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Benefits of Remote Patient Monitoring

By Keith Loria

Remote patient monitoring offers a proactive approach to medication management for older adults with chronic conditions, allowing real-time tracking of medication intake and adherence.

“It facilitates timely interventions by health care providers, ensuring medications are taken correctly and consistently,” says Randy Boldyga, a long-time health care executive and current CEO of Annapolis, Maryland-based health IT company RXNT. “It also empowers patients through personalized reminders and education, improving their engagement and understanding of their treatment regimens.”

Sarah Bonza, MD, MPH, a family physician who works with geriatric patients treating severe chronic diseases such as heart disease, certain types of cancer, dementia, and complications arising from such diseases, agrees that the management of patients with chronic conditions has been improved by the use remote patient monitoring technology.

“The wearable biosensors are gaining traction lately,” she says. “There are advanced biosensors that can monitor a range of physiologic metrics such as glucose levels and cardiac rhythms. Some of my patients have Samsung Galaxy 5 and Apple Watch Ultra smartwatches, which they all connect to diabetes trackers like Dexcom CGM.”

The chronic conditions managed and supported with these tools range from cardiac disease to kidney disease to general primary care, and the monitors can support patient care in urban and remote or secluded locations.

Jen Wall, RN, BSN, senior director at FTI Consulting and former chief nursing officer at Hebrew Senior Life, notes that remote patient monitoring also provides a connectedness to patients who may struggle with isolation and/or lack of transportation.

“There are some great platforms out there that integrate chronic disease and medication management,” she says. “The patients have real-time contact with care teams through a texting function. Vital signs are tracked remotely, and blood sugars are monitored in real time by a bank of clinical nurses. It’s been found that this level of connection and responsiveness, as well as dose adjustment in conjunction with a physician, increases patient adherence and improves patient outcomes.”

Key Benefits
Remote patient monitoring systems offer key benefits, such as improved patient engagement and adherence to treatment plans, as patients become more involved in their health care journeys.

“They provide health care providers with real-time data, enabling early detection of potential health issues and more timely interventions,” Boldyga says. “These systems also enhance access to care for patients in remote or underserved areas, reducing the need for frequent hospital visits. Ultimately, they contribute to better overall health outcomes and a reduction in health care costs.”

Bonza believes the most helpful feature of remote patient monitoring when it comes to medication adherence and management is its ability to track adherence to medications.

“Caregivers can monitor this, but sometimes patients, especially those belonging to the geriatric population, may have poor recall and may not accurately tell if they’ve already taken their medications.”

Importance of Wearables
The recent launch of various remote patient monitoring wearables represents a significant advancement in health care for both patients and providers, especially during this period of health care staffing shortages and increasing patient demands.

The integration of wearables in remote patient monitoring significantly enhances the ability to track and manage the health of older adults with chronic conditions.

“These devices continuously gather vital health data, like heart rate, activity levels, and sleep patterns, providing a comprehensive view of the patient's health status,” Boldyga says. “This real-time data not only aids in medication adherence by correlating physiological responses with medication intake but also enables personalized health care, allowing for timely adjustments to treatment plans.”

Wall notes there are numerous wearable devices that provide clinical data to providers and the patients themselves, whether an Apple watch or something more sophisticated like a continuous glucose monitor, smart technology clothing, or foot pads that measure temperature/blood circulation.

“These devices provide objective data that can support a patient’s present complaint and medical history to aid the clinician in diagnosis and management,” she says. “Health related wearables, fitness trackers, the AFib detection module in the Apple watch, fall detection technology similar to crash detection technology, fertility supports, sun exposure monitors, and seizure monitors are just some technologies that are out there.”

There’s even a belt that is designed like an airbag for older adults that inflates around the hips and waist, potentially preventing hip fractures if the wearer were to fall.

Wearables are convenient, Bonza shares, because it’s what is known as “on-the-go” tech.

“If you have something on you that can remind you when to take your meds, the less likely are you to forget really,” she says. “Plus, wearables also have health metrics tracking systems for vital signs, activity levels, sleep hours, etc., which all can be integrated with medication adherence data.”

These wearables are instrumental in streamlining clinical workflows, enabling health care staff to allocate more time for direct patient care by reducing the need for routine monitoring tasks. They also enhance patient outcomes by providing continuous health data, allowing for more timely and informed medical decisions.

“This innovative approach is a step toward more efficient and effective health care delivery, ensuring that both patients and providers are better supported in these challenging times,” Boldyga says. “Ultimately, wearables are pivotal in delivering more responsive, preventive, and personalized care.”

Obstacles to Use
“The technology is not new really; some hospices have smart remote patient monitoring devices that detect nonadherence if alerts/notifications are missed and can report data on whether pill dispenses are opened,” Bonza says. “I think one of the limiting factors here is the adaptability of hospice institutions with this technology. It requires training and integration with the patient care workflow. Plus, they don’t come cheap.”

There are obstacles to patient acceptance as well. One of the primary challenges in getting older patients on board with remote patient monitoring is the digital divide, as some may lack familiarity or comfort with technology.

“Health care providers can only prescribe treatment, but it is up to the patient and their caregivers to participate and fulfill their responsibility to medication adherence,” Bonza says. “For chronically ill patients, it might be a challenge to adhere to medications, especially patients with memory impairments.”

Additionally, concerns about privacy and data security can make older patients hesitant to embrace these systems.

“It’s crucial to address potential physical and cognitive limitations that may affect their ability to use these devices effectively,” Boldyga says. “To overcome these barriers, it’s important to provide user-friendly technology, robust support and education, and reassurances about data security and privacy.”

To improve adherence in remote patient monitoring, Boldyga recommends health care providers focus on personalized patient engagement, such as tailored reminders and educational content that resonates with individual needs and preferences.

“Simplifying the user interface of devices and apps can significantly enhance usability for all age groups, especially older adults,” he says. “Additionally, incorporating family members or caregivers in the monitoring process can provide extra support and motivation for patients.”

Regular feedback and communication from health care providers, reinforcing the importance of adherence and addressing any concerns, also play a critical role in maintaining patient commitment to their health regimens.

While adoption can be an issue, Bonza doesn’t feel it’s impossible to get older patients on board.

“The patient, their families, and their health care providers should collaborate on making the adoption of the technology work and integrate it to their treatment and care plans,” she says. “It can be daunting to learn technology, and these kind of things have a learning curve. If there is continuous user education and support, the adoption and usage of this tech would be smoother, thus improving patient medication monitoring.”

Just remember, Wall says, ongoing touchpoints with the patients are important, either by phone or in person.

“The benefit of the device is that they do not have to travel to a clinic or medical facility, but the human touch point with a provider team is still important,” she says. “It provides a safety net and the security that someone is paying attention and checking in. Also, it’s important that they are educated appropriately about the device, how it works, and what to expect.”

— Keith Loria is a freelance writer based in Oakton, Virginia.