Remote Patient Monitoring
What Is Remote Patient Monitoring?
If you have a symptom or a complaint and you go to see your doctor, they will check you in their office. They will ask you about your symptoms, they will examine you, and they will check your vital signs. They may also order lab tests or X-rays. All of these checks are one-time checks valid only at the time and place where they are performed. In other words, if your pulse is 75 beats per minute and your blood pressure is 135/85 when your doctor checks you at their office, that only tells you your pulse and blood pressure at that one particular point in time. If the doctor feels that your are really sick and that you need to continue to have your vital signs monitored while undergoing further tests or treatments, they may admit you to the hospital where you will have your vital signs monitored by the nursing staff continuously or as needed. And once you are ready to be discharged from the hospital, the doctor must first convince themself that it has become safe to stop monitoring your vital signs – that you can move to a situation where nobody will be keeping track of your oxygen saturation levels, your blood pressure, or your pulse rate. The concept of remote patient monitoring is a way for your doctor to continue monitoring your vital signs even when you are not in the hospital or in their office.
Modern technology has allowed for a variety of remote patient monitoring devices to be manufactured, including the CardiacSense Medical Watch, which can monitor various vital signs and transmit them to monitoring centers as well as to your personal physician. In this way you and your doctor are afforded peace mind, knowing that you are not completely “off the grid” once you leave their office or after you leave the hospital. For many diseases with long recovery times, this can be a real blessing.
How Is Remote Patient Monitoring Used?
The most common way remote patient monitoring is used is as described above – to extend the time that your doctor is able to track your vital signs after you leave the office or hospital. In a related scenario, the capability of remote patient monitoring may actually allow a person to be discharged earlier than they otherwise might, since the doctor doesn’t have to wait until they are absolutely convinced that there is no longer any need for monitoring. But there are other ways that remote patient monitoring may be used as well.
Chronic Disease Monitoring
Many patients have chronic diseases which they live with most of their lives. These diseases may be managed and minimized but are never totally cured. These are diseases such as asthma, chronic obstructive pulmonary disease (COPD), congestive heart failure (CHF), sleep apnea, and more. With these diseases, if the treatment is successful and the patient continues taking their treatments, most of the time the patient remains healthy. However, occasionally the patient can suffer an exacerbation of their disease. This can occur due to a missed medication dose, or to an environmental trigger, or just due to bad luck. But whatever the case, these exacerbations can be serious and often result in the patient being admitted to the hospital again. Normally, patients with these diseases live at home in an unmonitored environment and either report any symptoms they have to their doctors or try to make an appointment to see their doctor when they feel their symptoms getting worse. But sometimes, despite our best intentions, the patient doesn’t become aware of their symptoms until its too late and they have to be admitted to the hospital. Sometimes, the patient tries to schedule an appointment with their doctor but the doctor’s schedule is full and they can’t been seen for several weeks, leading them again to wait until it’s too late and they are hospitalized. Or, they may be forced to seek care earlier in the emergency room. If patients’ with these long term diseases could be monitored remotely – with a remote patient monitoring system – then it might be possible to catch an exacerbation before it leads to a hospital admission. For example, If the respiratory rate or oxygen saturation level could be monitored remotely, then the doctor would notice the dropping oxygen level or the increasing respiratory rate even before the patient felt like anything was wrong. The doctor could then intervene and correct the situation hopefully before it became so bad that the patient had to be hospitalized.
Some people have symptoms which only occur once in a while. They may suffer from heart palpitations that only occur once or twice a month – and of course never happen when they are actually being checked by their doctor. In that case, the doctor would rely on remote patient monitoring devices that continuously monitors the patient and for a long period of time in order to make the diagnosis. The device must be comfortable, easy to use and good-looking since the patient will always use it. By giving the person a remote monitoring device, they could monitor the patient’s heart rhythm even while the patient goes on living their regular life at home. And if the palpitations return, even several weeks or months into the future, the remote monitoring device will be able to detect the problem when it recurs.
Remote patient monitoring may also be used to complement tele-health visits. Especially during the COVID-19 pandemic, tele-health visits have become increasingly popular as a way for people to stay in touch with their doctors without having to expose themselves to infectious risk by coming in person to the doctor’s office. However, one of the problems with tele visits is that although one is able to converse with their doctor and ask questions, the doctor has no way to actually check your vitals. One can purchase a home blood pressure machine and perhaps a home finger clip oxygen saturation monitor, which would allow for basic vitals to be taken. But with a remote monitoring device, the same vitals and even more would be available to your doctor not only at the time of your tele-health visit, but also the rest of the time as well.
Finally, for some diseases it is necessary to titrate the treatment to the appropriate affect. For example, when treating hypertension your doctor may start with a single medication at a low dose and gradually increase the dose or gradually add additional medications until your blood pressure is well controlled. This usually is done by making a single dose change and then seeing the patient back in the office in a few weeks to recheck the blood pressure.
Imagine how much easier this would be if you had a remote patient monitoring device – your doctor could simply check the remote results and change the medication dose as needed, all without the need for multiple office visits. Similarly, if a doctor starts home oxygen therapy on a patient with COPD, the doctor could rely on the remote patient monitoring device to give them the patient’s oxygen saturation rather than requiring the patient to return to the office just to have their O2 level checked.
Is Remote Patient Monitoring Expensive
There are many devices today which can be used for remote patient monitoring and they range in price. However, because these devices are usually prescribed by your physician, they are most often covered by insurance. And because such devices have the benefit if used properly of actually decreasing overall healthcare spending by keeping people out of the hospital, there is a monetary incentive for insurance plans and even national programs such as Medicare to cover their use.