Life as a Healthcare CIO: Remote Patient Monitoring and Self-Responsibility

At HIMSS next week, I’ll be doing 5 presentations about the future of healthcare IT, focusing on patient directed data exchange, internet of things, and telemedicine. Remote patient monitoring, which combines all three, will be increasingly important.

Remote patient monitoring can take numerous forms, and the evidence supporting these tools is mixed. Here’s another excerpt from our new book—The Transformative Power of Mobile Medicine—co-authored by Paul Cerrato that dives into the issues. For those interested in reading the entire book, the publisher is offering a deep discount until March 31, 2019; coupon code: HIMSS2019.

Many thought leaders are convinced that remote patient monitoring improves patient care, but surveys suggest that health-care professionals are still not convinced. An analysis from the New England Journal of Medicine Catalyst Insights Council asked respondents to rate various patient engagement initiatives. “Remotely monitoring using wireless devices/wearable” was listed as the least effective way to engage patients while having physicians, nurses, or other clinicians spend more time with patients was listed as the most effective tactic. [1] There is also uncertainty about the benefits of remote patient monitoring in the scientific literature. Of course, remote patient monitoring can take so many different forms that it’s impossible to make a blanket statement about its effectiveness. But a randomized controlled trial (RCT) that included more than 1400 patients (median age 73 years) who had been hospitalized for heart failure generated less than encouraging results. Michael Ong, MD, from the University of California, Los Angeles, and his colleagues divided the group into an intervention arm, which received health coaching phone calls along with the collection of vital signs that included blood pressure, heart rates, symptoms, and weight with the help of electronic devices, and a control arm that received the usual care [2]. Ong et al. couldn’t find any significant difference in hospital readmission rates 180 days after discharge for any cause: 50.8% were readmitted despite having all the extra attention and access to all the high-tech monitoring devices versus 49.2% in the usual care arm. Similarly, the investigators detected no difference in 30-day readmission or 180-day mortality. The experimental group did, however, report better quality of life at 180 days.