Digital Connected Care: The Innovation Journey That Delivers on the Promise of Remote Patient Monitoring

The Digital Connected Care article series elevates the conversation from tech talk to the practical application of remote patient monitoring in clinician designed workflows with evidence of improved outcomes without increasing staff burden.

As the two-year anniversary of the earliest detection of the coronavirus approaches, COVID-19 continues to overwhelm health systems and disrupt life where vaccinations remain low. Digitally connecting with patients outside the care setting, employing remote patient monitoring (RPM) offers a method to help manage surges by allowing 24/7 monitoring of patients at home to determine if/when their condition warrants admission to a hospital.

These same mechanisms can be applied to managing acute and chronic diseases outside the clinical setting., However, the evolution from visionary technology to demonstrated improved outcomes remains elusive. The opportunity is now to incorporate RPM or more specifically, patient-generated health data (PGHD), into clinician-designed workflows and devices that meet the needs of the patient and the care team. Patient-generated health data refers to clinical information actively generated by the patient, such as surveys, questionnaires and biometrics (for example, home blood pressure readings).

The U.S. Department of Health and Human Services recently published a report that concluded, in part, that the promise of PGHD is tempered by lack of standards, data integration, evidence of use, burden of tracking, suitability of use and unknown accuracy of data. While there is a significant and growing interest in the practical application of PGHD into the clinical workflow, the report cited a low number of such applications primarily due to lack of workflows designed specifically for PGHD with which to demonstrate value.

Accelerate Health, the innovation hub of HIMSS, is working with a community of healthcare providers and system integrators to define care models and specific workflows to demonstrate how the proper integration of PGHD can meet the needs of the patient and care team and drive mainstream adoption of RPM. At the foundation of these solutions is low-friction access to patient data through the implementation of open standards-based software. This provides one open API, thus allowing any compliant sensor to securely and automatically connect to any compliant gateway and clinical health record system on a global scale.

Look for these future articles that highlight opportunities and efforts to deliver on the promise of RPM:

• Workflows by the Clinician, for the Clinician
  Clinicians must guide system developers on how to support specific clinical workflows with digital tools to facilitate improved outcomes for the patient and care team.
• Self-Measured Blood Pressure to Manage Hypertension
  Applications, such as self-measured blood pressure to help manage hypertension, provide opportunity to demonstrate the practical application of RPM.
• Surge Care for the 21^st Century
  With recent surges exceeding hospital capacity, new venues for care need to be expanded. Within this care model is the inherent need for accurate, real-time data any time day or night.
• Translating Data into Knowledge
  It’s essential to design automated clinical decision support systems that translate PGHD into organized information that facilitates the interpretation of that data which, in turn, can be used to build a knowledge base and set of rules to apply that knowledge base.
• Inclusive Access and Control
  Remote patient monitoring direct-to-cloud solutions expand access by all to Wi-Fi and/or reliable cellular communications.
• Convergence and Evolution of Workflows
  Clinicians must take a leading role in the design of applications that link remote patient monitoring and well-designed software to meet specific needs of the patient and care team and providing evidence it improves patient outcomes.
• Economics of Interoperability
  Medical device manufacturers embracing one open API enjoy savings of more than $7 million in development, ongoing maintenance and customer support costs over the life of a product.
• Automatic and Secure PGHD Exchange
  While practical applications are very specific yet diverse, an underlying requirement to enable scale across all applications is to empower any device to securely and automatically connect to any gateway or health record system.
• Tools for the Product Developer
  A development environment employing a suite of popular integration and test tools simplifies and accelerates the integration of health data collection and upload software into remote monitoring products.
• Beyond the Tech: Policy Hurdles for Remote Patient Monitoring
  Deeply embedded obstacles exist to realizing the full benefit of digital connected care.
• Facilitating Behavior Change, or Not …
  Tools and information to measure and treat chronic conditions enable, but by no means ensure, care team and patient behavior changes needed to improve outcomes.