Does remote patient monitoring work?

Remote patient monitoring is not a novel concept, in fact, the term was first coined in the late nineteenth century. It is however recent technological innovations that have accelerated a wider variety of applications.

We have recently written an extensive article covering the basic principles of remote patient monitoring. In this post we’ll highlight evidence-based merits of remote patient monitoring.

The latest research suggests that Remote Patient Monitoring has a beneficial effect on patients (adherence, symptom distress, quality of life and satisfaction), providers (willingness to comply, clinical decision making, symptom management) and care systems (referrals, patient-provider communication, hospital visits.)

The literature is rich with evidence that supports remote patient monitoring as a highly effective strategy for improving several aspects of the end-to-end patient journey. Indeed, telemonitoring has been applied effectively in patients who have diverse and heterogeneous diseases such as congestive cardiac failure (1), chronic obstructive pulmonary disease (COPD) (2), asthma (3), diabetes mellitus (4), high-risk pregnancies (5) and chronic kidney disease (CKD) (6) amongst others.

Chief amongst the benefits of telemonitoring is that of long-term costs savings; the evidence suggests that the cost savings of telehealth strategies are most sensitive to patient risk. In other words, remote patient monitoring is more cost-effective in higher risk patients (7). Another benefit of telemonitoring is that of increased patient engagement and higher patient satisfaction. One recently published systematic review which analysed 44 studies on telehealth found that patient satisfaction is associated with the telehealth and that patients’ expectations are met when healthcare providers deliver healthcare via videoconferencing or any other telehealth method (8). Another systematic overview which evaluated 80 systematic reviews found that telemonitoring could reduce hospitalisations in the short-term (<12 months), improve clinical effectiveness in patients with chronic co-morbidities and reduce the risk of hospitalisation and mortality amongst high-risk patients (9).

Remecare is one such remote patient monitoring health application which seeks to guide cancer patients with their medication intake and monitor them for the development of adverse effects during chemotherapy. Remecare integrates a patient-physician communication channel for seamless correspondence and sends patients timely reminders for medication intake. Remecare also has a smart-notification system which prompts healthcare providers to the development of adverse effects in their patients.

Remote patient monitoring applications like Remecare enable healthcare institutions to transition from an outdated and archaic reactive healthcare system to a monitoring-focused proactive one. The increased frequency at which healthcare providers can access patient data with ease enables for a greater time-to-event analysis. In other words, healthcare providers can track their patients’ physiological data and reported symptoms and intervene earlier, thereby mitigating the severity of the adverse event. For example, a patient who develops a rash after taking a medication and reports it via Remecare could be advised to seek emergency care in view of a possible allergic reaction. Conversely, had the patient not reported the rash, they could have well progressed into anaphylaxis which could be fatal.

References

1. Leng Chow W, Aung CYK, Tong SC, et al. Effectiveness of telemonitoring-enhanced support over structured telephone support in reducing heart failure-related healthcare utilization in a multi-ethnic Asian setting. J Telemed Telecare. 2020;26(6):332-340.
2. Kruse C, Pesek B, Anderson M, Brennan K, Comfort H. Telemonitoring to Manage Chronic Obstructive Pulmonary Disease: Systematic Literature Review. JMIR medical informatics. 2019;7(1):e11496.
3. Nemanic T, Sarc I, Skrgat S, Flezar M, Cukjati I, Marc Malovrh M. Telemonitoring in asthma control: a randomized controlled trial. The Journal of asthma : official journal of the Association for the Care of Asthma. 2019;56(7):782-790.
4. Home telemonitoring for type 2 diabetes: an evidence-based analysis. Ont Health Technol Assess Ser. 2009;9(24):1-38.
5. Lanssens D, Vandenberk T, Thijs I, Grieten L, Gyselaers W. Effectiveness of Telemonitoring in Obstetrics: Scoping Review. Journal of medical Internet research. 2017;19:e327.
6. Martínez García MA, Fernández Rosales MS, López Domínguez E, Hernández Velázquez Y, Domínguez Isidro S. Telemonitoring system for patients with chronic kidney disease undergoing peritoneal dialysis: Usability assessment based on a case study. PLoS One. 2018;13(11):e0206600.
7. Liu SX, Xiang R, Lagor C, Liu N, Sullivan K. Economic Modeling of Heart Failure Telehealth Programs: When Do They Become Cost Saving? International journal of telemedicine and applications. 2016;2016:3289628.
8. Kruse C, Krowski N, Rodriguez B, Tran L, Vela J, Brooks M. Telehealth and patient satisfaction: A systematic review and narrative analysis. BMJ Open. 2017;7:e016242.
9. McLean S, Sheikh A, Cresswell K, et al. The impact of telehealthcare on the quality and safety of care: a systematic overview. PLoS One. 2013;8(8):e71238.