The COVID-19 pandemic has brought into sharp focus the need to harness and leverage digital tools and technology for remote patient monitoring (RPM). With the onset of lockdown, and a sense of unease when visiting conventional clinical settings, we’ve seen a need for more robust disease detection and monitoring of individual and population health, which could be aided by wearable sensors and at-home devices.
Whilst RPM is not a new concept, the pandemic has seen a dramatic rise in the accessibility to remote monitoring, with the market for at-home devices expected to double in size over the next 5 years.
The pandemic has led to huge spikes in digital technology adoption as doctors and patients have complied with social distancing guidelines. In fact, according to the Royal College of General Practitioners, 71% of routine consultations were remote in the four weeks leading up to April 12 2020, compared to the 25% in the same period in 2019. This is a tremendous shift.
COVID-19 has sharpened our minds.
We all understand the need for social distancing, to manage infection rates and ensure healthcare systems are not overwhelmed. Having the technological capability to offer remote consultations, where appropriate, is definitely offering a tangible benefit. However, although adopting a remote monitoring system to complement usual care may improve user satisfaction and potentially have some benefits on outcome, it still presents challenges and requires real-time collaboration between GP practices and a network of other healthcare providers and technologies to ensure the right patients are treated at the right time.
Incorporating RPM into a patient’s chronic disease management may improve patients’ quality of life, by allowing them to maintain independence, prevent complications, and to minimise personal costs. It can be especially helpful for patients who are managing a more complex self-care processes such as post-operative care, home dialysis, diabetes or congestive heart failure. Key features of RPM, such as trend analysis of physiological parameters, enable early data analysis and detection of condition deterioration, which could, in turn reduce hospital visits, duration of hospital stays and, with timely intervention, improve patient outcomes. With patients today becoming more technically savvy and less resistant to innovations like virtual consultations or remote monitoring through wearable devices, they’re open to anything that promises to streamline their experience. Especially, if it gives them greater control over their treatment plans.
RPM allows patients to take more control of their own health whilst reducing footfall to our healthcare facilities, allowing resources to be focused where they are needed most. As demand for healthcare continues to grow, RPM can, when implemented intelligently, play a key role in assisting healthcare staff manage increasing demand without adding pressure to an already strained system.
The need for timely medical communication has never been more important than during this pandemic, where the patient care journey quite often needs to take place outside of the hospital setting. Devices such as blood pressure cuffs, pulse oximeters and glucometers capture both physiological and subjective data which is then evaluated by a healthcare professional or via a clinical decision algorithm for potential problems. Patients, their caregivers and clinician network are then alerted if a problem is detected.
However, physicians have been challenged to reinvent their practices in order to accommodate their patients during the COVID-19 pandemic and swiftly adopt and adapt to video consultations and RPM. Understanding how these systems integrate into daily practice to communicate data efficiently and effectively is essential to optimise the opportunity. Many innovations, such as the National Programme for Information Technology in 2002, initially failed as clinicians were reluctant to engage with them, citing delays, operational challenges and poor cost control as key issues.
For the patient, RPM and at-home devices need to be easy to use, intuitive and accurate if they are to help manage symptoms. As the abundance of health information at our fingertips increases, clinicians raise concerns about over-reliance on self-diagnosis (and in some cases misinterpretation). Adopting RPM to bridge the gap between clinicians and patients during the pandemic and beyond will be instrumental in striking that balance and avoiding mis-diagnosis.
A fundamental role of RPM is to improve the quality of data and information flow so that timely, effective and safe care can be delivered. Data from RPM applications can be uploaded to Electronic Patient Records (EPR), this helps to provide a more complete patient medical history including real-time information. There are many important considerations that digital health technology providers, and at-home diagnostic device makers that capture personal information, need to understand. The regulatory and technical environment they will operate in and protection of patient data is paramount. Will their technology be downloadable hardware, app-based, only accessible via WIFI? Can information collected be anonymised? What is developed in a high-tech company might not work seamlessly in a patient’s home, or even an NHS hospital with older, less powerful infrastructure which could impede digital communication.
The opportunity presented by RPM to enable treatment and care to be less reactive, to empower patients and clinicians to intervene early and prevent unnecessary exacerbations and avoidable hospital admissions, is huge. With a patient-centric, digital-first approach, the wider health economy will gain from a huge influx of data. Data that can be analysed, using machine learning and artificial intelligence, to help us identify those people who are more at risk, from either physical or psycho-social conditions. Furthermore, data can inform clinical research into drug discovery and disease prevention, facilitating faster vaccine development and new treatments, not just for COVID-19, but also for other diseases.
COVID-19 seems to have provided the motivation for both patients and clinicians to embrace new technologies such as RPM, with it likely to be a common feature of routine clinical practice going forward. Demand on our healthcare systems will continue to rise, yet with technology focused on earlier detection and intervention, this can be better managed, preventing more costly treatments and providing the catalyst for lasting, transformative change across the entire healthcare network benefiting us all.
Lisa Lishman is partner and commercial director at Page & Page and Partners