Examples of Remote Patient Monitoring Applications

When we consider the ease with which remote patient monitoring can be delivered using technology, it’s easy to see how RPM has the potential to transform the delivery of care in the United States. 

To further examine the potential impact of RPM on patient care, we’ve identified nine of the top patient applications for remote patient monitoring, broken down by three of the specialties most frequently offering and prescribing RPM to their patients: cardiology, pulmonology, and endocrinology. 

Cardiology Remote Patient Monitoring 

Within cardiology, there are four noteworthy examples of remote patient monitoring. 

1. Hypertension management — Patients with hypertension are usually relatively or completely asymptomatic, so the only way to accurately identify whether many patients are experiencing high blood pressure is to measure the blood pressure using a monitor. All patients typically need to do is place a cuff on their arm and start the accompanying monitoring device that measures and transmits blood pressure data. 
   
   Thanks to this simple activity performed on an ongoing basis, cardiologists receive the information they need to advise patients about worthwhile changes in their life in areas including medications, diet, exercise, smoking, drinking alcohol, and consuming caffeine.  
2. Medication management and titration — For patients with high blood pressure, treatment is typically ongoing and involves one or more medications. There are more than 10 classes of blood pressure medications. Since blood pressure medication regimens usually undergo frequent and occasionally substantial changes, a remote monitoring device is the best option to deliver practitioners the timely and accurate data they need to recommend appropriate and safe adjustments.
3. Weight measurement for congestive heart failure — It has been shown that patients can gain 10 pounds of “extra” fluid weight before showing any symptoms of congestive heart failure (CHF). Besides increased weight, such as feeling unwell or experiencing swelling, fluid retention — which can occur in the lungs, kidneys, abdomen, legs, and feet — is a common symptom of heart failure. But such weight gain and subsequent fluid retention can easily be missed if not regularly monitored. 
   
   With daily remote weight monitoring performed using a connected/smart scale, cardiologists receive alerts when cardiac decompensation occurs, permitting fast action that will help improve the patient's condition and decrease the need for hospitalization or urgent care. Daily weight monitoring is considered essential for effective CHF management, with the American Heart Association noting that weight gain is often the first indication of worsening heart failure.  
4. Weight measurement for obesity — Health problems linked to being overweight and obesity include high blood pressure and heart disease as well as type 2 diabetes, strokes, and some forms of cancer. “An increase in body fat can directly contribute to heart disease through atrial enlargement, ventricular enlargement, and atherosclerosis,” states Dr. Harold Bays in a Cardiology Magazine article. 
   
   The good news is that obesity is treatable and reversible, and doing so can deliver a wide range of health benefits that include decreasing serious health risks, reducing cholesterol levels, and addressing sleep apnea. With ongoing, remote monitoring of a patient's obesity, cardiologists can provide better and more targeted advice for changes that can help stabilize or decrease weight. 

Pulmonology Remote Patient Monitoring 

There are three examples of remote patient monitoring frequently offered by pulmonologists and a third example encompassing multiple conditions. 

1. COPD management — Chronic obstructive pulmonary disease (COPD) may be incurable, but it is manageable and treatable. To do so, pulmonologists work with patients to develop a plan that combines medications, oxygen therapy, rehabilitation, and support. With remote patient monitoring, pulmonologists gain the ability to perform effectively and timely oversight of COPD. This leads to improvements in decision support and patient adherence to guidance and recommendations. A remote electronic respiratory monitor also allows pulmonologists to virtually support patients while avoiding potential exposure for anyone in their organization to COVID-19, particularly when patients undergo testing and measuring of their lung function. 
2. Asthma management — For asthma patients, pulmonologists can develop an effective management plan that combines exercise, ways to avoid triggers, medications, and other strategies, including remote patient monitoring. The usage of an electronic respiratory monitor is increasingly serving to support asthma patients and help optimize asthma management. And with good reason: Studies indicate that ongoing monitoring of interventions have been directly linked to better asthma control, more symptom-free days, and decreased need for rescue medication. 
3. Other respiratory disease management — While pulmonologists are largely leveraging remote patient monitoring to support COPD and asthma patients, they are also beginning to see an uptick in remote support for patients with cystic fibrosis (CF), bronchiectasis, and other respiratory diseases. It is apparent that as pulmonologists and their patients further embrace RPM, the number of patients with varying diseases who benefit from these virtual services will steadily increase. 

Endocrinology Remote Patient Monitoring 

Within endocrinology, let's examine two common examples of remote patient monitoring. 

1. Glucose monitoring — Like other diseases that can be aided through remote physiologic monitoring, diabetes is chronic and incurable, but there are several ways to reduce the impact of diabetes on a patient's life, including weight loss, diet changes, and engaging in an active lifestyle. Pivotal to managing diabetes and preventing complications is blood sugar testing. Such testing serves to identify when blood sugar levels are high or low and helps with diabetes medication management, evaluation of the effects from changes to diet and exercise, and tracking progress toward treatment goals. 
   
   For some diabetes patients, blood sugar testing is recommended periodically up to a few times a day. Such patients are increasingly receiving remote support for their diabetes management via the usage of a blood glucose meter. When patients test their blood sugar using this glucose monitoring device, endocrinologists receive the data captured and can make changes to a medication regimen and provide recommendations to improve management, if the information warrants it. Evidence shows that RPM is effective in controlling HbA1c levels in people with type 2 diabetes.
2. Continuous Glucose Monitoring — Ongoing measurement of blood sugar levels is advisable for people with diabetes (mainly those with type 1 diabetes) to detect noteworthy changes in blood sugar levels in near real-time and reveal sugar level highs and lows that fingerstick testing alone may not be able to identify. To perform ongoing measurement, patients are provided a continuous glucose monitoring system, often referred to as a CGM. To use a CGM, a small sensor is attached to the abdomen that includes a cannula which penetrates the skin and performs the “continuous measurement” around the clock (there's a few-minute interval between readings). The data captured is then sent to a device.
   
   If it's a remote patient monitoring device, the equipment then transmits the information to the prescribing organization for review within the RPM system. As with remote, non-continuous glucose monitoring, remote CGM provides endocrinologists with their patient's blood sugar readings — and most importantly, any that raise red flags (i.e., glucose levels too high or low).

With all of these proven applications, it’s evident that implementing a remote physiologic monitoring program can positively impact patient health, but how does RPM impact the financial health of an organization?

Explaining Condition-Focused RPM to Patients

The descriptions above should help you better envision how remote patient monitoring can be incorporated into your organization to benefit your patients. However, if you still have questions about the value of RPM, it may be worthwhile to spend a little more time researching specific applications. As RPM adoption grows, so does the understanding of its numerous benefits.

For example, if you're contemplating whether to add remote patient monitoring to support those patients suffering from heart failure, you may want to read this blog post. It provides an overview of the challenge and effects of heart failure on the U.S. population before explaining how home monitoring for heart failure management can be the difference-maker patients and providers may be looking for. The column then supports this claim with examples of how RPM helps with care delivery for hypertensive patients and weight monitoring as an analogue for monitoring fluid while also explaining the cost-effectiveness of RPM, including for home monitoring of blood pressure.

As another example, if you are considering whether to leverage RPM for patients with lung diseases (e.g., asthma, chronic obstructive pulmonary disease (COPD), bronchiectasis), read this blog post. It discusses the remote measuring and monitoring of peak expiratory flow. Among its key takeaways: The value of remote monitoring for patients with lung diseases has never been greater due, in part, to COVID-19.

• Usage of peak flow monitors helps bridge gaps in care caused by reductions in-person visits, whether by choice or necessity.
• There are numerous benefits of remote peak expiratory flow monitoring, both clinical and financial.
• Advancements in technology have made it much easier for organizations to add and provide peak expiratory flow remote monitoring and patients to participate in these RPM programs.