Introduction
Remote Patient Monitoring (RPM) is technological utilization in capturing and tracking medical information from patients. As a sub-category of homecare telehealth, RPM allows mobile medical devices to collect patient-generated health data (PGHD) and forward it to healthcare workers. The technique is frequently used to help clients needing post-discharge, chronic, and senior care. This essay discusses one perspective of remote patient monitoring and analyzes two policy articles that resonate with the paper’s primary idea.
Perspective of RPM
A significant perspective on remote patient monitoring is that the technology enhances the management of chronic and acute illnesses and helps to personalize treatment using high-frequency medical data. As a result, RPM can better clinical outcomes for individuals and, at the same time, reduce downstream care costs, especially those related to preventable hospital admissions. The technology benefits the healthcare system by supporting clinicians to remain vigilant about managing critical medical conditions with a high morbidity degree if left untreated. Additionally, the program offers a more clinical focus on illnesses that require extra professional attention. However, a disadvantage of the technology is that it can cause medical professionals to miss the opportunity of providing additional care to patients. Also, the accessibility and availability of the technology are limited in remote areas and small medical institutions.
Article 1
The authors’ primary objective was to establish the safety and feasibility of a remote patient monitoring program for managing severe COVID-19. Initially, RPM systems were developed to support individuals with chronic and complex conditions, such as chronic obstructive pulmonary disease (COPD) and congestive heart failure (Coffey et al., 2021). However, the framework was later adopted to help COVID-19 patients as the illness was acute, novel, and self-limited with varied complications and clinical presentations. Additionally, the sickness had a unique requirement for self-isolating during the infection and recovery phases. Therefore, the authors of this RPM policy sought to establish a specialized program with operational infrastructure and nursing resources to provide ambulatory management for individuals with coronavirus.
The policy implementation involved two models of care with varied observation capabilities and supporting different patient risk levels for severe illness. The two prototypes helped patients at high and low-risk levels for infection. Monitoring vital signs and symptom assessments was done twice daily on patient-reported characteristics. The results were obtained using peripheral medical devices like blood-pressure monitors, thermometers, and pulse oximeters (Coffey et al., 2021). On the other end, centralized registered nurses answered the technology-generated alerts and used standard pathways to provide patient management and clinical assessments. The health providers escalated severe cases to the COVID-19 care team physicians. The program also included other health solutions to assist people who suspected that they had the illness. However, the previously established RPM system for older patients with chronic and complex conditions was maintained.
A patient at a higher risk of suffering from severe COVID-19 was eligible for high-intensity care if immunocompromised. In addition, individuals above sixty-five years and who had a BMI of above forty were allowed to receive the aforementioned care level. Infected people without these risk factors obtained high-intensity care if they had been hospitalized for more than seven days, had cardiac complications, were in ICU, got readmissions, or needed mechanical dialysis, oxygen supplementation, or ventilation. The program evaluated 7074 patients across forty-one states in America (Coffey et al., 2021). The RPM engagement rate among these clients was 78.9%. Besides, the rates of hospitalization and emergency department visits in thirty days after enrollment were 9.4% and 11.4%, respectively (Coffey et al., 2021). Lastly, the mortality rate within the thirty days was 0.4%. Thus, according to the study findings, a multisite RPM policy for severe COVID-19 management is safe, practicable, and linked to low mortality rates (Coffey et al., 2021). The finding mentioned above is connected to the initial perspective of this paper as it supports the implementation of RPM in managing acute conditions. However, the authors argue that further research should be conducted on ambulatory RPM programs for managing other critical illnesses.
Article 2
The research aimed to explore RPM as an effective tool for providing care to individuals with suspected or confirmed COVID-19. A second objective was to depict symptom presentation and demographic characteristics in possible coronavirus cases (Tabacof et al., 2021). The outbreak of the illness caused a global public health emergency that overwhelmed medical systems throughout the world. Subsequently, healthcare institutions were forced to adopt telemedicine strategies as the technology had proven effective in managing respiratory and chronic diseases. The integration of RPM techniques lessened the burden of the pandemic on emergency departments, making them a compelling solution at the time.
In this research, the authors evaluated the feasibility of the COVID-19 Precisions Recovery Program (PRP), an RPM clinical solution implemented in New York for symptomatic and physiologic patient monitoring. Following a virtual or in-person physician evaluation, individuals were directed to the PRP if they displayed symptoms accordant to coronavirus (Tabacof et al., 2021). In addition, patients regarded as high risk for respiratory deterioration by their evaluating doctors received pulse oximeters. High-risk respiratory deterioration criteria involved people with a severe cardiovascular and respiratory medical history, individuals discharged with supplemental oxygen, and those with previous complex inpatient hospitalizations requiring mechanical ventilation, severe COVID-19 symptoms, and acute respiratory failure.
Retrospective data was gathered from the PRP during the coronavirus catastrophe in New York. The study recorded one hundred and twelve clients with a mean age of forty-nine years, and 60.7% were women. Common comorbidities were diabetes (17.7%), hypertension (36.3%), and hypercholesterolemia (26.5%) (Tabacof et al., 2021). The presentation of symptoms did not differ significantly in terms of PCR-test status. Of the population, 17.9% received a negative result, while 33% had an unknown coronavirus status (Tabacof et al., 2021). According to the research findings, RPM programs are a significant technique for providing care to individuals infected with COVID-19. However, access to clinical care should be independent of PCR-test outcomes. The article supports the initial perspective by claiming that RPM programs assist clinical management by enhancing symptom detection and preventing hospital readmissions. Therefore, RPM is a viable alternative to in-person care when dealing with acute conditions.
Conclusion
To conclude, RPM programs help ensure people remain healthy by allowing disabled and older individuals to stay longer at home and limit movement to skilled nursing facilities. An argument that supports the technology is that it reduces the number of lengthy stays, readmissions, and admissions in hospitals, lowering the expenditure and improving the quality of life. The two articles that have been summarized support the idea that RPM is a vital telehealth technique that helps both patients and healthcare professionals. However, the program is not available to all patients depending on location and remote accessibility. Besides, the accuracy of RPM devices is not proven, and, thus, their effectiveness remains uncertain to many people. Therefore, the included studies recommend further research on the topic to establish the efficacy of RPM.
References
Coffey, J., Christopherson, L., Glasgow, A., Pearson, K., Brown, J., Gathje, S., Sangaralingham, S., Porquera, E., Virk, A., Orenstein, R., Speicher, L., Bierle, D., Ganesh, R., Cox, D., Blegen, N., & Haddad, T. (2021). npj Digital Medicine, 4(1), 123. Web.
Tabacof, L., Kellner, C., Breyman, E., Dewil, S., Braren, S., Nasr, L.,Tosto, J., Cortes, M., & Putrino, D. (2021).Remote Patient Monitoring for Home Management of Coronavirus Disease 2019 in New York: A Cross-Sectional Observational Study. Telemedicine and e-Health, 27(6), 641-648. Web.