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The Past, Present and Future of Remote Patient Monitoring

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The pandemic has laid bare many of the shortcomings of our current health system, but it also has accelerated RPM, which could transform how we practice medicine and manage patient care.

In the future, the evolution and adoption of remote patient monitoring (RPM) will be divided into pre- and post-COVID-19 periods. The pandemic has been that impactful on this aspect of telehealth.

That was the takeaway of a recent webinar Vivify Health hosted that brought together some of the leading experts on the topic. It was moderated by Kristi Henderson, DNP, NP-C, FAAN, FAEN, senior vice president of telehealth & innovation at Optum, and featured:

  • Andrew R. Watson, MD, FACS, vice president of clinical IT transformation, University of Pittsburgh Medical Center International Division and past president of the American Telemedicine Association
  • Christopher Northam, vice president of telehealth, HCA Healthcare
  • Joseph C. Kvedar, MD, professor of dermatology at Harvard Medical School, president of the American Telemedicine Association and author of several books on telehealth

To view the webinar, click here.

The pandemic has laid bare many of the shortcomings of our current health system, but it also has accelerated RPM, which could transform how we practice medicine and manage patient care.

“Remote monitoring has enormous potential to really dominate the field of telemedicine and provide longitudinal interactions for primary care, specialty care, post-acute care and the like,” Dr. Watson said.

To understand how this is happening it’s useful to examine the relatively brief history of telehealth.

Pre-COVID 19

Telemedicine began emerging around 2000 with such breakthroughs as rural clinics sending test results to radiologists in big-city hospitals. Synchronous RPM followed in 2015 with videoconferencing between patients and clinicians and remote examinations.

In 2018, asynchronous telehealth moved to the fore. While early telehealth involved one-on-one, real-time interactions such as video conferences between providers and patients, asynchronous telehealth is the electronic transmission of patient-generated data to a provider who uses the information to evaluate the case or render a service outside of real-time or live interaction. Editor’s note: An early adopter of telehealth, the U.S. Dept. of Veterans Affairs launched the VA Home Telehealth remote monitoring program as early as 2003.  Vivify launched its mobile, cloud-based platform for holistic remote care management in 2009.

RPM accelerated rapidly along with technical advances in software and consumer electronics. Patients embraced the capabilities of their tablets, computers and smartphones and became increasingly comfortable with bring your own device (BYOD) interactions with healthcare providers.

Watson compared RPM to an air traffic management system with controllers intervening only when a plane veers off course or shows other signs of trouble. It’s scalable, commoditized and saves providers an enormous amount of time.

“The stage was being set for RPM to really move forward. Who would have thought it would take a pandemic to do it, but that’s really what happened so RPM was ready and fully prepared for this pandemic when it came,” Dr. Watson said. 

RPM and COVID: A Case Study

HCA Healthcare had been working for years with Vivify Health on RPM when it saw the pandemic coming in mid-February. That partnership allowed HCA to pivot quickly to implement remote screening and monitoring of COVID-19 patients and employees using a BYOD approach, Northam said.

HCA adopted Vivify’s Pathway +Go platform and a joint HCA-Vivify team had the system operational for employees and patients by the beginning of April. 

HCA invited more than 53,000 of its employees to join the +Go platform and 81% did so. Of the 21,000 patients invited, 25% joined. Participation among both groups was higher than expected, Northam said.

Over the course of the year, HCA added capabilities and functions to its platform. It now includes such program differentiators as defined clinical protocols, integration with EMRs, centralized clinical monitoring, daily reporting and internal audit and change management processes, Northam said.

HCA uses the system to monitor the health of its patients and employees and determine which ones need additional care and intervention. 

“All in all, this has been a tremendous solution,” Northam said. “We’re very grateful to our Vivify partners.”

Post-COVID-19

The growth of RPM will continue after the pandemic ends, Dr. Kvedar predicted. Its benefits are too many and the need for it is too great, particularly due to the shortage of clinicians.

“If we only do things face to face with our patients, whether it be on video or in the office, we are running out of clinicians to meet the demand for services,” he said.

Healthcare systems will take the lessons they learned about RPM during the pandemic and adjust their systems to use it in an ever-expanding range of care, from management of chronic and unplanned disease to preventing readmissions and providing post-acute care.

Accomplishing that will require seamless integration of providers and vendors, data management, hardware and the centralized operation team responsible for making sure the system works to the benefit of all.

“We brought the doctor’s office into your home and we need to revel in that success, but we need to think differently about how we use the technology in the next phase of this exciting development,” Dr. Kvedar said. “The puzzle pieces are starting to come together.”

Widespread adoption of RPM opens the door to other advancements, such as digital therapeutics and employers incentivizing monitored healthy behavior with financial rewards.

“There is plenty of innovation left to do,” Dr. Kvedar added.

The goal, he said, is a fully integrated digital experience, one that nearly eliminates emails, phone calls and messages as means of communication between patients and providers. In the near future, patients should think of their digital devices as the first and primary means of communicating with their clinicians.

Vivify Health looks forward to making that goal a reality and using RPM to improve healthcare for patients and providers.

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Vivify Health is transforming healthcare with the market’s most comprehensive patient-centered connected care platform, spanning from remote monitoring of high-risk patients and patient activation to population and employee health. Vivify’s platform is the digital pathway to collaborative care on demand — with a focus on ease of use for employees, members, patients and providers.

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