In a recent Medical Economics opinion piece, Samant Virk, MD, writes that properly navigating remote patient monitoring is “a great responsibility.” We certainly agree, and, prior to its use in medical practices and healthcare facilities, we encourage all insureds to implement protocols specific to remote patient monitoring. These preparations, as well as the training and awareness-building that go along with them, can help you and your patients benefit from the technology while preserving patient safety and reducing risk.
What is remote patient monitoring (RPM)?
According to the American Medical Association (AMA), remote patient monitoring is one service in a “broad array” of services under the telemedicine/telehealth umbrella. Specifically, AMA defines remote patient monitoring as use of wearable devices and mHealth apps to collect and transmit patient data “outside of the office, mostly asynchronous, which results in clinical decision making and care management follow up.” RPM tools often provide data related to “weight, blood pressure, pulse oximetry, respiratory flow rate, musculoskeletal system status, therapy adherence, therapy response and other patient generated data for review and treatment management.” Insider Intelligence estimates that 30 million patients in the U.S. will use digital health monitoring devices by 2024.
What are some of the benefits of remote patient monitoring?
RPM complements existing aspects of quality patient care through enhancements in key areas, such as:
- continuity of care;
- management of chronic conditions;
- consultation and connection during high-risk periods; and
- better data to inform care team decisions.
Lucienne Ide, MD, who founded an RPM company, tells Healthcare IT News here that although funding and reimbursements are currently lagging for RPM, the technology facilitates the shift “from an in-clinic, episodic, reactive model of care to one that is continuous and proactive, a blend of in-clinic and remote. RPM is an effective way to ensure all patients are able to receive the quality, continuous care their condition requires.”
UCLA Health, as reported in HealthTech Magazine, found this continuous care approach particularly helpful post-discharge, using remote technology to monitor vital signs “more closely” for 7-10 days after patients left the hospital. Others are also finding success using RPM to reduce readmissions, including the University of Pittsburgh Medical Center (which reduced readmission risk by 76%, according to Insider Intelligence) and UCLA (which saw readmissions rates among cardiac patients decline from 15% to 10%, reports HealthTech Magazine).
Challenges associated with remote patient monitoring
To successfully implement RPM and benefit from its addition to the patient care protocol, medical practices and healthcare facilities must avoid some of its pitfalls and risks. Dr. Virk outlines some of these in Medical Economics, including:
- data silos,
- workflow challenges,
- poor communication,
- ineffective use of provider time,
- poor integration and
- failure to measure outcomes.
For RPM to reach its full potential, he recommends storing the data in one place centered around the patient (regardless of which device or provider collects it) and using the data to be proactive instead of reactive.
Reducing risk when implementing remote patient monitoring
Just because RPM technology has capacity to collect the data doesn’t mean your practice automatically has the capacity to use it safely and effectively. Many of the challenges related to RPM, including those highlighted by Dr. Virk, have the potential to result in patient safety threats and liability risks.
As a result, practices and facilities must be cautious when integrating RPM into their care models, including creating strict protocols and workflows. In addition, experts recommend:
- starting small, i.e. using it for “very focused use cases” (HealthTech Magazine);
- relying on “human healthcare workers … to interpret and act on the results” (HealthTech Magazine); and
- using a “centralized team” to “support primary care teams in managing RPM” (Healthcare IT News).
For additional guidance on RPM implementation, including general considerations related to cybersecurity and patient confidentiality, we recommend consulting the following resources:
- AMA’s Remote Patient Monitoring Implementation Playbook,
- MLMIC’s Risk Management Tip on Utilizing Telehealth in Your Practice,
- MLMIC’s Risk Management Checklists on technology in healthcare, specifically, the checklist on security of patient information and health IT; and
- MLMIC Insider posts on cybersecurity risks, like this one on vulnerabilities of specific medical devices.