Written by Emily Howard

The healthcare system in the United States is in the midst of a dramatic technological advancement. In the past, mobile technology was just another commodity for telecommunication (and allowing your mom to quiet her worries by 20 phone calls if you’re home late). Now, it has a central role in making professional health services and care accessible to patients in the comfort of their home rather than primarily in a hospital or clinic.

Remote patient monitoring (RPM), or home care telehealth, is a form of healthcare that utilizes mobile devices to check on patients, linking to health monitoring devices. Using the gathered data, doctors can then share a patient’s latest health condition with families, physicians, and other third party health care providers. Though it is still in its infancy stage, experts believe there is endless potential with the mobile technology revolution and thus endless ways to improve and strengthen patient healthcare.

Assisting Our Elders

An unfortunately reality of growing older means that health issues arise which many believed they would never face. This can often mean an abrupt change in lifestyle, having the schedule family time and activities around doctors visits. It’s been found that four out of five older adults in the United States suffer from health challenges stemming from chronic diseases and injuries. RPM technology is an excellent way to combat the frustrations of frequent doctors visits and still keep chronic illnesses under control by utilizing specific devices targets toward their injury or disease. David Lindeman, Ph.D., Director of the Center for Technology and Aging, explains that RPM technologies helps healthcare providers keep an eye on older patients’ daily condition, manage their chronic illness, and provide better recovery care, things which previously always had to be monitored in a series of doctors visits. Consistent monitoring thanks to RPM technology can even help slow the progression of chronic illnesses as changes in symptoms and accidents are reported sooner.

Helpful Devices- In More Ways Than One

A number of basic measurement equipment has been integrated with RPM technologies like scales, blood pressure cuffs, and cardioverter-defibrillators. These devices work by electronically sending results to healthcare providers after use.  So, if a nurse or doctor receives an alert that a diabetic patient’s blood sugar is alarmingly high, he/she can call the patient to discuss the contributing factors and adjust treatment plans as necessary and even intervene immediately if a reading indicates a life-threatening problem. RPM technology can also give confidence back to patients as many chronic illnesses can often leave patients feeling helpless. Learning about the device readings and how their

In the past MicroHealth had the unique opportunity to work on a project with AMC Health, a premier remote patient monitoring company: Medical Device “Plug-and-Play”. On this project, we worked to enhance medical device’s ability to “plug and play” with communication devices (Bluetooth modem) and electronic health records (EHRs). Once data was recorded on an RPM device, it would send it to a Bluetooth modem, encrypt it, and then sent to case management systems and EHRs for health care providers to access later. RPM technology has integrated with many other devices, platforms, and databases to increase the efficiency of using these items.

Top Obstacles Encountered with the Use of RPM Technology

Regardless of how ideal or efficient RPM technology may be in monitoring patients’ health, there are still many obstacles patients and health care providers face with its integration and active patient management. These obstacles can be divided into three groups:

Patient-Associated Obstacles

The most frequent users of RPM technology are from the elderly population and many times results in patient-associated obstacles. In some cases, patients have difficulty learning how to properly operate the devices or they might misinterpret buttons or not place the devices in the right places when trying to obtain measurements.  Other times, older users can be forgetful, unintentionally leaving their devices at home when they go out. One of the most common devices that is left at home is a “personal emergency response system”, or PERS. This is fall detection technology with integrated passive sensors that detect falls by measuring the balance and gait of the patient.

Other patients find their PERS unattractive, embarrassing and uncomfortable to wear, thereby discouraging them from wearing their gadgets in public places. To solve the problem with the gadgets’ unattractive and embarrassing features, Android released an app – the iFall app – that integrates the PERS technology in a normal-looking android phone. iFall is 97.5 percent sensitive and 100 percent specific for falls. Once it detects a potential fall, it notifies its user. If the user does not respond, the system then sends a message to pre-specified contacts to notify them of the fall.

Healthcare Provider Obstacles

With the introduction of Affordable Care Act (ACA), physicians found themselves with more responsibility for their patients’ wellness. From being just mere followers of the pay-per-service model, doctors and nurses fixed interest in their patients’ clinical outcome and RPM devices assist with that responsibility. RPMs became an arm for the ACA’s implementation by keeping patients healthy and out of healthcare facilities. The issue is, with fewer patients visiting the hospital and their doctors’ clinics, healthcare providers face difficulties of reimbursement. Presently, many states do not allow the reimbursement for telehealth services. Though with doctors voicing their concerns about reimbursement, Medicaid is now developing reimbursement models that can ensure the physicians payment for each homecare telehealth service they render.

Manpower Obstacles

Every bit of information captured from RPM gadgets goes into a centralized electronic system for review and analysis. Because RPM data is monitored fairly regularly, many people mistakenly believe they do not need to call 911 in emergency situations since life-threatening data is automatically transmitted. However, there might be fewer medical personnel in offices over weekends and holidays or there are other emergencies to which healthcare providers are attending. Consequently, there is sometimes a delay between data reception and response. Because of this, physicians are now voicing their concern about this efficiency gap as it is preventing some patients from getting emergency care quickly.

A Look Into the Future

As the younger generations age, more and more patients may adapt to the present RPM technology, elevating the prominence of it in healthcare. Because younger generations have grown up during a technology boom with most individuals operating technology regularly, it seems likely that they will be able to keep up the evolution of RPM tech.

While current remote patient monitoring devices use analog phone lines to input data to the central electronic server, it is project that in the future it will all be done wirelessly. This means that this valuable patient data will be transmitted through devices like Bluetooth modems and smartphones, and hopefully increases the speed of data delivery. With the constant improvements being made the existing devices it is possible for remote patient monitoring to be an integral part of healthcare.


Sources:

Center for Technology and Aging Report Examines Remote Patient Monitoring Technology Cost and Quality Benefits for Management of Chronic Disease

Remote monitoring: Out of sight, right in line

Telemedicine Gaining Speed with Physicians Despite Obstacles