Remote Patient Monitoring and Your EHR

There are few opportunities that excite healthcare administrators more than the ability to lower costs and reduce utilization of services. Remote patient monitoring (RPM) is a group of technologies that minimizes costs while at the same time improves the care of patients suffering from chronic diseases. In addition, RPM has the ability to improve quality of life by allowing patients to maintain their independence rather than necessitating institutional care. However, remote patient monitoring is no panacea. While process transformation can offer benefits, it also comes with new responsibilities and human resource implications. What do you need to know about RPM and how should you determine whether it is appropriate for your practice?

The Whole Systems Demonstrators (WSD) was a two-year research project funded by the UK National Health Service between 2008 and 2010. The objective of the trial was to collect robust evidence on the effectiveness of telecare and remote monitoring technologies.

Findings were highlighted at the International Congress on Telehealth and Telecare in March 2012 and are presented in the following Prezi. (Click on the arrow to begin)

As with any new process or technology, physicians are naturally cautious with respect to the impacts on their patients. Initially, early adopters will integrate RM technologies into care delivery. As further evidence is collected, these technologies will become standard practice. Remote monitoring is still in its infancy; however, demand will grow as the cost of the technology drops and mobile applications to record data and monitor patients become more commonplace. Consider the following with respect to RM technologies in your practice:

  • Patient Population
    • Do you have the right patient mix who could benefit from RM technologies? An elderly patient population or a high prevalence of congestive heart failure, diabetes mellitus, or renal disease are examples of conditions for whom remote monitoring technologies are available.
  • Type of Practice
    • Do you run a high volume family practice or do you have the resources, time, and staff to explore new ways to deliver care? Without staff who can assist with patient monitoring, do follow up telephone calls, and intervene when necessary, providing a remote monitoring service could have unintended legal implications if the response time and actions do not conform with standards of care.
  • EHR System
    • Does your EHR system provide any interfaces with specific remote monitoring technology? Until the industry standardizes around specific data specifications and display elements, the ability to “plug and play” with any device from a specific class of devices will be limited.
  • Lifestyle Implications
    • Mobile phones, tablets, cloud-based computing, and a variety of anywhere access technologies are making it increasingly more difficult to “disconnect” from one’s work and separate work and family time. Consider carefully any remote monitoring technologies that send alerts directly to personal communication devices. The potential disruption to one’s personal life could be significant.

Remote monitoring technologies are here to stay. Because of the added flexibility they provide to patients with chronic disease and their ability to reduce hospitalization, improve quality of life, and allow patients to stay at home healthier and longer before requiring interventions, RMTs make good economic and clinical sense. However, as with any new treatment or tool, the evidence must be clear and the processes for implementation and use must be well documented.

Have you had any experience implementing or using remote monitoring technologies? Share your thoughts.


3 responses to "Remote Patient Monitoring and Your EHR"
  • April 27, 2012
    Joe Humphry

    Remote monitoring is today available for all patients providing information such as vital signs, sleep patterns, mood and activity level. The ubiquitous monitoring provides opportunity for earlier intervention with improved outcomes. The jury is already in related to quality and cost. The United States is just not adapting our delivery system to improve care. In addition, the EHR is not able to import or manage the data generated by remote monitoring. Telehealth innovative solutions are being developed in other countries with dramatic impact.
    Telemedicine Can Cut Health Care Costs by 90%
    11:42 AM Monday April 23, 2012

    In Hawaii, we provide remote glucose monitoring through a Bluetooth enabled glucose meter for patients with type 2 diabetes. The cost is the same for meter and strips as other meters. The cost to the patient and health plan is not increased. The need for scheduled chronic disease visits is reduced and the provider gets nothing for the monitoring and management services. In addition, these services are not incorporated into meaningful use criteria or coordination of care as part of the patient center medical home. Physicians need to take the successes of the existing experience and work to further improve care, but that does not look likely to happen in the US.

  • May 5, 2012
    Arvind Cavale

    Very well said Joe. It will not happen because of the price-fixed 3rd party payer system, that sees every remote-monitoring opportunity as an opportunity for fraud and overuse. It is only when each individual becomes responsible for his/her care/payment, we cannot expect innovation to succeed.

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