de 2016 por la Jiang Li
Remote patient monitoring (RPM) isn’t a new concept, but interest and adoption have increased significantly in the past 18 months. The pandemic took remote care from an enticing notion to the need-to-have status it holds now. Covid-19 spurred healthcare systems and organizations around the world to explore and execute medical monitoring differently.
RPM adoption increased exponentially, and efforts to solidify the reimbursement structure, simplify implementation, prepare the workforce and other hurdles are in full swing. While RPM isn’t the first-line technology yet, it can potentially replace the majority of traditional in-clinic healthcare monitoring. Globally, the adoption rate is tied to government reimbursement and public health policies; yet, while RPM trends upward around the world, it’s fascinating to see where implementation has been successful and why. In the U.S., in part because the Covid-19 pandemic was rampant early, health systems pushed telehealth and RPM forward quickly. In China, they maintained more control, and their telehealth adoption was less aggressive.
Government policy significantly contributes to adoption and can be a help or a hindrance. Sponsored programs or reimbursement codes help project funding, and initiatives can kick-start implementation, especially in developing countries without a quality healthcare network.
Today, the U.S. leads in adopting RPM technology — followed by Europe and Asia-Pacific. The rest of the world is still lagging. At Vivalink, working with more than 100 RPM partners across 32 countries provides a vantage point. The breakdown of applications is a telling look at the various climates of innovation, based on patient population, socioeconomic factors, political and regulatory environments and more. Generally, I see that countries rapidly implemented RPM concurrently with an initial increase in Covid cases, then optimized RPM for long-term use after the surge. Geography is a driving factor in determining if RPM is a viable option. The need to collect physiological parameters, such as human vitals outside a clinical setting, collection frequency and ambulatory status, all play a role in determining the optimum technologies to use.
The Covid Factor
The pandemic served as a catalyst to adopt RPM. Initially, each country rushed to RPM to deal with Covid, but each situation is different. Looking at Vivalink’s global activity versus “Covid” Google search trend, you can follow the resurgence as it drives interest in RPM technologies. Interest in RPM solutions spiked along with the spike in Covid in early 2020, but 2021 interest continued, indicating RPM is here to stay. The initial spike in RPM adoption and virtual care created a perfect demonstration of the power of the technology and served as a strong catalyst for its long-term adoption globally.
Key factors to consider for implementation include the type and frequency of required data collection to determine the best sensors and devices, patient feasibility to self-manage, ambulatory use case impact on data quality and data network transmission reliability.
Geographic regulatory issues and logistics are factors, but individual countries are succeeding in using RPM technology for monitoring. One of our partners is monitoring Covid-19 patients with blood oxygen, ECG and temperature sensors. In an Australian study, remote sensors monitor essential workers and alert management if a temperature reaches above a set point to proactively detect potential Covid-19 symptoms in real time before other symptoms occur.
Ease of use figured into each of these scenarios and is one of the key factors of success, especially when there’s no clinician standing by. The decentralized nature of the technology can be challenged by network reliability. However, this can be overcome by selecting technologies that can cache and automatically synchronize data to the cloud.
Pandemic-driven applications created a new level of interest and demand for the technology. However, applications driven by Covid-19 aren’t the only thriving RPM implementations. After the initial surge associated with the pandemic, especially in the U.S. and China, there’s been a steady increase in comfort with RPM.
Globally, we’re seeing applications created for patient populations that benefit from vital signs monitoring related to the severity or chronic nature of their condition. In India, cardiovascular disease (CVD) is a heavy burden on the country as the leading cause of mortality. Research estimates that India accounts for 60% of the world’s heart disease burden. Multi-vital monitoring in a virtual hospital helps combat the high levels of Indian cardiovascular disease. In China, local governments are optimizing solutions for senior care.
Close to 326,000 registered clinical trials were underway in 2019. But Covid-19 caused participants to avoid many healthcare facilities in 2020. Keeping critical drug development clinical trials moving forward safely required implementing new research methods, including using decentralized clinical trials (DCTs). This keeps research timelines moving forward to prove the financial commitments worthwhile. Finding ways to continue monitoring patients without negative consequences helped salvage trials. Long term, DCTs and the ability to remotely capture patient health data offer significant benefits, including expanding the participants’ geographic footprints.
Keys To Implementation
When RPM technology makes sense for chronic disease management, disease detection, rehab or post-surgical monitoring, or for DCTs, start by determining the most important requirements for the use case. Ensure the technology can cache and synchronize data to the cloud, especially if network reliability is a potential issue.
Government sponsorship or reimbursement codes can significantly help with funding, so make sure that’s taken into consideration. A successful operation requires collaboration between the clinical team and RPM implementation partner to ensure both clinical and technical issues are addressed from the onset. Clinicians must be able to easily interact with the device technology and view it as a help rather than a hindrance to elicit full buy-in. For optimum patient compliance, it’s critical that the device is easy to use, comfortable and provides reminders.
The World Ahead
Whether domestic or international, the adoption of virtual healthcare technology garners significant benefits for health systems, the pharmaceutical and device industries and, most importantly, patients. Around the world, organizations are taking advantage of opportunities to proactively monitor and manage the health of their patients, subjects or employees. Worldwide, Covid impacted adoption and is likely to continue after the pandemic.