospitals. Among nearly 110,000 patients offered RPM, 26.4% actively participated. Those who activated RPM were less inclined to return to the emergency department within 90 days compared to non-participants (19.8% vs. 23.6%). Over the subsequent year, patients utilizing RPM faced a 16.2% lower likelihood of returning to the emergency department.

Despite modest participation rates, the study indicates that RPM might help decrease return visits to the emergency department, highlighting the need for further investigation into improving participation rates and validating these results.

Patient Satisfaction With a Multisite, Multiregional Remote Patient Monitoring Program for Acute and Chronic Condition Management

This research, published in the Journal of Medical Internet Research, investigates patients' perceptions and contentment with an RPM initiative. Conducted between Jan. 1, 2021, and Aug. 31, 2022, the survey revealed that a significant majority of participants felt at ease managing their health from home (89.0%) and were pleased with the RPM program (93.6%). Furthermore, most participants showed trust in this care approach and were inclined to recommend RPM to others with similar conditions (92.8%).

The findings highlight RPM's efficacy as a healthcare delivery model, providing patients with a positive experience and high-quality care within the confines of their homes. This underscores the significance of patient engagement in RPM programs for achieving favorable outcomes, reflecting the growing acceptance and acknowledgment of RPM's advantages in enhancing patient care.

Real-World Adherence and Effectiveness of Remote Patient Monitoring Among Medicaid Patients With Diabetes

This study from the Journal of Medical Internet Research examines the role RPM could play in helping manage diabetes among Medicaid patients, considering the high prevalence and costs associated with the condition. It examines real-world data from an RPM program serving Texas Medicaid patients with diabetes to assess adherence to daily RPM protocols, the relationship between adherence and changes in blood glucose levels, and the impact of testing time on these changes.

The findings suggest that RPM may improve diabetes management by increasing adherence rates and enhancing glycemic control. Adherent patients, defined as those transmitting data on at least 120 out of 150 days, experienced a notable decrease in mean blood glucose levels over a 5-month period and improved variability in blood glucose levels. Follow-up phone calls to ensure adherence also proved effective in improving adherence rates, although some patients faced challenges in transmitting data.

Overall, the study highlights the potential of RPM in reducing adverse outcomes associated with diabetes, underscoring its role in improving patient care and overcoming barriers to self-monitoring.

Six Months of Remote Patient Monitoring Is Associated with Blood Pressure Reduction in Hypertensive Patients

This study in Telemedicine and e-Health explores how RPM impacts blood pressure management in hypertensive patients. It addresses concerns regarding the lack of clinical outcomes data and Medicare requirements for monitoring frequency. After six months, there was a notable reduction in average mean arterial pressure (MAP) from 97 to 93, with the most significant decrease observed in patients initially hypertensive. This group experienced a reduction from 106 to 97, achieving normotensive status. Interestingly, the reduction in MAP was evident regardless of the number of days per month patients measured, indicating RPM's effectiveness in blood pressure management regardless of monitoring frequency.

These findings highlight RPM's potential in enhancing chronic disease management and offer valuable insights into its role in improving patient care.

Post-hospitalization remote monitoring for patients with heart failure or chronic obstructive pulmonary disease in an accountable care organization

The final study we will look at, published in BMC Health Services Research, sought to assess how RPM impacted post-hospitalization outcomes among patients dealing with congestive heart failure and chronic obstructive pulmonary disease within an accountable care organization. RPM included tools like vital sign monitoring devices and a tablet equipped with symptom tracking software, overseen by nurses.

Although there were no significant differences observed in the frequency (59% vs. 66%) or timing (median 29 vs. 38 days) of a composite outcome comprising death, hospitalization, or emergency care visits between the RPM and non-RPM groups, the 6-month mortality rate was notably lower among RPM participants (6.4% vs. 17%). After adjustment, the analysis suggested that RPM enrollment might be linked to decreased odds of adverse events (adjusted odds ratio [aOR] 0.68) and reduced 6-month mortality (aOR 0.41).

These results imply that RPM could potentially enhance health outcomes, particularly mortality rates, for certain patient groups.

Remote patient monitoring continues to demonstrate its value

In summary, RPM has become essential in healthcare, especially for chronic condition management like asthma, diabetes, and hypertension. The studies discussed demonstrate the significant advantages of RPM, including better patient outcomes, increased engagement, and lower healthcare use.

From monitoring blood sugar levels to tracking blood pressure and respiratory function, RPM empowers patients to manage their health while providing clinicians with valuable data for informed decisions. With advancing technology and evolving healthcare systems, RPM's widespread use has the potential to revolutionize healthcare delivery, leading to improved patient outcomes and a higher quality of life.

Arun Chandra, MD, is an internist and cardiology fellow at Weill Cornell Medicine and the clinical lead for Prevounce Health.