What are the trends and challenges in Remote Patient Monitoring today?
For remote patient monitoring to work efficiently, the doctor and patient must work together at an initial stage. At first few visits to the clinic; the doctor examines the patient and decides the frequency and type of health parameters that needs to be watched continuously. In the management of diabetes and heart disease, a patient needs to regularly track vitals such as blood pressure, blood sugar, weight, and need to adhere to the given medication schedule. Of course, all of these using digital devices! The data is then saved into a unique application (App) manually or automatically using Bluetooth connection on the digital devices. Most Apps for remote patient monitoring prefer using cloud-connected devices to take reading for vital parameters from which the data can be transferred automatically to the App. A doctor can log in to the App and track daily reading and progress from the patient.
What are the benefits of Remote Patient Monitoring?
Remote patient monitoring can provide several benefits, mainly related to the management of chronic illnesses such as diabetes and heart disease. A patient can get treated from a specialist of choice without having to travel. The most remarkable benefit of remote patient monitoring is that a doctor can co-relate change in any parameter to day-to-day activity. For instance, if the doctor notices a rise in blood sugar, he can immediately check if the glucose lowering medications were missed. Some Apps used for patient monitoring also allow the patient to track their diet and activity. This further helps the doctor to relate the changes in blood sugar and other health parameters.
Remote patient monitoring helps by way of efficient treatment, real-time data monitoring, prevention of emergency episodes or complications. It is certainly time saving and provides education, feedback, and data transmission, besides facilitates communication between patient and doctor.
Is there any evidence for the efficacy of Remote Patient Monitoring?
Researches have studied the effectiveness of Telemonitoring or Remote Patient Monitoring in patients with various health conditions such as heart problems, cancer, lung diseases, kidney diseases and diabetes. Studies that observed hypertensive patients reported that home BP telemonitoring showed better BP control compared with usual care.Another study reported that Telemonitoring could reduce the emergency department visits in people with heart failure as their vitals and clinical alerts are watched over by medical staff remotely.
Clinical evidence reports that Remote Patient Monitoring in people with diabetes can help to achieve better glycaemic control. A study that compared home telemonitoring and standard care with monthly co-ordination call revealed that in just three months, telemonitoring showed a 1.7% decrease in the A1c value, whereas standard care showed only. 0.7% decrease.
How does Remote Patient Monitoring help in tackling Diabetes?
A recently published randomized controlled trial explored the use of Telehealth in the management of patients with Type 2 Diabetes. Study participants were comprised of low-income adults living in rural communities with poorly controlled Type 2 Diabetes. Subjects were randomly divided into a control group and an intervention group. The control group received usual care for Type 2 Diabetes, while the intervention group received a combination of telehealth with nurse case management. Study participants were asked to take daily blood glucose and blood pressure readings using a telehealth system for diabetes. The telehealth system allowed the nurse case manager to virtually monitor the patients in real time and adjust medication dosage when necessary, under the supervision of a physician.
These results suggest that the combined approach of telehealth and nurse case management is more beneficial than usual care for patients with Type 2 Diabetes. Additionally, these results demonstrate that remote monitoring through telehealth is a safe and viable care delivery option for patients living in rural communities. The authors of this RCT attribute much of the success of the intervention group to improved patient adherence. Adherence to prescribed therapy and lifestyle modifications are necessary components of the management of type 2 diabetes. It was concluded that remote patient monitoring through telehealth improved patient adherence in a variety of ways:
- The telehealth system allowed patients to easily report daily blood glucose readings.
- The nurse could quickly respond to a patient’s status and titrate medications when necessary.
- Telehealth facilitated regular communication between the patients and the nurse case manager.
The findings from this study are consistent with mounting evidence supporting the case for managing diabetes with remote monitoring / telehealth platforms
How has COVID-19 impacted the market?
Remote patient monitoring (RPM) platforms and devices were sparsely used by health care providers. However, as the whole world is currently adjusting to the ‘new normal’, many health care organizations are starting to realize the benefits of RPM technology. The Indian Telemedicine market is expected to grow at a 20 per cent CAGR to reach USD 32 Mn by 2020 in the aftermath of to the COVID-19 pandemic. Among the various telehealth solutions, RPM has gained the most traction as it can be used to monitor less critical COVID-19 patients as well as the elderly who are more vulnerable to the virus.
Ultimately, how are we bracing for a change in better healthcare delivery ?
Several studies report a substantial shortage of doctors and specialists who can engage in real patient care. This condition is expected to develop in the coming years in various countries, including India.Remote patient monitoring, therefore, seems like a promising tool in the management of chronic lifestyle illnesses such as heart disease, diabetes, stroke and others. However, for the remote patient monitoring plan to work efficiently, the patient needs to be determined and involved in managing his/her own healthcare condition. Regular monitoring and keeping the App up-to-date with data can help the doctor to track progress and take actions when needed. This technology demands the patients to use digital devices to self-monitor and record important parameters and then actively partner in collaboration with health care providers to manage their condition.
Remote Patient Monitoring through telehealth has great potential to change the way diabetes is managed by improving efficiency of care and enhancing quality of treatment for all patients who suffer from this condition. Providers who embrace new health technology will be able to increase access to care in underserved communities and contribute to reduced healthcare costs associated with diabetes management.