At Prevounce, our Physician Advisory Board plays a pivotal role in shaping the future of our clinical operations and advancing innovation in remote care management. This esteemed board, consisting of our Clinical Lead Arun Chandra, MD, along with Pranjal Gupta, MD, and Tony Wang, MD, convenes quarterly to assess challenges and identify new opportunities in remote care management. During the most recent session, Dr. Chandra guided a thought-provoking discussion by posing key questions to Dr. Gupta and Dr. Wang. They explored the evolving landscape of remote care management, offering valuable insights into its transformative potential for healthcare.
Dr. Arun Chandra: Remote patient monitoring (RPM) has been discussed as a tool to improve patient outcomes. Can you share specific examples of its success in clinical practice?
Dr. Pranjal Gupta: Absolutely. RPM has proven incredibly effective in specific cases. One example from my practice involved a patient with a wearable device that detected their heart rate spiking to 200 bpm. This young patient presented to the emergency department because of the alert, despite having minimal symptoms. With early intervention, we quickly identified and treated an underlying arrhythmia and prevented further complications. This case underscores how RPM can detect silent conditions and facilitate timely interventions. However, broader adoption is still hindered by a lack of standardized systems for interpreting and acting on wearable data.
Dr. Tony Wang: At my institution, RPM has been utilized in research settings with promising results. For instance, during COVID-19, we monitored post-discharge patients with conditions like COPD and CHF, aiming to reduce readmissions. These trials demonstrated a reduction in readmissions by 4-7%, showing that RPM can play a pivotal role in improving outcomes in vulnerable populations. Despite these successes, we haven’t yet incorporated RPM into routine care at scale. Our focus remains on finding ways to make these programs sustainable and accessible to all patient demographics.
Dr. Chandra: Wearable devices like Apple Watches and Fitbits are becoming more common among patients. How are these being integrated into clinical workflows?
Dr. Gupta: In emergency medicine, wearables like the Apple Watch are already a part of daily practice. For example, patients often bring in data that shows arrhythmias such as atrial fibrillation. This information, particularly the timestamp of onset, is critical for guiding treatment decisions.
That said, we currently treat this data as supplemental rather than central to decision-making. Without seamless integration into EMRs, wearable data relies heavily on patient interpretation. Patients will often show me their fitness app on their phone, and I document what they report. A standardized approach for importing this data into EMRs would greatly enhance its clinical utility.
Dr. Wang: In my practice, wearables like CGMs (continuous glucose monitors) have a much more established role. We frequently use CGMs to monitor glucose levels during surgery, relying on the patient’s own device to guide insulin administration in real-time. However, devices like the Apple Watch are not yet integrated into anesthesiology or critical care workflows. For these to be useful, we’d need standardized ways to analyze trends and act on them. Additionally, as Dr. Gupta mentioned, we must address the challenge of interpreting vast amounts of data without creating unnecessary anxiety for patients or overburdening providers.
Dr. Chandra: Post-discharge care is often a vulnerable period for patients. How can RPM help bridge the gap between hospital and home?
Dr. Gupta: Post-discharge is indeed a critical period, especially for conditions like CHF, pneumonia, or uncontrolled hypertension. One innovative approach involves sending patients home with wearables to monitor vital signs. This helps identify early signs of decompensation, such as hypoxemia or volume overload, which could lead to readmission if not addressed promptly. We also utilize ED follow-up programs, where patients discharged from the ED can have a telehealth check-in within 48-72 hours. This ensures that they are monitored closely during this vulnerable period and can receive timely intervention if needed.
Dr. Wang: In the surgical population, post-discharge RPM could be a game-changer. Many patients, particularly elderly individuals or those recovering from complex surgeries, face significant risks in the days and weeks following discharge. Unfortunately, we don’t yet have widespread protocols for using RPM in this context. That said, some of our high-risk surgical patients, such as those undergoing major cancer surgeries, are already part of structured follow-up programs. Expanding RPM into broader post-operative care could improve outcomes and reduce complications.
Dr. Chandra: How can RPM and telehealth programs support specific patient populations, such as those with obstetric conditions or sepsis?
Dr. Gupta: For obstetric patients, particularly those at risk for preeclampsia, RPM could make a huge difference. At my institution, it’s common practice to send postpartum patients home with blood pressure monitors and clear instructions on when to seek care. These simple interventions help identify complications early. Another area with significant potential is sepsis monitoring. In emergency medicine, we often admit patients with mild infections like pneumonia or UTIs simply because we can’t ensure adequate follow-up. A structured RPM program could monitor vital signs such as heart rate, blood pressure, and temperature, allowing us to discharge low-risk patients with confidence while avoiding unnecessary admissions.
Dr. Wang: I agree. Obstetric patients, especially those with preeclampsia, are an excellent use case for RPM. In my practice, postpartum patients with preeclampsia are sent home with blood pressure cuffs and instructed to monitor their readings. While this isn’t a high-tech solution, it’s effective. For sepsis monitoring, I’m more cautious. While the concept of outpatient sepsis management through RPM is promising, it requires very careful patient selection. Patients with a history of rapid deterioration may not be suitable candidates, as sepsis can progress quickly and unpredictably. Nonetheless, for well-defined, low-risk populations, this could be a valuable tool.
Dr. Chandra: What are some challenges you foresee in scaling RPM and CCM programs?
Dr. Gupta: One major challenge is filtering meaningful signals from the noise. Wearables and RPM devices generate an enormous amount of data, much of which may not be clinically significant. Without proper protocols, this can lead to provider fatigue and patient anxiety. Additionally, equity is a significant concern. Not all patient populations have equal access to these technologies, and we risk exacerbating existing healthcare disparities. For example, affluent patients may benefit disproportionately from RPM programs, while underserved populations are left behind.
Dr. Wang: I’ll add that integration into existing workflows is another hurdle. Many wearables don’t feed directly into EMRs, making it cumbersome for providers to act on the data. Addressing these technical barriers is essential for broader adoption. Finally, there’s the ethical concern of ensuring that RPM doesn’t become a substitute for high-quality in-person care. While RPM has the potential to enhance care, it should complement — not replace — traditional models.
Final Thoughts From the Physician Advisory Board
The Prevounce Physician Advisory Board brings together diverse perspectives on remote care management, highlighting both their transformative potential and the challenges ahead. By addressing issues like data integration, patient anxiety, and equitable access, remote care management programs can become vital tools in improving outcomes across a range of patient populations.
Offering Remote Patient Monitoring Devices to Patients
If you are interested in offering remote patient monitoring services to your patients, speak to the RPM experts at Prevounce. Prevounce offers comprehensive cloud software, the Pylo line of cellular-connected devices, and expert services that simplify the provision of remote patient monitoring, chronic care management, preventive care, and annual wellness visits. The Prevounce remote patient monitoring system supports new and existing RPM programs, helping organizations collect and interpret pertinent patient data and achieve timely, compliant RPM coding, billing, and documentation.
When you book a consultation with Prevounce, one of the leading remote patient monitoring companies in the country, you’ll speak with one of our specialists who will answer the questions you have about RPM and help you determine what RPM devices are right for your organization and patients.
If you're at a stage where you're looking to learn more about remote patient monitoring and how to develop a successful RPM program, we recommend downloading this comprehensive guide.