Remote Patient Monitoring: Nurses in Charge
The remote patient monitoring (RPM) revolution is here. RPM uses technology to collect data from an individual in one location-a patient at home, for example-and then transmits that information to a healthcare professional at another location.
The RPM market will surge in the coming years due, in part, to the aging of the population, chronic lifestyle-related conditions and pressures to contain costs, reports Persistence Market Research. RPM will continue to embrace wearable, stand-alone and implantable devices.
Opportunity plus results
RPM offers nurses the tools to collect vital signs like a patient's weight, blood pressure, heart rate, temperature and blood glucose and oxygen. Nurses' roles range from patient education and support and monitoring to care decision making and coordination.
Mayo Clinic, for example, has already reduced the number of in-person prenatal visits via RPM. Mayo's OB Nest combines eight in-person appointments with six virtual visits with a nurse via phone or e-mail. Home monitoring equipment tracks fetal heart rate and maternal blood pressure.
The Mayo program allows providers to spend more time with high-risk patients and boosts patient satisfaction while reducing the time required for multiple patient check-ins. Other RPM benefits cited by the Center for Technology and Aging and the Oregon Center for Aging and Technology include admissions and readmissions prevention, chronic condition management and avoidance of skilled nursing facilities and other, more costly forms of care.
That's not to say that RPM implementation is easy. Adoption barriers include device design and affordability and reimbursement by payers. Other roadblocks cited by the Health Information Management Systems Society (HIMSS) include a perceived shortage of caregivers and low education and literary levels among some patient populations.
The age of RPM
RPM takes many forms. MedStar Visiting Nurse Association, for example, relies on its In-Home Health Monitoring Program to monitor
patients in between nurse and therapy visits. Patients use a remote
monitoring device to record vital signs and other health information,
which they send to RPM nurses via phone or Internet.
Centura's Health at Home relies on Cardiocom's RPM technology to monitor patients with diabetes, CHF and COPD. Nurses serve some patients through a 24/7 clinical call center while targeting others via three weekly phone calls that review medications and patient understanding and actions, according to the Center of Technology and Aging‘s Measuring Return on Investment of Remote Patient Monitoring.
Other initiatives are more expansive. The University of Southern California's (USC) Center for Body Computing has laid the groundwork for "borderless medicine" with its virtual care clinic, according to MHealth Intelligence. Among the clinic's tech tools are wearable sensors, mobile apps, augmented and virtual reality, virtual providers, data collection and analytics and artificial intelligence.
Nurses could participate in what some have labeled "hologram house calls," beaming their image in real time to a patient in another location. Adds Leslie Saxon, MD, executive director of USC's Center for Body Computing: "We can provide patients around the globe with healthcare where there's never been any. And we can provide patients with the type of data they need and information they need to be in command of their healthcare story."
RPM Nursing Ed
Nurses can access RPM knowledge via numerous channels, including the following:
HIT Associations: Check out nursing programs presented by HIT organizations like HIMSS, as well as more general programs related to nursing priorities like care coordination. The American Telemedicine Association hosts a Remote Patient monitoring and Telehealth SIG.
Nursing associations: Visiting nurse associations throughout the country have integrated varied RPM programs into their services. Some are multidisciplinary partnerships. The Center on Technology and Aging, for example, cites a program involving the New England Healthcare Institute, Atrius Health the Visiting Nurses Association.
Guidelines and cases: Study guidelines and recommendations for RPM programs. Also review case examples and studies like UCLA Health, which involves nurses in RPM.
Conferences/modules: Among the educational resources that could benefit nurses are the Telehealth and RPM Summit, telehealth symposia sponsored by individual states and the RPM learning modules like the one offered via Stratis Health.
Publications: Scan nursing publications and articles in the popular and trade press. Coverage of RPM trends and benefits appears in publications as varied as the Wall Street Journal, Medical Economics and mHealthIntelligence.
Connecting the Dots
Barriers to the proliferation of RPM relate to design, cost, reimbursement, security, staffing and research on outcomes. Still, the U.S. RPM market is on the upswing, projected to reach slightly less than $1 billion by 2018, according to Transparency Market Research. Nurses can play a vital role-both in RPM system planning, selection and implementation and linking RPM to initiatives in population health management and building accountable communities.
Additional RPM Resources
- Partners Healthcare Connected Cardiac Care
- Essentia Health, Duluth, MN
- Alere Inraitio2
- MobileHelp CareAngel