The Evolving Role of Remote Patient Monitoring in Post-Pandemic Hospitals

By Jiang Li, CEO, Vivalink
Twitter: @Viva_LNK

The collective experience of the 2020 pandemic is driving change across multiple aspects of our daily lives, from remote work to distance learning, and telemedicine. As the world begins to gain perspective on the lasting effects of COVID-19, healthcare is one of the sectors poised for significant change.

People have become more and more comfortable using technology to facilitate common interactions. We routinely participate in online meetings; we use our watches to monitor fitness; and we’re growing more comfortable consulting with a doctor through a computer screen. The accelerated increase in telemedicine born during a pandemic foreshadows a broader shift to more options for home health care going forward.

During the first quarter of 2020, the number of telehealth visits increased by 50 percent, compared with the same period in 2019, according to the Centers for Disease Control and Prevention. Sixty-nine percent of patients who had a telehealth encounter during the early pandemic period in 2020 were managed at home.

“Our patients are glad we offer telehealth options because they don’t want to come to the medical centers. This allows them to stay home and stay safe,” says Edward Lee, MD, executive vice president and chief information officer of The Permanente Federation, Kaiser Permanente. “Before [COVID-19], telehealth was a choice and convenience, but now it’s one of the ways patients remain healthy with social distancing.”

The use of remote patient monitoring (RPM) is among the technologies responsible for increased confidence in quality care outside a traditional provider facility. To gauge where RPM stands with healthcare facilities, we surveyed more than one hundred healthcare professionals about their opinions regarding the current technology. Findings revealed significant growth and advancement of RPM technologies throughout the course of the COVID-19 pandemic, positioning it for accelerated growth over the next five years.

The survey reveals that nearly half (43 percent) believe RPM adoption will be on par with in-patient monitoring in five years, and 35 percent believe that it will surpass in-patient monitoring in this time frame. Twenty percent of the respondents noted having already adopted RPM, and another 23 percent plan to adopt within 12 months.

When it comes to remote data collection, 90 percent of the respondents indicated that continuous, 24-hour data is important when compared to episodic data. Respondents ranked the most important physiological parameters to monitor as heart rate at 72 percent; blood pressure at 73 percent; respiratory rate at 61 percent; and temperature at 55 percent.

One of the biggest challenges to adopting RPM technology is cost. The survey found 55 percent of respondents believe that reimbursement is essential to the overall success of RPM. However, the Centers for Medicare and Medicaid Services (CMS) recently announced increased support of at-home hospital care for eligible patients. This expansion of the CMS Hospitals Without Walls program provides reimbursement, creating the necessary incentives for hospitals to incorporate RPM programs.

Hospitals are in business to care for patients, but the bottom line remains that healthcare is a business. If the economics of successful patient engagement includes RPM and telemedicine, then those technologies are more likely to be fully embraced.

RPM isn’t going to replace hospital visits altogether. Rather, the more likely scenario is a hybrid model of care, combining remote and inpatient healthcare. With the right equipment, a viable scenario would be limited to in-person interaction with a doctor while a trained professional provides in-home guidance and patient care. Successful technology augments the care cycle; it doesn’t completely replace personal contact.

There’s no doubt the COVID-19 pandemic was an accelerator to the growth of the RPM market. The majority of the survey respondents (55 percent) answered that they are using or plan to use RPM for COVID-19 patient monitoring. Another reason for adopting the technology is patients’ peace-of-mind. Nearly three-quarters of respondents (72 percent) said that patients are hesitant to visit a hospital or doctor’s office in-person.

Even after the pandemic, some part of that mindset is likely to remain. With Gen X and Baby Boomers more comfortable than ever using digital technologies in their daily lives, and Gen Z having grown up with technology, the shift to remote care is imminent. But, patients have to be receptive or it won’t matter how economically viable telehealth and RPM are for hospitals. The technology has to be simple and accessible, and the devices have to be small and comfortable.

That increased level of convenience could lead to better overall interactions between patients and providers. If consulting with a doctor is as simple as a click-away, generations of patients are more likely to interact with caregivers. In turn, that can lead to better care for chronic and acute conditions and better health overall.

According to Forbes, “A growing body of evidence shows that for some conditions, high-level care provided in the home can result in better patient outcomes at a lower cost.” For acute care, continuous patient data collection can be critical because symptoms may not be persistent or obvious. A cardiac patient benefits from continuous monitoring to ensure providers catch any changes before it becomes an issue. Healthcare professionals can continue to monitor postoperative patients days after being discharged to the home.

The Annals of Internal Medicine journal published a randomized controlled trial of hospital-level care at home for acutely ill adults, providing more evidence that the approach can work. According to the study, home hospitalization reduced costs, healthcare use and readmissions, while increasing physical activity compared with typical hospital care.

Providers can easily supervise chronic conditions such as hypertension using RPM to conduct periodic spot checks without the need for in-person visits. Telehealth and RPM don’t lead to impersonal healthcare; it’s just another way for providers to interact and stay connected with patients.

As the healthcare landscape evolves to meet the changing needs of both patients and providers, RPM and telehealth will need to adapt and improve. Proactively addressing these challenges is critical to providing the best and most cost-effective solutions.