OPERATING ROOM
Remote patient monitoring
Breaking down walls, barriers for expedient and meaningful use of data by Kara Nadeau
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dvances in technology, payment reforms, patient-centered care and the digitization of healthcare delivery have driven a momentous evolu- tion and expansion of patient monitoring over the past two decades. The COVID-19 pandemic has further accelerated patient monitoring trends, with both a desire and a need to deliver care effectively and safely in the home.
Digital technology, including remote
monitoring, artificial intelligence and auto- mation, could save health systems around the world anywhere between $1.5 trillion and $3 trillion a year by 2030, according to The McKinsey Global Institute.1 Extension of monitoring from the hos-
pital into the home supports many fac- tors that can improve care quality while reducing costs, such as continuity of care, transition of care from the acute to non- acute setting and care coordination among clinicians. For patients, remote patient monitoring (RPM) offers greater conve- nience, with the ability for their care teams to monitor their health status without the patient having to leave home. Monitoring solutions that transmit patient data, within a hospital’s network, remotely back to hospital or office-based clinicians, to home care nurses, or even to an off-site third-party RPM service pro- vider, present challenges as well. These include risks to electronic protected health information (ePHI) and lack of interoper- ability with connected systems due to proprietary hardware and software. Then there is the problem of data over-
load. Monitoring devices generate an abundance of data but it is quality over quantity that counts. Healthcare providers must find ways to cut through the data clutter and garner useful insights to inform care decisions.
Individual manufacturers of monitoring technologies, trade associations, healthcare organizations and other stakeholders are working on ways to leverage advanced patient monitoring capabilities for the benefit of the industry and the patients they serve. The possibilities are endless, and with growing consumer interest in more convenient and accessible care, now is the time to act.
Care delivery ever expanding In its future of health vision, Deloitte predicts that more care will be delivered to patients at home, or through virtual, outpatient and other settings. The focus of care will shift from treating diseases to promoting wellness and prevention. The consulting firm notes that the transition of care from acute care to outpatient and home settings is already happening today.2 Ushered in by the COVID-19 pandemic, the Centers for Medicare & Medicaid Services (CMS) Hospital Without Walls initiative is evidence of this shift. Launched in March 2020, it allowed health systems and hospitals to provide services in loca- tions beyond their existing walls to accom- modate patient surges.
CMS expanded this effort in November
2020 with an “Acute Hospital Care At Home” program that provides “eligible hospitals with unprecedented regulatory flexibilities to treat eligible patients in their homes.” As of August 9, 2021, 69 U.S. health systems, including 148 hospitals in 32 states, were approved by CMS to participate in the program.3 Under the program, a registered nurse (RN) evaluates home-based patients once per day (in-person or remotely). The patient also receives two in-person visits daily from either an RN or a mobile integrated health paramedic (based on
14 October 2021 • HEALTHCARE PURCHASING NEWS •
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the patient’s nursing plan and hospital policies).4
Patient monitoring to facilitate care expansion
There are obvious risks in transition- ing patients from an acute care hospital to a non-acute facility or to the home. Monitoring of vital signs and other bio- logical parameters is clearly easier when a patient is in a hospital bed versus in a post- acute setting or in the varied and unpre- dictable setting of a home environment. Leading manufacturers of monitor tech- nology and other medical equipment with decades of experience in the acute care setting have been innovating to facilitate monitoring of patients well beyond the four walls of a hospital. This includes both monitoring for early detection of emerging issues and for the management of pre- existing conditions. Hillrom, a medical technology company that nearly 100 years ago was focused on bringing the home into the hospital through more comfortable furnishing, is now leading the charge toward advancing connected care in the hospital and back into the home. In 2015, Hillrom acquired point of care diagnostics provider Welch Allyn, and has since been adapting its hospital grade solutions to facilitate effec- tive, safe and connected monitoring and intelligent diagnostics, delivering data clinicians can trust. “Our mission has always
been to enhance outcomes for patients and caregivers. Technology is a means to do a better job of that,” said Andreas Frank, President, Front Line Care, Hillrom. “Where in the past health-
care was centralized, with a patient going Andreas Frank
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