Remote patient monitoring

Last updated

Remote patient monitoring (RPM) is a technology to enable monitoring of patients outside of conventional clinical settings, such as in the home or in a remote area, which may increase access to care and decrease healthcare delivery costs. RPM involves the constant remote care of patients by their physicians, often to track physical symptoms, chronic conditions, or post-hospitalization rehab. [1]

Contents

Devices like smartwatches are continually updated with new remote monitoring technologies such as heartbeat monitors. CardiacSense medical watch.jpg
Devices like smartwatches are continually updated with new remote monitoring technologies such as heartbeat monitors.

Incorporating RPM in chronic-disease management may significantly improve an individual's quality of life, by allowing patients to maintain independence, prevent complications, and to minimize personal costs. [2] RPM facilitates these goals by delivering care through telecommunications. This form of patient monitoring can be particularly important when patients are managing complex self-care processes such as home hemodialysis. [3]

Key features of RPM, like remote monitoring and trend analysis of physiological parameters, enable early detection of deterioration; thereby reducing emergency department visits, hospitalizations, and the duration of hospital stays. [4] [5] [6] [7] While technologies are continually being developed to tackle this type of health care, physicians may utilize basic communication methods such as Zoom, Snapchat, or even landline phones. [1]

Pilot programs for Remote Patient Monitoring began in 1970s when Kaiser Permanente created monitoring systems for rural communities in order to provide better healthcare to isolated regions. [8] Literature related to Remote Patient Monitoring suggests that interventions based on health behavior models, care pathways, and personalized coaching lead to the best outcomes. [9]

Research on the use of Remote Patient Monitoring technologies has helped determine that further development of telehealth ecosystems, in which physicians can give recommendations and means of care while also receiving transmitted health information, can lead to better patient outcomes and higher patient satisfaction. [10] [11] Researchers also note that Remote Patient Monitoring will become more important as healthcare changes from a volume focus to a value focus. [10]

During the COVID-19 pandemic, Remote Patient Monitoring has been used extensively and allowed for more fields such as psychology or cardiology to use virtual care. By 2025, the Remote Patient Monitoring industry is expected to double, due to factors such as the COVID-19 pandemic and increased at-home care. [12] Use of Remote Patient Monitoring has been proven to ultimately provide better patient compliance and improved physician management, while decreasing costs of care. [13]

Key features of RPM

Accessibly

Both patients and care providers can access the RPM record anytime from anywhere. Instantaneous access is helpful in making accurate health decisions and improves clinical operations. [14]

Cost-effectiveness.

Not much evidence has been able to support whether or not telehealth is more cost effective or not. There is some research showing that it can be a less expensive way for doctors to provide care because they aren't using any of their physical resources on the patient. Sage journals published a case study researching if telehealth is cost effective for the patient in the comfort of their home. Langabeer et al. (2017), stated that this study's method was to utilize telehealth resources when people called 911 and EMS responded. Once EMS was on scene, they would pull up a virtual system putting them in direct contact with an emergency department provider at the hospital. The provider was then able to triage the patient at the scene of the call and determine the best course of treatment potentially being no transport to the hospital. This in turn is more cost efficient for the patients and the medical providers both. This showed to be helpful in-patient outcomes because the provider was able to determine the critical level of the patient therefore allowing them to determine the best course of action at an earlier time. [15] [16]

Promptness

RPM helps in faster decision-making. RPM collects, improves, and analyzes data promptly, which is time-saving. Report-making has become easy through RPM.

Technological components

The diverse applications of RPM lead to numerous variations of RPM technology architecture. However, most RPM technologies follow a general architecture that consists of four components.: [17]

Depending on the disease and the parameters that are monitored, different combinations of sensors, storage, and applications may be deployed. [5] [17]

Applications

Physiological data such as blood pressure and subjective patient data are collected by sensors on peripheral devices. Examples of peripheral devices are: blood pressure cuff, pulse oximeter, and glucometer. The data are transmitted to healthcare providers or third parties via wireless telecommunication devices. The data are evaluated for potential problems by a healthcare professional or via a clinical decision support algorithm, and patient, caregivers, and health providers are immediately alerted if a problem is detected. [4] As a result, timely intervention ensures positive patient outcomes. The newer applications also provide education, test and medication reminder alerts, and a means of communication between the patient and the provider. [4] The following section illustrates examples of RPM applications, but RPM is not limited to those disease states

Cancer

Use of RPM among patients with cancer has been proven to improve outcomes overall, with studies showing improvements in re-hospitalization rates and decreased healthcare resource usage. [18] These remote monitoring technologies help to lower severity of pain as well as improving depression. [19]

The RPM has improved the life expectancy of Cancer Patients up to 20%. Remote patient monitoring devices help in early interventions, prescriptions, chemotherapy modifications, etc. RPM has helped in reducing Cancer emergency room visits or prolonged chemotherapy treatments. It is estimated that the hospitalization rate of patients with RPM is 2.8% and without RPM is 13% [20]

COVID-19

The use of remote patient monitoring reduces face-to-face interactions between physician and patient. COVID-19 Nurse.jpg
The use of remote patient monitoring reduces face-to-face interactions between physician and patient.

RPM can provide continuity of care for symptomatic COVID-19 patients post-discharge from hospital and those with mild to moderate oxygen desaturation levels that do not require hospitalization, and patients with long-COVID symptoms. Due to the nature of the pandemic, RPM is a necessary means of providing care to at-risk patients such as elderly or immunocompromised people.

Studies show that the use of RPM during the pandemic has helped to reduce hospitalizations [21]  and decrease the use of acute care resources. [18] [22]

The FDA has given emergency authorized use of RPM technologies for the purpose of decreasing the spread of COVID-19 and to prevent overload for healthcare resources and personnel. [18] [23] [24]

Chronic Obstructive Pulmonary Disease (COPD)

For patients with chronic obstructive pulmonary disease, RPM may contribute to increased patient knowledge, earlier interventions, and shared decision making. However, the evidence is varying and issues of cost, and the shift of responsibilities to patients have also been raised. [25] [26] [27]

Dementia and falls

Telehealth response watch Telehealth - Response Watch.jpg
Telehealth response watch

For patients with dementia that are at risk for falls, RPM technology promotes safety and prevents harm through continuous surveillance. [4] RPM sensors can be affixed to the individual or their assistive mobility devices such as canes and walkers. [4] The sensors monitor an individual's location, gait, linear acceleration and angular velocity, and utilize a mathematical algorithm to predict the likelihood for falls, detect movement changes, and alert caregivers if the individual has fallen. [4] Furthermore, tracking capabilities via Wi-Fi, global positioning system (GPS) or radio frequency enables caregivers to locate wandering elders. [4]

Diabetes

Diabetes management requires control of multiple parameters: blood pressure, weight, and blood glucose. The real-time delivery of blood glucose and blood pressure readings enables immediate alerts for patient and healthcare providers to intervene when needed. There is evidence to show that daily diabetes management involving RPM is just as effective as usual clinic visit every 3 months. [28]

Congestive heart failure

A systematic review of the literature on home monitoring for heart failure patients indicates that RPM improves quality of life, improves patient-provider relationships, shortens duration of stay in hospitals, decreases mortality rate, and reduces costs to the healthcare system. [29] [30]

Infertility

A recent study of a remote patient monitoring solution for infertility demonstrated that for appropriately screened patients who had been seeking In-Vitro Fertilization (IVF) treatment, a six-month remote monitoring program had the same pregnancy rate as a cycle of IVF. [31] The remote patient monitoring product and service used had a cost-per-patient of $800, compared to the average cost of a cycle of IVF of $15,000, suggesting a 95% reduction in the cost of care for the same outcome.

Surgery

When compared to standard of care with no devices, a 2021 study showed that post-surgical remote patient monitoring detected 30% more medication errors, 10-14% reduction in patient paint, and a 5% reduction in hospital re-admissions. [32] [33] [34] The randomized study, conducted by PJ Devereaux and Micheal McGillion, split 905 patients between a standard of care group and a RPM group, which used at-home clinical grade vital sign devices to transfer their vital signs to a Clinician Portal where they were monitored remotely and could communicate through text, chat, or video calls. [32] [33] [35] The scientists (Devereaux and McGillion) are now conducting two follow-up studies (PVC-RAM 2 [36] and PVC-RAM 3 [37] ) to investigate secondary findings of PVC RAM1.

Telemedicine in prison systems

A forerunner to RPM, Florida first experimented with "primitive" telemedicine use in its prisons during the latter 1980s. [38] Working with Doctors Oscar W. Boultinghouse and Michael J. Davis, from the early 1990s to 2007, Glenn G. Hammack led the University of Texas Medical Branch's development of a pioneering telehealth program in Texas state prisons. [39] Many of the studies conducted on telehealth have focused on the effectiveness in rural or remote communities so an article published by plos one looked at a study done focusing on the effectiveness of telehealth in the prison system. This review looked at 29 different studies that all utilized telehealth in the prison slightly different. The parameters and interventions delivered varied causing the outcomes to vary. The overall systemic review provided mixed evidence on the impact and outcomes of telehealth usage in prisons. Considering the fact, the world population is growing this means so is the prison population which also means the spectrum of health issues is also broadening. This being the main reason for these studies to have been conducted. This leads to the conclusion that more testing and studies must be completed too fully determine the effectiveness in patient outcomes. There was definitely evidence in the studies showing a positive effect from telehealth in the prison system and it did in some cases prove to be effective with positive impacts. It also showed in some cases to be just as effective as normal conventional care. The study stated that the idea to consider is what is being treated and what the context of the situation being addressed is. If the situation is critical, then other measures or responses may be necessary. [40]

Veterans Health Administration

The Veterans Health Administration (VHA), United States' largest integrated healthcare system, is an early adopter which became highly involved in the implementation and evaluation of RPM technologies. It has expanded use of RPM beyond common chronic disease applications, to post-traumatic stress disorder, cancer and palliative care. VHA's findings indicate improvements in a wide range of metrics, including decrease in emergency department visits, hospitalizations, and nursing home admissions. [6] Findings from the VHA Care Coordination/Home Telehealth program show that RPM deployment resulted in significant savings to the organization. [41]

Whole System Demonstrator Trial in UK

The UK's Department of Health's Whole System Demonstrator (WSD) [42] launched in May 2008. It is the largest randomised control trial of telehealth and telecare in the world, involving 6191 patients and 238 GP practices across three sites, Newham, Kent and Cornwall. The trials were evaluated by: City University London, University of Oxford, University of Manchester, Nuffield Trust, Imperial College London and London School of Economics.

In the UK, the Government's Care Services minister, Paul Burstow, has stated that telehealth and telecare would be extended over the next five years (2012-2017) to reach three million people. [43]

Limitations

RPM is highly dependent on the individual's motivation to manage their health. Without the patient's willingness to be an active participant in their care, RPM implementation will likely fail. The shift of accountability associated with RPM brings up liability issues. [17] There are no clear guidelines in respect to whether clinicians have to intervene every time they receive an alert regardless of the urgency. The continuous flow of patient data requires a dedicated team of health care providers to handle the information, which may, in fact, increase the workload. Although technology is introduced with the intent to increase efficiency, it can become a barrier to some healthcare providers that are not technological. There are common obstacles that health informatics technologies encounter that applies to RPM. Depending on the comorbidities monitored, RPM involves a diverse selection of devices in its implementation. Standardization is required for data exchange and interoperability among multiple components. Furthermore, RPM deployment is highly dependent on an extensive wireless telecommunications infrastructure, which may not be available or feasible in rural areas. Since RPM involves transmission of sensitive patient data across telecommunication networks, information security is a concern. [17] Debate surrounds the potential cybersecurity issues of RPM, including the likelihood of hacks which could pull personal medical data. [44] Additionally, most remote monitoring devices are limited to single-user applications, and could be expanded in the future for better inclusion of multi-user technologies. [44]

Reimbursement

United States

Since 2020, Medicare fully covers doctors and other medical staff receiving payment for RPM patient setup and training. This is then followed by a fixed monthly amount for operating health monitoring devices and logging patient readings. Medicaid also covers these procedures in 34 states. [45]

Cigna, Humana and UnitedHealth Care are among the large private U.S. private health insurance companies that offer members to track certain health data, such as blood pressure, glucose values and other metrics, and send them to their virtual primary care providers who can review the data during patient visits. Some of these plans include coverage of the use of medical devices for remote patient monitoring. [46]

Germany

Digital health applications (known as DiGA in German: "Digitale Gesundheitsanwendungen") have been eligible for nationwide insurance coverage since the end of 2019 through a fast-track application process. [47] Medical devices that are used for remote patient monitoring through apps, have to be considered Category I (low risk) or IIa (low-medium risk) to be eligible. [48] Telehealth and coaching, even when combined with remote patient monitoring through wearables, is not directly covered by the DiGA directive, but needs to be reimbursed separately under different provisions. [49]

Controversy

Published by the New England Journal of Medicine, a randomized controlled trial involving congestive heart failure patients concluded that the use of telemonitoring failed to provide a benefit over usual care. [50] The telemonitoring patient group was instructed to call a designated number daily, and answer a series of questions about their symptoms using a keypad. [50] Clearly, the process described by Chaudhry et al. (2010) differs from the RPM methodology illustrated in the overview, which involves actual collection and transmission of physiological data through point-of-care devices. With articles [51] [52] from Forbes associating RPM with the negative findings by Chaudhry et al. (2010), it may be difficult to clear the misconception that telemonitoring is synonymous with remote patient monitoring. Researchers at the Semnan University of Medical Science have determined that while Remote Patient Monitoring is a more feasible type of care for elderly people at home, especially during a difficult period like the ongoing COVID-19 pandemic, it is difficult for physicians to maintain control over their care while not under their supervision. [53] The lack of standardization of RPM nomenclature and definition makes it difficult to differentiate between different forms of patient monitoring involving technology. Different forms of RPM have varying effectiveness, with researchers supporting more resources going towards developing technologies which counter the pitfalls of these methods. [9]

See also

Related Research Articles

<span class="mw-page-title-main">Telehealth</span> Health care by telecommunication

Telehealth is the distribution of health-related services and information via electronic information and telecommunication technologies. It allows long-distance patient and clinician contact, care, advice, reminders, education, intervention, monitoring, and remote admissions. Telemedicine is sometimes used as a synonym, or is used in a more limited sense to describe remote clinical services, such as diagnosis and monitoring. When rural settings, lack of transport, a lack of mobility, conditions due to outbreaks, epidemics or pandemics, decreased funding, or a lack of staff restrict access to care, telehealth may bridge the gap as well as provide distance-learning; meetings, supervision, and presentations between practitioners; online information and health data management and healthcare system integration. Telehealth could include two clinicians discussing a case over video conference; a robotic surgery occurring through remote access; physical therapy done via digital monitoring instruments, live feed and application combinations; tests being forwarded between facilities for interpretation by a higher specialist; home monitoring through continuous sending of patient health data; client to practitioner online conference; or even videophone interpretation during a consult.

eHealth describes healthcare services which are supported by digital processes, communication or technology such as electronic prescribing, Telehealth, or Electronic Health Records (EHRs). The use of electronic processes in healthcare dated back to at least the 1990s. Usage of the term varies as it covers not just "Internet medicine" as it was conceived during that time, but also "virtually everything related to computers and medicine". A study in 2005 found 51 unique definitions. Some argue that it is interchangeable with health informatics with a broad definition covering electronic/digital processes in health while others use it in the narrower sense of healthcare practice using the Internet. It can also include health applications and links on mobile phones, referred to as mHealth or m-Health. Key components of eHealth include electronic health records (EHRs), telemedicine, health information exchange, mobile health applications, wearable devices, and online health information. These technologies enable healthcare providers, patients, and other stakeholders to access, manage, and exchange health information more effectively, leading to improved communication, decision-making, and overall healthcare outcomes.

<span class="mw-page-title-main">Telenursing</span> Nursing care through telecoms

Telenursing refers to the use of information technology in the provision of nursing services whenever physical distance exists between patient and nurse, or between any number of nurses. As a field, it is part of telemedicine, and has many points of contacts with other medical and non-medical applications, such as telediagnosis, teleconsultation, and telemonitoring. The field, however, is still being developed as the information on telenursing isn't comprehensive enough.

Telecare is technology-based healthcare such as the monitoring of patient vital organs so that they may remain safe and independent in their own homes. Devices may include health and fitness apps, such as exercise tracking tools and digital medication reminder apps, or technologies that issue early warning and detection. The use of sensors may be part of a package which can provide support for people with illnesses such as dementia, or people at risk of falling.

<span class="mw-page-title-main">Telerehabilitation</span> Delivery of rehabilitation services over the internet

Telerehabilitation (or e-rehabilitation is the delivery of rehabilitation services over telecommunication networks and the internet. Telerehabilitation allows patients to interact with providers remotely and can be used both to assess patients and to deliver therapy. Fields of medicine that utilize telerehabilitation include: physical therapy, occupational therapy, speech-language pathology, audiology, and psychology. Therapy sessions can be individual or community-based. Types of therapy available include motor training exercises, speech therapy, virtual reality, robotic therapy, goal setting, and group exercise.

<span class="mw-page-title-main">Telepsychiatry</span> Mental-health care by telecommunication

Telepsychiatry or telemental health refers to the use of telecommunications technology to deliver psychiatric care remotely for people with mental health conditions. It is a branch of telemedicine.

<span class="mw-page-title-main">Rural health</span> Interdisciplinary study of health and health care delivery in rural environments

In medicine, rural health or rural medicine is the interdisciplinary study of health and health care delivery in rural environments. The concept of rural health incorporates many fields, including wilderness medicine, geography, midwifery, nursing, sociology, economics, and telehealth or telemedicine.

Home automation for the elderly and disabled focuses on making it possible for older adults and people with disabilities to remain at home, safe and comfortable. Home automation is becoming a viable option for older adults and people with disabilities who would prefer to stay in the comfort of their homes rather than move to a healthcare facility. This field uses much of the same technology and equipment as home automation for security, entertainment, and energy conservation but tailors it towards old people and people with disabilities.

mHealth Medicine and public health supported by mobile devices

mHealth is an abbreviation for mobile health, a term used for the practice of medicine and public health supported by mobile devices. The term is most commonly used in reference to using mobile communication devices, such as mobile phones, tablet computers and personal digital assistants (PDAs), and wearable devices such as smart watches, for health services, information, and data collection. The mHealth field has emerged as a sub-segment of eHealth, the use of information and communication technology (ICT), such as computers, mobile phones, communications satellite, patient monitors, etc., for health services and information. mHealth applications include the use of mobile devices in collecting community and clinical health data, delivery/sharing of healthcare information for practitioners, researchers and patients, real-time monitoring of patient vital signs, the direct provision of care as well as training and collaboration of health workers.

Teledermatology is a subspecialty in the medical field of dermatology and probably one of the most common applications of telemedicine and e-health. In teledermatology, telecommunication technologies are used to exchange medical information over a distance using audio, visual, and data communication. Applications comprise health care management such as diagnoses, consultation, and treatment as well as (continuous) education.

Connected health is a socio-technical model for healthcare management and delivery by using technology to provide healthcare services remotely. Connected health, also known as technology enabled care (TEC) aims to maximize healthcare resources and provide increased, flexible opportunities for consumers to engage with clinicians and better self-manage their care. It uses readily available consumer technologies to deliver patient care outside of the hospital or doctor's office. Connected health encompasses programs in telehealth, remote care, and disease and lifestyle management. It often leverages existing technologies, such as connected devices using cellular networks, and is associated with efforts to improve chronic care. However, there is an increasing blur between software capabilities and healthcare needs whereby technologists are now providing the solutions to support consumer wellness and provide the connectivity between patient data, information and decisions. This calls for new techniques to guide Connected Health solutions such as "design thinking" to support software developers in clearly identifying healthcare requirements, and extend and enrich traditional software requirements gathering techniques.

<span class="mw-page-title-main">Doctor's visit</span> Meeting between a patient and a physician

A doctor's visit, also known as a physician office visit or a consultation, or a ward round in an inpatient care context, is a meeting between a patient with a physician to get health advice or treatment plan for a symptom or condition, most often at a professional health facility such as a doctor's office, clinic or hospital. According to a survey in the United States, a physician typically sees between 50 and 100 patients per week, but it may vary with medical specialty, but differs only little by community size such as metropolitan versus rural areas.

Digital health is a discipline that includes digital care programs, technologies with health, healthcare, living, and society to enhance the efficiency of healthcare delivery and to make medicine more personalized and precise. It uses information and communication technologies to facilitate understanding of health problems and challenges faced by people receiving medical treatment and social prescribing in more personalised and precise ways. The definitions of digital health and its remits overlap in many ways with those of health and medical informatics.

Telehomecare (THC) is a subfield within telehealth. It involves the delivery of healthcare services to patients at home through the use of telecommunications technologies, which enable the interaction of voice, video, and health-related data. The management of care is done from an external site by a healthcare professional.

<span class="mw-page-title-main">Glooko</span>

Glooko, Inc provides a Software-as-a-Service (SaaS) application and accompanying mobile app for diabetes patients and their healthcare providers in the United States and internationally.

Mental health informatics is a branch of health or clinical informatics focused on the use of information technology (IT) and information to improve mental health. Like health informatics, mental health informatics is a multidisciplinary field that promotes care delivery, research and education as well as the technology and methodologies required to implement it.

e-consult is a mechanism developed by the Department of Veterans Affairs that enables primary care providers to obtain specialists' inputs into a patient's care treatment without requiring the patient to go to a face-to-face visit.

Doxy.me is a web-based telemedicine platform designed specifically for healthcare providers to conduct video consultations with patients. Doxy.me is known for its simplicity and ease of use.

<span class="mw-page-title-main">Impact of the COVID-19 pandemic on the telehealth industry</span> Impact of coronavirus on telehealth

Before the COVID-19 pandemic, telehealth adoption was gradually increasing. With the outbreak of COVID-19 in early 2020, healthcare professionals reduced in-person visits to minimize exposure. This led to an increase in the use of telemedicine. with a concomitant increase in publications.. Telehealth has since remained widely utilized in healthcare services.

Telemedicine in Nepal is a new approach that connects healthcare providers with patients in remote areas, overcoming geographical and infrastructure challenges to improve access to healthcare. By utilizing information technology, telemedicine has proven to be a cost-effective and efficient solution for delivering healthcare services across the country.

References

  1. 1 2 Wicklund E, ed. (4 May 2021). "How COVID-19 Affects the Telehealth, Remote Patient Monitoring Landscape". mHealthIntelligence. Retrieved 2021-08-19.
  2. ↑ Bayliss EA, Steiner JF, Fernald DH, Crane LA, Main DS (2003). "Descriptions of barriers to self-care by persons with comorbid chronic diseases". Annals of Family Medicine. 1 (1): 15–21. doi:10.1370/afm.4. PMC   1466563 . PMID   15043175.
  3. ↑ Cafazzo JA, Leonard K, Easty AC, Rossos PG, Chan CT (8 September 2008). "Bridging the self-care deficit gap: Remote patient monitoring and the hospital-at-home.". International Conference on Electronic Healthcare. Lecture Notes of the Institute for Computer Sciences, Social Informatics and Telecommunications Engineering. Vol. 0001. Berlin, Heidelberg: Springer. pp. 66–73. doi:10.1007/978-3-642-00413-1_8. ISBN   978-3-642-00413-1.
  4. 1 2 3 4 5 6 7 "Technologies for remote patient monitoring in older adults: Position paper" (PDF). Oakland, CA: Center for Technology and Aging. April 2010.
  5. 1 2 O'Donoghue J, Herbert J (2012). "Data Management within mHealth Environments: Patient Sensors, Mobile Devices, and Databases". J. Data and Information Quality. 4: 1–20. doi:10.1145/2378016.2378021. S2CID   2318649.
  6. 1 2 Coye MJ, Haselkorn A, DeMello S (2009). "Remote patient management: technology-enabled innovation and evolving business models for chronic disease care". Health Affairs. 28 (1): 126–35. doi:10.1377/hlthaff.28.1.126. PMID   19124862.
  7. ↑ Vavilis S, Petković M, Zannone N (2012). "Impact of ICT on home healthcare" (PDF). In ICT Critical Infrastructures and Society. Berlin, Heidelberg: Springer. pp. 111–122.
  8. ↑ Gruessner V (9 November 2015). "The History of Remote Monitoring, Telemedicine Technology". mHealthIntelligence. Retrieved 2021-08-19.
  9. 1 2 Noah B, Keller MS, Mosadeghi S, Stein L, Johl S, Delshad S, et al. (January 2018). "Impact of remote patient monitoring on clinical outcomes: an updated meta-analysis of randomized controlled trials". npj Digital Medicine. 1 (1): 20172. doi:10.1038/s41746-017-0002-4. PMC   6550143 . PMID   31304346.
  10. 1 2 Riaz MS, Atreja A (December 2016). "Personalized Technologies in Chronic Gastrointestinal Disorders: Self-monitoring and Remote Sensor Technologies". Clinical Gastroenterology and Hepatology. 14 (12): 1697–1705. doi:10.1016/j.cgh.2016.05.009. PMC   5108695 . PMID   27189911.
  11. ↑ Ong MK, Romano PS, Edgington S, Aronow HU, Auerbach AD, Black JT, et al. (March 2016). "Effectiveness of Remote Patient Monitoring After Discharge of Hospitalized Patients With Heart Failure: The Better Effectiveness After Transition -- Heart Failure (BEAT-HF) Randomized Clinical Trial". JAMA Internal Medicine. 176 (3): 310–8. doi:10.1001/jamainternmed.2015.7712. PMC   4827701 . PMID   26857383.
  12. ↑ Jercich K (5 August 2020). "RPM market will double in next five years, predict stakeholders". Healthcare IT News. Retrieved 2021-08-19.
  13. ↑ Kuhn K, Warren J, Leong TZ, eds. (2007). Medinfo 2007. IOS Press. ISBN   978-1-58603-774-1.
  14. ↑ Ekeland, Anne G.; Bowes, Alison; Flottorp, Signe (2010-11-01). "Effectiveness of telemedicine: A systematic review of reviews". International Journal of Medical Informatics. 79 (11): 736–771. doi:10.1016/j.ijmedinf.2010.08.006. hdl: 11250/2377962 . ISSN   1386-5056. PMID   20884286. S2CID   205285886.
  15. ↑ Langabeer, James R; Champagne-Langabeer, Tiffany; Alqusairi, Diaa; Kim, Junghyun; Jackson, Adria; Persse, David; Gonzalez, Michael (September 2017). "Cost–benefit analysis of telehealth in pre-hospital care". Journal of Telemedicine and Telecare. 23 (8): 747–751. doi: 10.1177/1357633X16680541 . ISSN   1357-633X. PMID   27913657. S2CID   26707384.
  16. ↑ Shigekawa, Erin; Fix, Margaret; Corbett, Garen; Roby, Dylan H.; Coffman, Janet (2018-12-01). "The Current State Of Telehealth Evidence: A Rapid Review". Health Affairs. 37 (12): 1975–1982. doi:10.1377/hlthaff.2018.05132. ISSN   0278-2715. PMID   30633674. S2CID   58624713.
  17. 1 2 3 4 Smith T, Sweeney R (September 2010). Fusion trends & opportunities medical devices and communications. AnalystReport (Report). Connecticut: NERAC Publication.
  18. 1 2 3 Pritchett JC, Borah BJ, Desai AP, Xie Z, Saliba AN, Leventakos K, et al. (June 2021). "Association of a Remote Patient Monitoring (RPM) Program With Reduced Hospitalizations in Cancer Patients With COVID-19". JCO Oncology Practice. 17 (9): e1293–e1302. doi: 10.1200/OP.21.00307 . PMC   8457804 . PMID   34085535.
  19. ↑ Kofoed S, Breen S, Gough K, Aranda S (March 2012). "Benefits of remote real-time side-effect monitoring systems for patients receiving cancer treatment". Oncology Reviews. 6 (1): e7. doi:10.4081/oncol.2012.e7. PMC   4419632 . PMID   25992209.
  20. ↑ Pritchett, Joshua C.; Borah, Bijan J.; Desai, Aakash P.; Xie, Zhuoer; Saliba, Antoine N.; Leventakos, Konstantinos; Coffey, Jordan D.; Pearson, Kristina K.; Speicher, Leigh L.; Orenstein, Robert; Virk, Abinash (September 2021). "Association of a Remote Patient Monitoring (RPM) Program With Reduced Hospitalizations in Cancer Patients With COVID-19". JCO Oncology Practice. 17 (9): e1293–e1302. doi:10.1200/OP.21.00307. ISSN   2688-1535. PMC   8457804 . PMID   34085535.
  21. ↑ Scarpioni R, Manini A, Chiappini P (December 2020). "Remote patient monitoring in peritoneal dialysis helps reduce risk of hospitalization during Covid-19 pandemic". Journal of Nephrology. 33 (6): 1123–1124. doi:10.1007/s40620-020-00822-0. PMC   7417857 . PMID   32780306.
  22. ↑ Annis T, Pleasants S, Hultman G, Lindemann E, Thompson JA, Billecke S, et al. (August 2020). "Rapid implementation of a COVID-19 remote patient monitoring program". Journal of the American Medical Informatics Association. 27 (8): 1326–1330. doi:10.1093/jamia/ocaa097. PMC   7239139 . PMID   32392280.
  23. ↑ Center for Devices and Radiological Health (2021-07-15). "Remote or Wearable Patient Monitoring Devices EUAs". FDA.
  24. ↑ Camden, Chantal; Silva, Mindy (2021-01-02). "Pediatric Teleheath: Opportunities Created by the COVID-19 and Suggestions to Sustain Its Use to Support Families of Children with Disabilities". Physical & Occupational Therapy in Pediatrics. 41 (1): 1–17. doi:10.1080/01942638.2020.1825032. hdl: 11143/18024 . ISSN   0194-2638. PMID   33023352. S2CID   222182992.
  25. ↑ Walker RC, Tong A, Howard K, Palmer SC (April 2019). "Patient expectations and experiences of remote monitoring for chronic diseases: Systematic review and thematic synthesis of qualitative studies". International Journal of Medical Informatics. 124: 78–85. doi: 10.1016/j.ijmedinf.2019.01.013 . PMID   30784430.
  26. ↑ Fan KG, Mandel J, Agnihotri P, Tai-Seale M (May 2020). "Remote Patient Monitoring Technologies for Predicting Chronic Obstructive Pulmonary Disease Exacerbations: Review and Comparison". JMIR mHealth and uHealth. 8 (5): e16147. doi: 10.2196/16147 . PMC   7273236 . PMID   32348262.
  27. ↑ Taylor ML, Thomas EE, Snoswell CL, Smith AC, Caffery LJ (March 2021). "Does remote patient monitoring reduce acute care use? A systematic review". BMJ Open. 11 (3): e040232. doi: 10.1136/bmjopen-2020-040232 . PMC   7929874 . PMID   33653740.
  28. ↑ Chase HP, Pearson JA, Wightman C, Roberts MD, Oderberg AD, Garg SK (May 2003). "Modem transmission of glucose values reduces the costs and need for clinic visits". Diabetes Care. 26 (5): 1475–9. doi: 10.2337/diacare.26.5.1475 . PMID   12716807.
  29. ↑ Martínez A, Everss E, Rojo-Alvarez JL, Figal DP, García-Alberola A (2006). "A systematic review of the literature on home monitoring for patients with heart failure". Journal of Telemedicine and Telecare. 12 (5): 234–41. doi:10.1258/135763306777889109. hdl: 10115/2297 . PMID   16848935. S2CID   23252843.
  30. ↑ "Using Telehealth to Reduce All-Cause 30-Day Hospital Readmissions among Heart Failure Patients". Telehealth at Home. Retrieved 2022-09-22.
  31. ↑ Chausiaux O, Hayes J, Long C, Morris S, Williams G, Husheer S (2011). "Pregnancy Prognosis in Infertile Couples on the DuoFertility Programme Compared with In Vitro Fertilisation/Intracytoplasmic Sperm Injection". European Obstetrics & Gynaecology. 6 (2): 92–4.
  32. 1 2 McGillion, Michael H; Parlow, Joel; Borges, Flavia K; Marcucci, Maura; Jacka, Michael; Adili, Anthony; Lalu, Manoj M; Ouellette, Carley; Bird, Marissa; Ofori, Sandra; Roshanov, Pavel S (2021-09-30). "Post-discharge after surgery Virtual Care with Remote Automated Monitoring-1 (PVC-RAM-1) technology versus standard care: randomised controlled trial". BMJ. 374: n2209. doi:10.1136/bmj.n2209. ISSN   1756-1833. PMC   8477638 . PMID   34593374.
  33. 1 2 Leighanne, Evans (2021-10-20). "Canadian study using Kitchener-based technology proves virtual healthcare post-surgery is beneficial". CTV Kitchener. Retrieved 2022-08-08.
  34. ↑ Kate, Bueckert (2021-10-26). "Post-surgery patients monitored virtually do better than those seeing doctors in person, study indicates". CBC News. Retrieved 2022-08-08.
  35. ↑ McGillion, Michael H.; Parlow, Joel; Borges, Flavia K.; Marcucci, Maura; Jacka, Michael; Adili, Anthony; Lalu, Manoj M.; Yang, Homer; Patel, Ameen; O'Leary, Susan; Tandon, Vikas (2021-01-01). "Post Discharge after Surgery Virtual Care with Remote Automated Monitoring Technology (PVC-RAM): protocol for a randomized controlled trial". CMAJ Open. 9 (1): E142–E148. doi:10.9778/cmajo.20200176. ISSN   2291-0026. PMC   8034369 . PMID   33653769.
  36. ↑ "ClinicalTrials.gov". ClinicalTrials.gov. Retrieved 2024-06-12.
  37. ↑ "PVC-RAM-3 - Research Studies — PHRI — Population Health Research Institute of Canada". PHRI. Retrieved 2022-08-08.
  38. ↑ Illove M (January 21, 2016). "State Prisons Turn to Telemedicine to Improve Health and Save Money". Annals of Emergency Medicine. 56 (5). The PEW Charitable Trusts: A15–A17. doi: 10.1016/j.annemergmed.2010.09.008 . PMID   21064235 . Retrieved 2019-10-03.
  39. ↑ Freudenheim M (May 29, 2010). "The Doctor Will See You Now. Please Log On". The New York Times. Retrieved 2019-10-03.
  40. ↑ Tian, Esther Jie; Venugopalan, Sooraj; Kumar, Saravana; Beard, Matthew (2021-05-17). "The impacts of and outcomes from telehealth delivered in prisons: A systematic review". PLOS ONE. 16 (5): e0251840. Bibcode:2021PLoSO..1651840T. doi: 10.1371/journal.pone.0251840 . ISSN   1932-6203. PMC   8128277 . PMID   33999946.
  41. ↑ Darkins A, Ryan P, Kobb R, Foster L, Edmonson E, Wakefield B, Lancaster AE (December 2008). "Care Coordination/Home Telehealth: the systematic implementation of health informatics, home telehealth, and disease management to support the care of veteran patients with chronic conditions". Telemedicine Journal and e-Health. 14 (10): 1118–26. doi:10.1089/tmj.2008.0021. PMID   19119835. S2CID   1537510.
  42. ↑ "Whole Systems Demonstrators: An Overview of Telecare and Telehealth" (PDF). U.K. Department of Health.
  43. ↑ "Roll-out of telehealth and telecare to benefit three million lives". U.K. Department of Health. 19 January 2012. Archived from the original on 19 January 2012.
  44. 1 2 Ondiege B, Clarke M, Mapp G (March 2017). "Exploring a New Security Framework for Remote Patient Monitoring Devices". Computers. 6 (1): 11. doi: 10.3390/computers6010011 .
  45. ↑ Bowman, Jeff (2023-02-07). "Reimbursements for Remote Patient Monitoring: How to Use Them to Raise Practice Revenue". RemetricHealth. Retrieved 2023-09-06.
  46. ↑ Vaidya, Anuja (January 31, 2022). "Cigna's MDLIVE Deploys Remote Patient Monitoring Program" . Retrieved September 5, 2023.
  47. ↑ "BfArM — Interesting facts". www.bfarm.de. Retrieved 2023-09-06.
  48. ↑ "BfArM — Differentiation and classification". www.bfarm.de. Retrieved 2023-09-06.
  49. ↑ "Das Fast-Track-Verfahren für digitale Gesundheitsanwendungen (DiGA) nach § 139e SGB V" (PDF). Federal Institute for Drugs and Medical Devices: 16. September 4, 2023.
  50. 1 2 Chaudhry SI, Mattera JA, Curtis JP, Spertus JA, Herrin J, Lin Z, et al. (December 2010). "Telemonitoring in patients with heart failure". The New England Journal of Medicine. 363 (24): 2301–9. doi:10.1056/nejmoa1010029. PMC   3237394 . PMID   21080835.
  51. ↑ Langreth R (18 November 2010). "Why remote patient monitoring is overhyped". Forbes.
  52. ↑ Krumholz H (19 November 2010). "A double whammy for remote patient monitoring". Forbe.
  53. ↑ Bahariniya S, Asar ME, Madadizadeh F (2021-03-31). "COVID-19: Pros and cons of different caring techniques of elderly patients". Journal of Education and Health Promotion. 10: 87. doi: 10.4103/jehp.jehp_1536_20 . PMC   8150075 . PMID   34084834.
This page is based on this Wikipedia article
Text is available under the CC BY-SA 4.0 license; additional terms may apply.
Images, videos and audio are available under their respective licenses.