Remote Patient Monitoring: Improving Chronic Disease Management 

Remote Patient Monitoring: Improving Chronic Disease Management 

by Ree AI Health Tech Med Tech

Chronic diseases affect millions worldwide, placing a significant burden on healthcare systems. The World Health Organization reports that chronic diseases account for 74% of all deaths globally. One of the most promising methods of chronic disease management is remote patient monitoring (RPM). Let’s explore how RPM helps people with chronic disease have a better quality of life.

Contents

What is Remote Patient Monitoring?

RPM is a healthcare delivery method that uses technology to collect patient data outside of traditional healthcare settings. But what exactly does this mean for patients and healthcare providers?

Definition of remote patient monitoring

RPM involves using digital technologies to gather and transmit health data from patients to healthcare providers. This allows for continuous monitoring of a patient’s health status without the need for frequent in-person visits.

Key components of RPM systems

ECG monitor closeup on stomach

A typical RPM system consists of several essential components:

  1. Sensing devices: These collect patient data such as blood pressure, heart rate, or blood glucose levels.

  2. Data transmission: The collected data is sent securely to healthcare providers.

  3. Data analysis: Healthcare professionals review and interpret the data.

  4. Patient interface: Patients can view their data and receive feedback through apps or web portals.

  5. Alert systems: Automated alerts notify healthcare providers of any concerning changes in a patient’s condition (Peyroteo et al., 2021).

Types of data collected through RPM

RPM systems can collect various kinds of health data, including:

This comprehensive data collection allows healthcare providers to gain a more complete picture of a patient’s health over time.

Common Chronic Diseases Managed with RPM

RPM is effective in managing many kinds of chronic conditions. Let’s look at some of the most common diseases that benefit from RPM.

Heart disease, CHF, and hypertension

RPM plays a crucial role in cardiovascular disease management, including heart disease, chronic heart failure (CHF), and hypertension (Zhang, et al., 2023). 

Patients can regularly monitor their blood pressure, heart rate, and other vital signs at home. This continuous monitoring helps healthcare providers to adjust medications and interventions as needed, which may prevent heart attacks and strokes.

Diabetes

Woman sticking herself with insulin needle

For patients with diabetes, RPM can be a game-changer. Continuous glucose monitoring systems allow for real-time tracking of blood sugar levels, helping patients and healthcare providers make informed decisions about insulin dosing and lifestyle changes. Studies have shown that RPM can lead to significant improvements in HbA1c levels, a key indicator of long-term blood sugar control.

Chronic kidney disease (CKD)

Woman on dialysis machine

RPM is becoming increasingly important in kidney care by using technology to support patients who need renal replacement therapy (RRT). 

RPM can improve patient outcomes, reduce hospital stays, and enhance treatment adherence. It also saves time and money for both patients and healthcare providers. A care plan for chronic kidney disease that includes RPM can help with patient education, CKD self-management, and home dialysis care. They can increase patient independence and improve their quality of life (Mata-Lima, 2024).

Asthma

Boy in bed using inhaler

For asthma patients, RPM can help track symptoms, medication use, and lung function. This information allows healthcare providers to adjust treatment plans and identify triggers, leading to better asthma control. A review of RPM interventions for asthma found improvements in quality of life and reductions in emergency department visits.

Chronic obstructive pulmonary disease (COPD)

COPD patients can benefit greatly from RPM. When health providers monitor oxygen levels, lung function, and symptoms, they can detect exacerbations early and intervene before hospitalization becomes necessary.

 

Anemia

Anemia, a condition characterized by a deficiency of red blood cells or hemoglobin, affects millions worldwide. It can lead to fatigue, weakness, and other health complications. RPM can helps manage anemia in many ways:

  • Early Detection: RPM can help detect anemia-related complications early by collecting data on patients’ blood oxygen levels and other indicators. This allows for timely interventions, reducing the risk of severe health issues.

Now let’s look at specific benefits of using RPM to manage chronic conditions.

Benefits of RPM for Chronic Disease Management

Implementing RPM in chronic disease management has several advantages for both patients and healthcare systems. 

Early detection of health issues

One of the most significant advantages of RPM is its ability to detect potential health issues early. By continuously monitoring patient data, healthcare providers can identify concerning trends or sudden changes before they become serious problems. This proactive approach can lead to timely interventions and prevent complications (Peyroteo et al., 2021).

Improved medication adherence

Medication adherence is crucial for managing chronic diseases effectively. RPM systems often include medication reminders and tracking features, which can significantly improve adherence rates. A review of multiple studies found that RPM interventions increased medication adherence by an average of 22%.

Better patient engagement and self-management

Man taking pulse oximeter reading

RPM empowers patients to take an active role in managing their health. A real-world use study reported RPM helps better adherence to CHF treatment regimens (Patrick et al., 2023). And RPM adherence is associated with better patient outcomes (Sabatier et al., 2022).

By providing real-time feedback and educational resources, these systems help patients better understand their conditions and make informed decisions about their care. This increased engagement can lead to improved health outcomes and quality of life for those living with chronic diseases (Peyroteo et al., 2021).

Reduced hospital readmissions

ER and urgent care entrance

RPM has shown promising results in reducing hospital readmissions for patients with chronic conditions. 

A study published in the Journal of Medical Internet Research found that RPM reduced 30-day hospital readmissions by 76% for patients with heart failure (Bashi et al., 2017). And another study showed a reduction in hospitalizations in chronic obstructive pulmonary disease (COPD) patients using RPM (Polsky et al., 2023).

Fewer trips back to the hospital improves patient outcomes and helps reduce healthcare costs.

Cost savings and effectiveness

Noninvasive RPM can be cost-effective compared to traditional methods for managing chronic disease (De Guzman et al., 2022).

RPM requires an initial investment in equipment and training. But over the long run, it can reduce healthcare costs long-term by preventing expensive health events like hospital readmissions, although those savings may take time to manifest. Technology advances may lower costs over time.

The level of cost-effectiveness also varies by disease and context. Studies on hypertension, COPD, and heart failure show the highest benefits for hypertension. Effectiveness depends on patient targeting and integration into existing healthcare systems. Local factors and clinical settings influence RPM’s cost-effectiveness, which emphasizes the need for tailored implementation plans.

RPM Technologies and Devices

The success of remote patient monitoring relies heavily on the technologies and devices used to collect and transmit patient data. Let’s explore some of the key tools in the RPM arsenal.

Wearable devices and sensors

Black woman smiling at phone with glucose meter on arm

Wearable technology has come a long way in recent years. These devices can now track a wide range of health metrics, including:

Many of these devices are designed to be comfortable and discreet, allowing for continuous monitoring without disrupting daily life.

Mobile health apps

Mobile health apps serve as the interface between patients and their health data. These apps often provide:

  • Data visualization and trends

  • Medication reminders

  • Educational resources

  • Communication tools for connecting with healthcare providers

The user-friendly nature of these apps makes it easier for patients to stay engaged with their health management.

Home-based monitoring equipment

Black man using his blood pressure monitor at home

For more specialized monitoring, home-based equipment can provide detailed health information. This may include:

These devices are designed to be easy to use, allowing patients to take accurate measurements at home.

Data transmission and analysis platforms

The backbone of any RPM system is the platform that receives, stores, and analyzes patient data. These platforms use secure cloud-based systems to:

  • Aggregate data from multiple sources

  • Apply algorithms to detect patterns and anomalies

  • Generate alerts for healthcare providers

  • Provide detailed reports for clinical decision-making

How to Implement RPM in a Healthcare Setting

While the benefits of RPM are clear, implementing these systems in healthcare settings can be challenging. Here are some key considerations for successful RPM implementation.

Choose the right RPM solution

Selecting an appropriate RPM solution is crucial for success. Healthcare providers should consider:

  • The specific needs of their patient population

  • Integration capabilities with existing electronic health record systems

  • User-friendliness for both patients and healthcare staff

  • Scalability to accommodate future growth

It’s important to evaluate multiple options and pilot test solutions before full implementation.

Train healthcare providers and patients

Nurse going over a chart with patient

Proper training is essential for both healthcare providers and patients to ensure effective use of RPM systems. This may include:

  • Hands-on training sessions for healthcare staff

  • Patient education materials and support resources

  • Ongoing technical support for troubleshooting issues

Investing in comprehensive training can significantly improve adoption rates and overall success of RPM programs.

Integrate RPM with existing health IT systems

Seamless integration with existing health information technology systems is crucial for success with RPM, which allows for:

  • Automatic data transfer to electronic health records

  • Streamlined workflow for healthcare providers

  • Comprehensive patient health profiles

A smooth integration takes a collaborative effort between IT teams, RPM vendors, and healthcare staff.

Address privacy and security concerns

As with any system handling sensitive health information, privacy and security are paramount in RPM. Healthcare organizations must:

  • Implement robust data encryption measures

  • Ensure compliance with HIPAA and other relevant regulations

  • Regularly audit and update security protocols

  • Educate patients on best practices for protecting their health data

Overcoming Challenges in RPM Adoption

While RPM offers numerous benefits, there are several challenges that healthcare organizations must address for successful adoption.

Man holding Medicare card

Reimbursement and insurance coverage

One of the primary barriers to RPM adoption has been uncertainty around reimbursement. However, recent changes in healthcare policies have improved the situation:

  • Medicare now provides reimbursement for certain RPM services

  • Many private insurers are following suit because they understand the cost-saving potential of RPM

Healthcare providers should stay informed about evolving reimbursement policies and advocate for expanded coverage.

Patient compliance and technology acceptance

Glucose meter on hand with a blood drop

For RPM to be effective, patients must consistently use the provided monitoring devices and follow recommended protocols. Strategies to improve compliance include:

  • Selecting user-friendly devices and apps

  • Providing ongoing patient education and support

  • Using motivational techniques, such as gamification or reward programs

  • Tailoring RPM programs to individual patient needs and preferences

Data management and interpretation

The large volume of data generated by RPM systems can be overwhelming for healthcare providers. To address this challenge:

  • Implement robust data analytics tools to identify meaningful trends and anomalies

  • Provide training for healthcare staff on data interpretation

  • Develop clear protocols for responding to alerts and abnormal readings

  • Consider incorporating artificial intelligence to assist with data analysis

As RPM technology evolves, regulatory frameworks are struggling to keep pace. Healthcare organizations must navigate:

  • Evolving FDA regulations for medical devices and software

  • State-specific telemedicine laws and licensing requirements

  • International considerations for cross-border remote care

Staying informed about regulatory changes and working with legal experts can help organizations navigate these complex issues.

The Future of RPM in Chronic Disease Management

As technology continues to advance, the future of RPM in chronic disease management looks promising. Here are some exciting developments on the horizon.

Artificial intelligence and machine learning integration

AI and machine learning take RPM to the next level as they can:

Expansion of RPM to new disease areas

While RPM has proven effective for common chronic conditions, we’re likely to see its application expand to other areas, such as:

  • Mental health monitoring

  • Neurological conditions like Parkinson’s disease

  • Post-surgical recovery and rehabilitation

  • Rare diseases that require specialized monitoring

Potential for population health management

People around a globe

RPM data, when aggregated and analyzed at a population level, can provide valuable insights for public health initiatives. This could lead to:

  • More targeted health interventions

  • Improved resource allocation in healthcare systems

  • Better understanding of disease trends and risk factors

  • Enhanced ability to respond to public health crises

Evolving healthcare policies and regulations

As RPM becomes more widespread, we can expect to see:

  • Continued expansion of reimbursement policies

  • Development of standardized guidelines for RPM implementation

  • Increased focus on interoperability standards for health data exchange

  • Greater emphasis on patient data ownership and privacy rights

Conclusion 

RPM offers a proactive approach to chronic disease management that benefits both patients and providers. By enabling continuous, real-time health tracking and timely interventions, RPM can significantly improve patient outcomes, reduce healthcare costs, and enhance the quality of life for those living with chronic conditions.

As technology continues to advance and healthcare systems adapt, the role of RPM in chronic disease management will likely expand, paving the way for more personalized and efficient healthcare delivery. Embracing this innovative approach can lead to a healthier future for millions of people worldwide.

References

Bashi, N., Karunanithi, M., Fatehi, F., Ding, H., & Walters, D. (2017). Remote Monitoring of Patients With Heart Failure: An Overview of Systematic Reviews. Journal of Medical Internet Research; 19(1). doi.org/10.2196/jmir.6571

Centellas-Pérez, F. J., Ortega-Cerrato, A., et al. (2023). Impact of Remote Monitoring on Standardized Outcomes in Nephrology-Peritoneal Dialysis. Clinical Research; 9(2),266-276. doi.org/10.1016/j.ekir.2023.10.034

De Guzman, K. R., Snoswell, C. L., Taylor, M. L., Gray, L. C., & Caffery, L. J. (2022). Economic Evaluations of Remote Patient Monitoring for Chronic Disease: A Systematic Review. Value in Health; 25(6), 897-913. doi.org/10.1016/j.jval.2021.12.001

Fakunle, A. (2022). The Future of Healthcare: How Remote Patient Monitoring Transforms Healthcare. Cleverdev Software. Retrieved from https://www.cleverdevsoftware.com/blog/the-future-of-healthcare

Mata-Lima, A., Paquete, A. R., & Serrano-Olmedo, J. J. (2024). Remote patient monitoring and management in nephrology: A systematic review. Nefrología. doi.org/10.1016/j.nefro.2024.01.005

Noncommunicable diseases. (2023). World Health Orgination (WHO). Retrieved from https://www.who.int/news-room/fact-sheets/detail/noncommunicable-diseases

Patrick, J., Picard, F., Girerd, N., et al. (2023). Security and performance of remote patient monitoring for chronic heart failure with Satelia® Cardio: first results from real-world use. Journal of Cardiology and Cardiovascular Medicine; 8:042–50. doi:10.29328/journal.jccm.1001152

Peyroteo, M., Ferreira, I. A., Elvas, L. B., Ferreira, J. C., & Lapão, L. V. (2021). Remote Monitoring Systems for Patients With Chronic Diseases in Primary Health Care: Systematic Review. JMIR MHealth and UHealth; 9(12). doi.org/10.2196/28285

Polsky, M., Moraveji, N., Hendricks, A., Teresi, R. K., Murray, R., & Maselli D. J. (2023). Use of Remote Cardiorespiratory Monitoring is Associated with a Reduction in Hospitalizations for Subjects with COPD. International Journal of Chronic Obstructive Pulmonary Disease; 18:219-229. doi.org/10.2147/COPD.S388049

Sabatier, R., Legallois, D., Jodar, M., et al. (2022). Impact of patient engagement in a French telemonitoring programme for heart failure on hospitalization and mortality. ESC Heart Failure; 9(5):2886–2898. doi:10.1002/ehf2.13978

Telehealth Interventions to Improve Chronic Disease. (2024). Centers for Disease Control and Prevention (CDC). Retrieved from https://www.cdc.gov/cardiovascular-resources/php/data-research/telehealth.html

Zhang, Y., Peña, M. T., Fletcher, L. M., Lal, L., Swint, J. M., & Reneker, J. C. (2023). Economic evaluation and costs of remote patient monitoring for cardiovascular disease in the United States: a systematic review. International Journal of Technology Assessment in Health Care;39(1):e25. doi:10.1017/S0266462323000156

Telehealth for Rural Areas: Bridging the Healthcare Gap

Telehealth for Rural Areas: Bridging the Healthcare Gap

by Ree AI Health Tech

In the vast expanses of rural America, access to quality healthcare has long been a challenge. But telehealth can be a digital lifeline for these communities. According to the American Hospital Association, 76% of U.S. hospitals connect with patients through video and other technology. This underscores the growing importance of telehealth for rural areas where medical facilities are often few and far between. 

Let’s explore how this technology is making waves in rural healthcare, its benefits, challenges, and what the future holds.

Contents

Benefits of Telehealth for Rural Residents

Telehealth is changing healthcare delivery, particularly in rural areas where access to medical services can be limited. 

A man hitchhiking from a farm

In a survey of 202 adults living in a rural area, 88% of them were open to telehealth. When asked about barriers to show up for doctor appointments or receiving adequate healthcare, they cited several reasons (Kolluri et al., 2022):

  • The wait to see the doctor is too long – 32.7%

  • Too expensive – 24.8%

  • Lack of transportation – 22.8%

  • Schedule conflicts – 22.8%

  • Not sick – 15.8%

  • Distrust the quality of healthcare – 13.9%

  • Other – 4.5% (“My insurance isn’t accepted for at least 100 miles.”)

With this data, we can clearly see how telehealth can positively impact rural patients. Here are some specific benefits.

Better access to doctors with reduced travel

For many rural residents, visiting a doctor means traveling long distances, which can be costly and time-consuming. Finding a specialist is also challenging due to limited availability. 

Telehealth bridges this gap by connecting patients with specialists through video visits and online consultations, which eliminates the need for long travel (Butzner & Cuffee, 2021). Patients who receive care from the comfort of their homes save on transportation costs and reduce the need to take time off from work.

Faster access to care in emergencies

Tele-emergency services provide real-time access to emergency medicine physicians, allowing rural healthcare providers to manage emergencies more effectively (Rural Health Information Hub, 2024). This quick access can be crucial in life-threatening situations.

Increased continuity of care for chronic conditions

Black woman gold top showing phone with glucose meter on arm

Chronic disease management is vital for improving patient outcomes. Telehealth enables continuous monitoring and follow-up care, ensuring that patients with chronic conditions receive consistent and timely interventions.

Improved patient engagement and health outcomes

Telehealth encourages patients to take an active role in their healthcare. With tools like remote monitoring and mobile health apps, patients can track their health metrics and communicate with healthcare providers more frequently, leading to better health outcomes.

These benefits highlight how telehealth is making healthcare more accessible and effective for rural patients. However, implementing telehealth in these areas comes with its own set of challenges.

Success Stories: Rural Telehealth in Action

Many rural communities have successfully implemented telehealth programs with success stories to celebrate. Here are a few.

Effective telehealth programs 

Project ECHO®

Programs like Project ECHO® have connected rural healthcare providers with specialists, allowing for better management of complex cases (Rural Health Information Hub, 2024). These kinds of programs show the potential of telehealth to improve healthcare delivery in rural communities.

Hybrid healthcare in the South

Woman getting a shot in her arm

East Carolina University (ECU) developed a hybrid healthcare program to improve health outcomes for rural residents in that area. A nurse visits patients at home and connects them virtually with providers at health centers. 

This program allows patients to access various healthcare services, including consultations with pharmacists, while the nurse assesses their needs. The program has proven beneficial, as illustrated by a bed-bound diabetes patient who, after joining, received comprehensive care and reduced hospital visits. 

This hybrid approach combines telehealth with in-person visits to address barriers faced by rural patients, such as long travel distances to healthcare facilities. It also allows the clinical team to collaborative and address patients’ health issues, making them more discoverable and actionable. 

Mobile clinic for substance abuse in the Mid-Atlantic

Wide top white van driving down street

The University of Maryland (UMD) launched a telehealth program to address the shortage of healthcare providers for opioid use disorder (OUD) in rural areas, particularly after a care center in western Maryland lost its OUD provider. They partnered with health departments and secured funding from the Health Resources and Services Administration (HRSA) to set up mobile clinics equipped with vans and computers. 

These clinics, staffed by a counselor, nurse, and peer recovery specialist, park in central locations to provide care. Telehealth plays a crucial role in expanding access to OUD treatment. This initiative has successfully served hundreds of people, reaching individuals who otherwise might not have access to treatment.

Emergency care access in rural hospitals in the Midwest

Two ambulances in front of Emergency entrance to hospital

In rural areas, residents face higher risks of death from accidents and strokes. Telehealth allows specially trained providers to assist rural hospital staff in delivering prompt emergency care, which is crucial for improving outcomes. 

One such case study comes from Sanford Health, which uses telehealth to improve emergency care access in rural hospitals across South Dakota, North Dakota, and Minnesota. Their program connects 32 rural emergency service locations to specialists through a virtual care hub. This hub allows rural staff to quickly consult with specialists on treating strokes, burns, and other traumas. 

The program’s success relies on technology, including two large monitors that allow specialists to access patient information from multiple sources simultaneously. 

Impact on local healthcare providers and clinics 

Telehealth allows rural clinics to offer a broader range of services, reducing the need for patient transfers and hospital bypasses. There can be caveats to this, but telehealth can improve the viability of rural healthcare facilities and helped retain healthcare providers in these areas. 

Economic benefits for rural communities 

Implementing telehealth can lead to economic benefits such as reduced patient transportation costs, increased local pharmacy revenues, and decreased hospital staffing costs.

These success stories illustrate the transformative impact telehealth can have on rural healthcare, providing a model for future initiatives.

While telehealth often leads to positive outcomes, its implementation in rural areas is not without obstacles.

Challenges in Implementing Rural Telehealth

Despite its advantages, telehealth implementation in rural areas faces several hurdles. Understanding these challenges is crucial for developing effective solutions.

Telehealth access for people experiencing homelessness

Man in homeless shelter

Federally Qualified Health Centers (FQHCs) serve vulnerable, unhoused, and underinsured people in the U.S. 

During the COVID-19 pandemic, FQHCs set up telehealth in shelters and community organizations, used vans for mobile telehealth services, and gave smartphones and tablets to shelters to connect unhoused patients with primary care doctors and specialists. 

However, challenges remain, like unreliable phone and internet service. Post-pandemic, many unhoused patients still rely on phone visits instead of video visits (Azar et al, 2024).

Limited broadband internet access

Reliable internet is essential for telehealth services. Unfortunately, many rural areas lack the necessary broadband infrastructure, which can hinder the delivery of telehealth services.

Technology literacy and adoption among older populations

Older adults may struggle with using new technologies, which can limit their ability to benefit from telehealth services. Providing education and support is necessary to increase technology adoption among this demographic (Gurupur & Miao, 2022).

Regulatory and licensing inconsistencies

Telehealth often involves providing services across state lines, since technology allows for worldwide connections. This can lead to regulatory and licensing challenges. The requirements vary by state, which complicates the process for healthcare providers (Gurupur & Miao, 2022).

Reimbursement and insurance coverage complexities

Doctor on the phone

Insurance coverage for telehealth also varies, as some providers don’t reimburse certain types of care. For example, each state has different rules and regulations about the types of services that can be reimbursed by Medicaid. This inconsistency discourages some healthcare providers from offering telehealth services.

Privacy and security concerns in digital health platforms 

Protecting patient data is a top priority in telehealth. Ensuring that digital health platforms comply with privacy regulations like HIPAA is essential to maintain patient trust.

Language barriers

In a study by UC Davis in Sacramento with The University of Queensland in Brisbane, providers had mixed experiences with interpreter services during telehealth visits. Some found it challenging to use interpreters effectively through their clinic’s telehealth platform. In some cases, non-English speaking patients were asked to come to the clinic in person instead of using telehealth. One provider mentioned relying on family members for translation, but this wasn’t always possible (Azar et al, 2024). 

On the other hand, many providers said they could meet the needs of non-English speaking patients using available interpreter services. Some clinics had smooth workflows for integrating interpreters into telehealth visits, while others were still working on finding good solutions to this issue (Azar et al, 2024).

Addressing these challenges requires collaboration between policymakers, healthcare providers, and technology companies. By overcoming these obstacles, telehealth can become a more integral part of rural healthcare.

The Future of Telehealth in Rural Healthcare

Lin et al (2018) found that health centers located in rural areas were associated with a 10-percentage-point increase in the probability of telehealth use, and 12.2 percentage points more likely to use telehealth for mental health care, compared to those in urban areas. 

Several years later, technology continues to improve, and telehealth plays an even more important role in providing healthcare to people in rural communities. Here are some trends and developments to watch.

Emerging technologies enhancing telehealth capabilities 

Innovations like wearable devices and artificial intelligence (AI) are expanding the possibilities of telehealth. These technologies provide more comprehensive monitoring and personalized care.

Policy changes and initiatives regarding rural telehealth 

Governments and organizations recognize the importance of telehealth in rural areas. However, telehealth in those communities can negatively impact their local healthcare access, and several federal waivers are set to expire soon. 

Rural vs. urban healthcare systems

Empty winding road

A study by the University of Tennesee at Knoxville found that rural hospitals often lose patients to urban hospitals offering telehealth services. This shift results in financial strain for rural hospitals, affecting their investment choices and capital structure. As a result, some rural hospitals may have to cut back on staff, including doctors and nurses, or even close down intensive care units. And in extreme cases, this can lead to bankruptcy. 

These financial challenges arise because rural hospitals lose revenue when patients opt for telehealth services from urban providers. This situation is worsened because rural hospitals typically face higher financial risks. 

Policymakers and patients should consider these long-term financial impacts when using telehealth services, as they can have unintended negative consequences for rural healthcare providers. Initiatives aimed at expanding broadband access and simplifying regulatory processes are crucial for the continued growth of telehealth.

Federal waiver expirations

At the end of 2024, six federal waivers and provisions will end  unless the U.S. government takes further action:

  • Site Waivers: Temporary Medicare changes, including geographic and site flexibilities, are set to expire, which affects FQHCs and Rural Health Clinics (RHCs).

  • In-Person Follow-Ups for Mental Telehealth: A waiver that removes the need for an in-person visit within six months of an initial telemental health visit is expiring.
  • HSA Safe Harbor: Laws that allow high-deductible health plans to cover telehealth services without affecting health savings accounts is ending.
  • Controlled Substance Prescribing: The temporary Drug Enforcement Administration (DEA) guidelines that allow telehealth providers to prescribe controlled substances without an in-person visit are set to expire.
  • Provider Privacy: Medicare telehealth providers currently have privacy regarding their location on claim forms, but this may change.
  • Acute Hospital Care at Home: A waiver that allows remote patient monitoring by eliminating the need for 24/7 on-site nursing is expiring.

Integration with other healthcare services and systems

Telehealth is becoming more integrated with traditional healthcare services, offering a seamless experience for patients. This integration can improve care coordination and ensure that telehealth complements in-person care effectively.

Potential for addressing healthcare disparities

Asian woman looking at phone in disgust

Telehealth has the potential to reduce healthcare disparities by providing equitable access to care for underserved populations. By making healthcare more accessible, telehealth can help address some of the systemic issues contributing to health disparities.

Conclusion

Quality healthcare should be equitable and available for everyone, regardless of their zip code. Telehealth can be a powerful tool to address the healthcare needs of rural communities. By breaking down geographical barriers, it’s bringing quality care to those who need it most. 

As technology advances and policies adapt, there are many opportunities for telehealth to further improve rural healthcare. By continuing to innovate and address existing challenges, telehealth can become a cornerstone of rural healthcare delivery.

Whether you’re a patient, provider, or policymaker, embracing telehealth could be the key to ensuring that everyone, regardless of location, has access to the care they deserve. The future of rural healthcare is here, and it’s digital. Are you ready to connect?

References

Azar, R., Chan, R., Sarkisian, M., Burns, R. D., Marcin, J. P. , Gotthardt, C. De Guzman, K. R., Rosenthal, J. L., & Haynes, S. C. (2024). Adapting telehealth to address health equity: Perspectives of primary care providers across the United States. Journal of Telemedicine and Telecare; 1-7. doi:10.1177/1357633X241238780

Butzner, M., & Cuffee, Y. (2021). Telehealth Interventions and Outcomes Across Rural Communities in the United States: Narrative Review. Journal of Medical Internet Research; 23(8). doi.org/10.2196/29575

Expanding access to emergency care in rural hospitals. (2024). Health Resources and Services Administration (HRSA). Retrieved from https://telehealth.hhs.gov/community-stories/expanding-access-emergency-care-rural-hospitals

Gurupur, V. P., & Miao, Z. (2022). A brief analysis of challenges in implementing telehealth in a rural setting. MHealth; 8. doi.org/10.21037/mhealth-21-38

Home-based, hybrid health care in rural communities. (2024). Health Resources and Services Administration (HRSA). Retrieved from https://telehealth.hhs.gov/community-stories/home-based-hybrid-health-care-rural-communities

Kolluri, S., Stead, T. S., Mangal, R. K., Littell, J., & Ganti, L. (2022). Telehealth in Response to the Rural Health Disparity. Health Psychology Research; 10(3). doi.org/10.52965/001c.37445

Lin, C. C., Dievler, A. , Robbins, C., Sripipatana, A., Quinn, M. & Nair, S. (2018). Telehealth in Health Centers: Key Adoption Factors, Barriers, and Opportunities. Retrieved from 

https://www.healthaffairs.org/doi/10.1377/hlthaff.2018.05125

Mobile clinics for substance use disorder. (2024). Health Resources and Services Administration (HRSA). Retrieved from https://telehealth.hhs.gov/community-stories/mobile-clinics-substance-use-disorder

Stewart, H. (2024). Telehealth trends in 2024: Converging challenges on the virtual care frontier. CHG Healthcare. Retrieved from https://chghealthcare.com/blog/telehealth-trends

Telehealth and Health Information Technology in Rural Healthcare. (2024). Rural Health Information Hub. Retrieved from https://www.ruralhealthinfo.org/topics/telehealth-health-it

Telemedicine usage can have unexpected impact on rural communities’ access to local care. (2024). News Medical. Retrieved from https://www.news-medical.net/news/20240801/Telemedicine-usage-can-have-unexpected-impact-on-rural-communities-access-to-local-care.aspx

The Key Benefits of Telehealth in Rural Areas. (n.d.). Health Recovery Solutions. Retrieved from https://www.healthrecoverysolutions.com/blog/the-key-benefits-of-telehealth-in-rural-areas

How to Set Up a Home Health Monitoring Station: The Ultimate Guide

How to Set Up a Home Health Monitoring Station: The Ultimate Guide

by Ree Health Tech Med Tech

Home health monitoring wearables to track blood pressure, heart rate and sleep are popular.  A 2022 AnalyticsIQ study of 8,000 Americans showed that we’ve doubled our use of wearable health devices between 2020 and 2021. Almost half of the respondents used at least one type of wearable tech, and Black, Latinx, male, and Gen X respondents used it the most.

This surge in popularity is no surprise, as home health monitoring empowers people to take control of their well-being from the comfort of their own homes. 

In this guide, we’ll walk you through the essentials of setting up a home health monitoring system. 

Contents

Let’s start with the fundamentals.

Home Health Monitoring Basics

Definition of home health monitoring

Home health monitoring uses technology to track and manage health conditions at home or on the go. 

Home health monitoring systems let you monitor various health metrics and share the data with healthcare providers remotely. It includes connected health devices and apps to collect, analyze, and transmit health data, facilitating continuous health management without frequent in-office visits (Story, 2010).

Source: ScienceDirect.com, Ahmed & Kannan, 2022.

Key benefits of monitoring health at home

Home health monitoring offers numerous advantages:

  • Increased Health Awareness: People become more aware of their health status, making informed decisions about diet, lifestyle, and treatment options.

  • Reduced Physical Consultations: Minimizes the need for in-person visits, which can be beneficial for people with mobility issues or those living in remote areas.

  • Real-Time Intervention: Allows for prompt medical interventions based on real-time data, to prevent potential complications.

  • Cost Savings: Reduces healthcare costs by decreasing hospital admissions and emergency room visits.

  • Improved Chronic Disease Management: Enhances the management of chronic conditions through continuous monitoring and timely adjustments to treatment plans.

Trackable health metrics 

Heart illustration for ECG monitor

Home health monitoring can track a wide range of health metrics, including:

  • Vital Signs: Heart rate, blood pressure, and body temperature.

  • Biometric Data: Blood glucose levels, blood oxygen saturation (SpO2), and body composition.

  • Activity Levels: Steps taken, calories burned, and sleep patterns.

  • Symptoms: Tracking symptoms related to chronic conditions or acute illnesses.

Medical and tech devices for home health monitoring

Several technologies and devices are available for home health monitoring (Dusun, 2024):

  • Smart Scales: Measure weight and body composition.

  • Blood Pressure Monitors: Track blood pressure levels.

  • Glucose Meters: Monitor blood glucose levels for diabetes management.

  • Pulse Oximeters: Measure blood oxygen saturation.

  • Wearable Fitness Trackers and Smartwatches: Monitor physical activity, heart rate, and sleep patterns.

  • ECG Monitors: Record heart rhythms to detect irregularities.

  • Medication Adherence Trackers: Ensure people take medications as prescribed.

Other conditions require more complicated devices that require training from your provider, including:

  • Apnea monitors

  • Heart monitors

  • Special monitors for dementia and Parkinson’s disease

  • Breathing apparatuses

  • Fetal monitors

Let’s review each of the less complex medical devices in turn.

Essential Devices for Home Health Monitoring

Smart scales for weight and body composition

Smart scale with monitor

A study in England showed that smart scale users who weighed themselves often were more likely to lose weight, and weigh themselves after recent weight loss (Sperrin et al., 2016).

Smart scales go beyond measuring weight; they can also analyze body composition, including body fat percentage, muscle mass, and bone density. These scales connect to health apps, allowing users to track their progress over time.

Before measuring your body composition:

  • Don’t drink alcohol for 2 days before measuring.

  • Avoid exercise, coffee, chocolate, or other diuretics (drinks that make you pee a lot) for 12 hours.

     
  • Don’t eat or drink anything for 4 hours before.

  • Don’t measure if you’re sick with a fever or diarrhea.

  • Use the bathroom within 30 minutes of measuring.

How to use a smart scale

Mondal & Mondal (2021) recommend the following steps to measure your body composition:

  1. Enter your age, sex, and height into the device.

  2. Stand in the right position to ensure you’re touching the electrodes properly.

  3. If your hands and feet are very dry, use a damp cloth to moisten them.

  4. Stand still during the measurement.

These devices may show body fat as a percentage, but don’t rely on just one measurement. Take three in a row, find the average (add the results, then divide by three), and write it down in a health log or app.

Blood pressure monitors

Woman on couch with Blood pressure monitor at home

Blood pressure monitors are essential for people with hypertension or heart conditions. These devices provide accurate readings of systolic and diastolic blood pressure to manage cardiovascular health.

Before taking your blood pressure:

  • Don’t measure your blood pressure until at least 30 minutes after having tea, coffee, energy drinks, cigarettes, or exercising.

  • Remove tight clothes and use the bathroom. 

How to use a blood pressure monitor

Mondal & Mondal (2021) recommend the following steps to take your blood pressure:

  1. Sit in a chair with back support, and legs uncrossed with feet flat on the floor. Rest your arm on a table at heart level.

  2. Put the cuff on their bare arm and start measuring. Don’t move or talk during the measurement.

  3. Take two readings one minute apart, and take the average of them (add the results, then divide by two). For better accuracy, you can do three readings, but it’s optional.

  4. Write down the final number in a health log or app to track any changes. 

Glucose meters for diabetes management

Glucose meter on hand with a blood drop

Glucose meters, or glucometers, are crucial for diabetes management, which helps people  monitor their blood sugar levels regularly. Some advanced models can sync with smartphones and health apps for easy tracking and data sharing with healthcare providers.

How to use a glucose meter

Mondal & Mondal (2021) recommend the following steps to measure your blood sugar:

  1. Check if that the test strips have not expired.

  2. Wash and dry your hands.

  3. Take a test strip and close the container. Use a new lancet each time.

  4. Put the lancet in the right spot on the device and set how deep it will prick based on what works for you or how thick your skin is.

  5. After loading the device, prick your ring or middle finger. You might need to gently squeeze your finger for enough blood.


    Once the blood touches the strip, the meter will take a moment to complete the measurement. The result will show up on the device or your phone.

  6. Throw away the used lancet in a special container for sharp objects and the strip in a biohazard bin. You might need to press your finger with cotton to stop bleeding. You can clean the lancet tip with an alcohol wipe. Write down your blood sugar reading right away in a health log.

Pulse oximeters for oxygen saturation levels

Man taking pulse oximeter reading

Pulse oximeters measure the oxygen saturation level in the blood, which is vital for people with respiratory conditions like chronic obstructive pulmonary disease (COPD) or COVID-19. These devices are easy to use and provide quick, accurate readings.

Before you take a measurement with a pulse oximeter, remove any nail polish from the finger you’re going to use.

How to use a pulse oximeter

Mondal & Mondal (2021) recommend the following steps to measure your oxygen level:

  1. Wash and dry your hands.

  2. Put the device on your finger so it’s not too loose or tight. Don’t use a finger with a tattoo or henna on it.

  3. Make sure your finger covers the lights and sensor properly.

  4. Avoid bright light, which can cause errors. If you can’t, cover the device with a cloth.

  5. Start the device, and keep your finger still during measurement.

Every few days of use, clean the device with an alcohol wipe to ensure accurate readings.

Wearable fitness trackers and smartwatches

Woman in a jacket touching smart watch

Wearable fitness trackers and smartwatches monitor various health metrics, including heart rate, steps taken, calories burned, and sleep patterns. They are popular for their convenience and integration with health and fitness apps.

Note that sometimes, these devices make errors. These errors can happen because the sensors in these devices aren’t perfect at counting or estimating. For example, fitness trackers worn on the wrist may count fewer steps than you actually take if you walk slowly (Hicks et al., 2019).

ECG monitors

Irregular heartbeats, known as heart rate arrhythmia, are a major sign of common heart diseases and can be very dangerous. Because these irregularities can happen suddenly, are hard to notice, and change quickly, it’s important to keep track of heart rate changes in real-time to spot and prevent problems early (Zhang & Yang, 2023).

ECG monitor closeup on stomach

A home electrocardiogram (ECG) monitor can track your heart rate. Note that while wearable ECG monitors can detect heart rhythm issues, but may miss some due to intermittent recording. They’re usually expensive and not covered by insurance. 

Medical-grade monitors are more accurate, using chest sensors for continuous recording. Personal devices use wrist or finger sensors and may require manual activation, making them less reliable for serious conditions (Samaan, 2022).

Before measuring your heartbeat:

  • Move electronic devices, metal, and magnets away from the ECG device.

  • Sit quietly for 5 minutes.

How to use

Mondal & Mondal (2021) recommend the following steps to analyze your heartbeat:

  1. If your hands are dry, use a damp cloth to moisten them.

  2. Follow the instructions to place the electrodes correctly.

  3. Start the device. Don’t move or talk during the measurement.

  4. Have a doctor look at the results afterward.

Medication adherence trackers

Taking your medication as prescribed is a critical part of your overall health and wellness. To help you remember when to take your meds, use one or more medication adherence monitoring technologies like:

  • Medication reminder apps

  • Electronic pill boxes, bags, or bottles

  • Ingestible sensors

  • Blister packs

While these devices offer real-time data and improve adherence monitoring, they face challenges like accuracy issues and expensive implementation. Most rely on proxy measures like device opening events, limiting data precision, and integration with clinical systems is a challenge. (Mason et al., 2022).

Next, we’ll learn how to pick the right health monitoring device for your specific needs.

Choosing the Right Monitoring Devices

Factors to consider when selecting devices

Purple pulse oximeter and mask

When choosing home health monitoring devices, consider the following factors:

  • Ease of Use: Devices should be user-friendly, especially for those with limited technical skills.

  • Accuracy and Reliability: Look for devices with proven accuracy and reliability, supported by clinical validation.

  • Compatibility: Ensure devices are compatible with your smartphone, tablet, or other health platforms.

  • Battery Life: Consider devices with long battery life to avoid frequent recharging.

  • Customer Support: Opt for brands that offer robust customer support and warranty services.

Compatibility with smartphones and other tech

Many home health monitoring devices are designed to sync with smartphones and other tech platforms. This integration allows for seamless data transfer, real-time monitoring, and easy access to health metrics through dedicated apps.

Accuracy and reliability of different brands

To ensure you choose the right device, check that the device is approved by the proper authority such as the FDA or ISO (Mondal & Mondal, 2021).

Research and reviews can also help determine the accuracy and reliability of different brands. Look for devices with positive feedback from users and healthcare professionals, and check for any clinical validation or certifications. 

Once you get your medical device, it’s important to use them properly, and calibrate them at the intervals the manufacturer recommends to maintain its accuracy (Mondal & Mondal, 2021). 

Budget considerations and cost-effectiveness

While some advanced devices can be expensive, there are cost-effective options available that still offer reliable performance. Consider your budget and prioritize devices that provide the best value for money without compromising on essential features.

Once you’ve chosen your devices, it’s vital to address the important aspects of data protection and privacy.

Privacy and Security Considerations

Blue lock shield

Home health monitoring and remote patient monitoring (RPM) are part of telehealth.  Telehealth provides convenience, but also comes with security risks and issues (Houser et al., 2023):

Let’s look at a few best practices to protect and secure your personal health information.

Protect your health data from breaches

Health data is sensitive and must be protected from breaches. Some tips:

  • Use strong passwords for your health apps and devices.

  • Turn on two-factor authentication in your apps.

  • Use email, chat, or messages through the patient portal. This is especially useful when a private location is temporarily unavailable. If the situation isn’t temporary, ask your health provider for suggestions (Houser et al., 2023).

     
  • Regularly update your software to protect against vulnerabilities.

Understand data ownership and sharing policies

Some apps may share data with third parties for research or marketing purposes. Read the privacy policies of your health apps and devices to understand who owns your data and they share it. Opt for apps that prioritize user privacy and offer clear data ownership policies.

Secure your home network for health devices

Some tips to secure your home network include:

  • Use a strong Wi-Fi password and enabling network encryption.

     
  • Check the URL address bar of your browser before you enter your personal information on a website. A secure website will show a lock icon in the address bar, and look for https:// at the beginning of the URL (as some do not include the “s”).

  • Install and use anti-virus software on your devices.

  • Avoid using public Wi-Fi networks for health monitoring, as they are more susceptible to breaches.

Check compliance with health data regulations 

Health Insurance Portability and Accountability Act (HIPAA) is a regulation in the U.S. that protects the privacy and security of people’s personal health information. Check whether your health monitoring devices and apps are HIPAA-compliant before you use them, or the similar standards in your region if you’re not in the U.S. (Gerke et al., 2020).

Now that you know how to secure your data, it’s time to create an effective monitoring environment in your home.

Setting Up Your Home Health Monitoring System

Create a dedicated space for health monitoring

Black woman smiling at phone with glucose meter on arm

Designate a specific area in your home for health monitoring. This space should be quiet, well-lit, and free from distractions to ensure accurate measurements. Keep all your monitoring devices and accessories organized and easily accessible.

Connect devices to your home network

Most home health monitoring devices use Wi-Fi or Bluetooth to connect to your home network. Follow the manufacturer’s instructions to pair each device with your smartphone or tablet. Ensure your home network is secure to protect your health data.

Sync devices with health apps and platforms

Download the necessary health apps for your devices and create accounts if required. Synchronize your devices with these apps to enable data transfer and real-time monitoring. Popular health platforms include Apple Health, Google Fit, and dedicated apps from device manufacturers.

Set a daily routine for regular measurements

Consistency is key to effective home health monitoring. Establish a routine for taking measurements, such as checking your blood pressure every morning or measuring your blood glucose levels before meals. Set reminders on your smartphone to help you stay on track.

With your system set up, let’s see how to make sense of the data you’re collecting.

Interpreting and Using Health Data

Learn about health metrics 

Get familiar with the health metrics your devices track, and understand what they mean. For example, know the normal ranges for blood pressure, blood glucose, and oxygen saturation levels. Health apps often provide explanations and visualizations to help you interpret the data (Chan et al., 2022).

Recognize normal ranges and potential red flags

Knowing the normal ranges for your health metrics allows you to identify potential red flags. For instance, a consistently high blood pressure reading may indicate hypertension, while low oxygen saturation levels could signal respiratory issues (Chan et al., 2022). Consult your healthcare provider if you notice any abnormal readings.

Set health goals and track progress

Use the data from your monitoring devices to set health goals, such as achieving a target weight or maintaining stable blood glucose levels. Track your progress over time and adjust your goals as needed. Health apps often offer goal-setting features and progress-tracking tools.

Share data with healthcare providers securely

Many health apps allow you to share your data with healthcare providers securely. This can be done through app integrations, email, or cloud storage platforms. Sharing your data helps your healthcare provider make informed decisions about your treatment plan and monitor your progress remotely.

Maximizing the Benefits of Home Health Monitoring

To get the most out of your home health monitoring system, consider these strategies for integrating it into your daily life.

Black woman gold top showing phone with glucose meter on arm

Integrate monitoring in your daily routine

Include health monitoring into your daily routine to make it a habit. For example, you can check your blood pressure while having your morning coffee or track your steps during your evening walk. Consistency ensures accurate data and better health management (Kariuki, n.d.).

Make lifestyle improvements

Use the insights from your health data to make positive lifestyle changes. For instance, if your fitness tracker shows low activity levels, you can set a goal to increase your daily steps. If your blood glucose levels are high, you can adjust your diet and exercise routine accordingly (Kariuki, n.d.).

Combine monitoring with telehealth services

Telehealth services complement home health monitoring by providing remote consultations with healthcare providers. Share your health data during these virtual visits to receive personalized advice and treatment plans. Telehealth can be especially beneficial for managing chronic conditions and reducing the need for in-person visits.

Involve your family in health-tracking

Involving family members in your health monitoring can provide additional support and motivation. Share your health goals and progress with them, and encourage them to participate in health-tracking activities. This can create a supportive environment and improve overall health outcomes.

Conclusion

Setting up a home health monitoring system is a proactive step to take charge of your well-being. Once you choose the right devices, set a consistent monitoring routine, and learn how to interpret your health data, you can gain valuable insights into your body’s needs and trends. 

Remember, home health monitoring is no substitute for professional medical advice. Use your newfound knowledge to have more informed discussions with your healthcare provider, ask questions, and make proactive decisions about your health. With the right approach, home health monitoring can lead to better health outcomes and an improved quality of life.

Which health monitors and wearables do you use, and how do they help you?

References

Chan, A., Cohen, R., Robinson, M., Bhardwaj, D., Gregson, G., Jutai, J. W., Millar, J., Rincón, A. R., & Fekr, A. R. (2022). Evidence and User Considerations of Home Health Monitoring for Older Adults: Scoping Review. JMIR Mhealth Uhealth, 5(4). doi.org/10.2196/40079

Consumer HealthTech Research Report. (2023). AnalyticsIQ. Retrieved from https://analytics-iq.com/wp-content/uploads/AnalyticsIQ-Research-Report-Consumer-HealthTech.pdf

Gerke, S., Shachar, C., Chai, P. R., & Cohen, I. G. (2020). Regulatory, safety, and privacy concerns of home monitoring technologies during COVID-19. Nature Medicine, 26(8), 1176. doi.org/10.1038/s41591-020-0994-1

Hicks, J. L., Althoff, T., Sosic, R., Kuhar, P., Bostjancic, B., King, A. C., Leskovec, J., & Delp, S. L. (2019). Best practices for analyzing large-scale health data from wearables and smartphone apps. Npj Digital Medicine; 2(1), 1-12. doi.org/10.1038/s41746-019-0121-1


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Houser, S. H., Flite, C. A., & Foster, S. L. (2023). Privacy and Security Risk Factors Related to Telehealth Services – A Systematic Review. Perspectives in Health Information Management; 20(1). 

Imtyaz Ahmed, M., & Kannan, G. (2022). Secure and lightweight privacy preserving Internet of things integration for remote patient monitoring. Journal of King Saud University – Computer and Information Sciences; 34(9), 6895-6908. doi.org/10.1016/j.jksuci.2021.07.016

Kariuki, F. (n.d.). The Top 13 Benefits of Remote Patient Monitoring. Health Recovery Solutions. Retrieved from https://www.healthrecoverysolutions.com/blog/the-top-13-benefits-of-remote-patient-monitoring

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