The use of telemedicine and telehealth, fueled by the pandemic, are quickly solidifying its place as a permanent facet of modern healthcare. Within telehealth, some of the most positive — and exciting — developments are occurring with the use of remote patient monitoring (RPM). The expanding usage of RPM, also referred to as remote physiological monitoring, is improving patient health outcomes, reducing the overall cost of healthcare, and improving the quality of life for many patients with chronic diseases. One of the most beneficial uses of RPM is for those suffering from heart failure. Outpatient care techniques that leverage home monitoring for heart failure management are proactively working to reduce the rates of acute exacerbation, keeping heart failure patients out of the hospital and healthier for longer than ever before.
Cardiovascular diseases like congestive heart failure (CHF) are a growing problem that places a big strain on the U.S. healthcare system, both logistically and financially. As one of the most expensive chronic diseases to treat, heart failure interventions are estimated to cost the United States over $30 billion annually. A 2018 study published by the National Center for Biotechnology Information identified cardiovascular disease as the leading cause of hospitalization in the United States and accounted for nearly one in three deaths. Furthermore, the Centers for Disease Control and Prevention found that more than 6 million adults in the United States suffer from heart failure, leading to a staggering 380,000 deaths per year.
Remote Patient Monitoring and Heart Failure
The broader concept of remote patient monitoring is a form of telehealth that uses technology to facilitate an exchange of physiological measurements from the patient to the care team and practitioner. This information is typically transmitted with either a cellular-connected or Bluetooth device and can be done so as needed or on a scheduled basis. Depending upon the type of information captured and transmitted, the healthcare team can evaluate the patient's current health status and make quick decisions regarding the type of care the patient may need. For patients with heart failure, CHF telehealth monitoring can help the patient's healthcare team identify and quickly react to small changes in the patient's health status that might otherwise lead to an acute or emergent issue.
More specifically, acute exacerbations of heart failure can be mitigated preemptively with the use of remote patient monitoring. A standard heart monitor can keep close tabs on heart rhythm, while other connected monitoring devices for heart failure management include scales to monitor fluid retention and blood pressure cuffs to monitor changes or fluctuations in the patient's blood pressure, both of which can help detect early indicators of trouble for someone with heart failure. Remote patient monitoring devices can also provide data for sound decision-making concerning medication titration and management, allowing practitioners to react swiftly to patient health status changes without requiring an office visit and before the patient may need an emergency room visit.
Home monitoring for heart failure management can be a game-changer for patients and practitioners alike. Aside from the potential for increasingly positive health outcomes, a remote patient monitoring system for congestive heart failure can help patients stay in their home environment, causing minimal interruption to their lives and keeping them comfortable and within their normal daily routines.
The use of congestive heart failure remote patient monitoring also means that the patient can stay better connected and engaged with their healthcare team. By transmitting pertinent information in real time, this leads to quicker and more effective responses or modifications when emergencies arise. In addition, time spent within RPM coordinating with patients helps better inform them about their conditions, engage them in their care, and educate them about red flags they personally can watch for.
Evaluating the Evidence: Remote Patient Monitoring Systems for Congestive Heart Failure
Published guidance from the American Heart Association supports the use of remote patient monitoring for patients with cardiovascular diseases. The AHA determined that the technologies used for remote patient monitoring contribute to better cardiovascular disease outcomes and concluded that RPM is a cost-effective and value-enhancing solution.
Among hypertensive patients, it was found that remote patient monitoring can help effectively control and reduce the symptoms associated with high blood pressure. The most common RPM connected device used for patients with hypertension is a blood pressure monitoring device. One area where RPM greatly shines concerning hypertension is CHF. As an UpToDate article notes, “Hypertension is the most prevalent modifiable risk factor for the development of heart failure.” Various studies have shown that congestive heart failure patients monitored via an RPM device are less likely to have their readings fall outside what is determined to be their healthy range. RPM can also serve to guide practitioners in making data-driven decisions to help better regulate CHF readings.
Weight monitoring as an analogue for monitoring fluid retention is another area that RPM has great potential to benefit CHF patients. The relatively new availability of affordable and accurate connected weight scales has resulted in an increase in the number of studies being performed to assess the efficacy of weight monitoring. A sudden small increase in weight for CHF patients may be an early warning of a worsening condition that could lead to major health complications or death. As such, there is a lot of excitement about using RPM and analytics to detect these small fluctuations in weight even when the patient might not notice. There is no lack of anecdotes about CHF patients who saved a trip to the hospital (or worse) due to weight monitoring RPM. The general feeling is that the pending RPM studies will bear this out.
In addition to the condition-specific benefits, intervention with remote patient monitoring also helps to create lasting, positive effects through the encouragement and reinforcement of lifestyle changes as well as timely modifications to medication, thus creating a longer-lasting impact on overall health.
Another study published in Science Daily confirmed that home monitoring of blood pressure does indeed result in better blood pressure control in hypertensive patients. The study also pointed out the cost-effectiveness of cardiovascular remote patient monitoring, citing that the technology for the average participant costs only a little more than $38. When coupled with prevented costly interventions and hospital emergency room visits or admissions, the utilization of RPM technology is effective in providing optimal patient care while reducing healthcare spending.
While the AHA study found that more research is needed to be conducted among patients with a diagnosis of heart failure, early conclusions suggest that remote patient monitoring can help improve patient health outcomes when compared to the typical and standard course of outpatient care. Overall, RPM for heart failure patients has been shown to decrease the number of heart failure-related hospital admissions and emergency room visits.
With the aforementioned $30 billion-plus being spent to treat heart failure patients annually, it's more important than ever to find creative solutions to keep patients crisis-free for as long as possible. Since remote patient monitoring provides a real-time connection with the healthcare team through the usage of smart technology and in a cost-effective manner, it can help save both lives and money.
RPM is a fairly new service, which is why we are seeing it undergo ongoing — and, at times, significant — regulatory changes. At Prevounce, we pride ourselves on remaining current with compliance to help ensure our RPM clients never need to worry about our remote patient monitoring system failing to meet evolving requirements. As CMS announces changes to RPM, whether they are proposed or final, we will be analyzing them on this blog and in webinars. Follow Prevounce on LinkedIn and Twitter to be sure you never miss our coverage.