By Traci Haynes, MSN, RN, BA, CEN
Mobile technology is growing exponentially. Hardly a day goes by when there isn’t information on a new medical app for mobile devices. Clinicians use them in their practice to increase efficiency in providing patient care and to effectively explain information to their patients. And individuals use them to learn more about their conditions, and then often to monitor their health status. They are also used as a way in which healthcare providers and patients communicate or interact.
The 2016 HIMSS Connected Health Survey reported that more than 50 percent of respondents indicated their hospitals currently use three or more connected health technologies, which positively affect their ability to communicate with patients and to deliver a higher standard of care. The Technology Marketing Corporation (TMC) reports that the global wearable medical devices market valued at $3.7 billion in 2015 is expected to reach $13.5 billion in 2022.
The advancement in technology in electronics and sensors has permitted devices to capture and present data from the number of steps walked to an EKG. Then it transmits that data to the user or healthcare provider by means of remote or wireless communication. TMC reports wearable medical devices are segmented into diagnostic (such as vital signs, sleep, activity, and fetal and obstetric monitors) and therapeutic (which includes pain management, insulin monitoring, respiratory therapy, and rehabilitation devices). Wearables have different sites of application including head strap, wrist, handheld, and shoe sensors.
Remote monitoring programs primarily focus on serious, chronic conditions that can result in repeated hospitalizations. Several studies have been done on pilot programs with discharged patients and their efforts to reduce avoidable readmissions and maintain medical stability. These individuals, based on their diagnosis, were outfitted at home with devices such as a digital scale, blood pressure monitor, EKG recorder, or pulse oximeter, along with a telestation that wirelessly sends measurements taken in the patient’s home to a monitoring center where the information is viewed.
If the patient data is outside the predefined parameters, appropriate interventions can be pplied, such as a medication change, dietary modification, home visit, or physician appointment. Another example is a sensor on an asthma controller inhaler and an emergency inhaler that sends a signal to a cellphone, which then transmits the information to a monitoring center to let them know whether the inhaler is being used as prescribed.
The innovations in technology and remote monitoring continue to expand. BAM Labs developed an FDA-approved sensor mat, to function as a smart bed, that is placed under a mattress to monitor presence, sleep pattern, and heart and breathing rates. The collected data is transmitted to an app viewable on an internet–connected device.
Other examples include eNeighbor developed by Healthsense, which uses sensors placed on the patient and throughout the home to detect falls, wandering, and medication adherence. Independa created a system for monitoring that can include gathering clinical measurements as well as sensors that monitor motion, toilet flushing, and door opening. The data is then reported via an online app.
Some experts say patient monitoring is necessary for hospitals and physicians to evaluate their business. And monitoring programs are tools to help achieve the triple aim: improve access, raise outcomes, and make the healthcare systems more cost effective.
Challenges have included funding, reimbursement, and patient engagement. Some individuals may have to be reminded or persuaded to use the apps, as unfamiliarity with technology can add an additional encumbrance. Other challenges include staffing needs, filtering the important biometric data and integrating it into the EHR, and questions of medical and legal liability.
Is there a return for the health systems that have implemented a remote monitoring program? The answer is “Yes.” An article in Medical Economics written by John Morrissey, published in 2014, indicated improvements in the bottom line over time. Gains were realized from decreased hospital admissions and reduced use of emergency services. Beyond costs savings, the patients benefitted from the assurance they were being monitored, which improved self-management skills, enhanced quality of life, and enjoyed increased satisfaction.
Traci Haynes, MSN, RN, BA, CEN is the director of clinical services at LVM Systems, Inc