Strengthening healthcare delivery with remote patient monitoring in the time of COVID-19
In the last decade, many studies have demonstrated the utility of RPM in improving the outcomes of patients with chronic health conditions.3 For example, patients with hypertension who monitored their blood pressure at home and shared readings with their healthcare provider achieved significantly be...
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| Published in: | BMJ health & care informatics Vol. 28; no. 1; p. e100302 |
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| Main Authors: | , |
| Format: | Journal Article |
| Language: | English |
| Published: |
London
BMJ Publishing Group Ltd
21.07.2021
BMJ Publishing Group LTD BMJ Publishing Group |
| Subjects: | |
| ISSN: | 2632-1009, 2632-1009 |
| Online Access: | Get full text |
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| Summary: | In the last decade, many studies have demonstrated the utility of RPM in improving the outcomes of patients with chronic health conditions.3 For example, patients with hypertension who monitored their blood pressure at home and shared readings with their healthcare provider achieved significantly better blood pressure control.4 Similarly, meta-analyses have found that monitoring blood glucose at home and sending measurements to the provider for clinical feedback yield significant improvements in glycaemic control.5 Further randomised controlled trials have shown RPM reduced mortality and readmissions in patients with heart failure and chronic obstructive pulmonary disease.6–8 In the context of COVID-19, RPM programmes could play an important role in strengthening healthcare delivery. [...]the St Antonius Hospital in the Netherlands developed an RPM programme which employed at-home oxygen saturation, temperature and symptom tracking to monitor patients with severe COVID-19 after hospital discharge, including those receiving oxygen therapy at home.11 The mean reduction in length of hospitalisation was 5.0±3.8 days per patient, and 97% of patients reported the programme was user friendly.11 The Cleveland Clinic and hospitals in the UK’s National Health Service (NHS) have also implemented RPM programmes which use pulse oximeters and structured telephone interviews to monitor patients post-discharge reporting comparable results.12 13 These studies have revealed the effectiveness of RPM in reducing hospital readmissions, increasing patient satisfaction and enabling early discharge in patient populations with COVID-19. Similar RPM initiatives from the Northwestern University and University of Minnesota health systems demonstrated the effectiveness of these technologies in supporting patients who were managing COVID-19 symptoms at home.15 16 Patients reported that the programme provided a sense of safety and a direct pathway for them to rapidly access COVID-19-specific medical care. [...]the costs of the COVID-19 post-discharge RPM programme in the Netherlands’ St Antonius Hospital were approximately fourfold less than the estimated costs of the saved patient-days, and a similar RPM programme at an NHS hospital resulted in a significant reduction of operational costs.11 20 Additionally, while the USA has implemented regulatory changes and Medicare reimbursement frameworks to support the use of telemedicine and RPM in response to the COVID-19 pandemic, this has not been the case in other countries.21 22 Policy and legislation must be developed to regulate the safety, privacy and reimbursement of RPM technologies globally.23 Additionally, further research is required to characterise the implementation and effectiveness of RPM programmes in LMICs and resource-limited settings before deploying RPM in these regions. |
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| Bibliography: | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 14 content type line 23 |
| ISSN: | 2632-1009 2632-1009 |
| DOI: | 10.1136/bmjhci-2020-100302 |