A reflection of technology in healthcare
At the beginning of this course, I found myself questioning the number of technologies that have negatively and positively impacted on patient care. As I shadow a nurse Informaticist, it is evident that technology did not just stop at iPhones, televisions, and computers. Instead, the most significant impact of technology is on the healthcare system. For instance, in this decade, hospitalization and a trip to the healthcare provider is much proactive and effective due to advancement in technology.
Type of technology used in healthcare
Remote monitoring technology is a subclass of telehealth, which enables patient monitoring and timely transfer of data from the patient to healthcare practitioners and back to the patient (Mittal et al. 2014). Often, remote patient monitoring utilizes wireless peripheral measurement devices, including glucometers, implantable, BP cuffs, pulse oximeter, biosensors, and sensors that passively collect data. For example, sensors that provide data on activity and movement patterns at home (Mittal et al. 2014). Remote patient monitoring devices are often used during post-discharge or between routine visits to the hospital.
Remote patient monitoring devices have been significant in the management of patients with cardiovascular conditions (Ong et al. 2016). For instance, hypertension is a considerable risk factor for cardiovascular disease, with an age-adjusted prevalence of 35% in the United States, translating to 85 million individuals being hypertensive. Remote patient monitoring has been shown to reduce systolic significantly and diastolic blood pressure compared to self-monitoring alone or usual care (Ong et al. 2016). Besides, remote patient monitoring has been shown to improve the outcomes of atrial fibrillation through reduced incidences of stroke, cardiac failure, increased hospitalization, and deaths (Ong et al. 2016). Remote patient monitoring ensures this through early identification of atrial fibrillation in both stroke and patients at risk of stroke.
How remote patient monitoring could support a healthcare decision
Remote patient monitoring is considered a cost-effective and highly potential means to motivate patients in self-care (Gheorghiu & Ratchford, 2015). RPM provides automatic feedback to patients while allowing healthcare teams to be alerted only if there is a need to review the patient’s data. Therefore, it reduces the workload of healthcare practitioners while maintaining high-quality care and compliance in chronic illness care. Gheorghiu & Ratchford (2015) cite that obstetric telemonitoring is the exchange of maternal and fetal information between a pregnant woman and the healthcare worker. By sharing the information, proper decisions on referral in cases of injuries or maternal concerns are made by the healthcare worker, which ensures quality referrals and reduces the costs of transport for the woman.
Evolution of Remote Patient Monitoring technology
According to Magsi et al. (2018), RPM began in the 1800s, when two physicians consulted over the telephone. In the late 1940s, a doctor sent x-ray images to another doctor using telephone wires, while in 1960s; psychiatric consultations were transferred using closed-circuit televisions. In 1961, a remote electrocardiogram, respiratory sensor, and a thermometer were used by Alan Shepard’s physicians to monitor his vitals while in the space. In the 1980s, the transmission of x-ray images between physicians was a common practice. However, in the 1990s, with the development of the Internet, the old-school telemedicine became obsolete.
Today, RPM is more than just physician consultations and sending imaging results for analysis. RPM has enabled patients to receive optimal care at the comfort of their homes. Ong et al. (2016) note that through the use of devices, patients’ vital signs can be monitored by the healthcare team and only act when there is a deviation in the data. Sebastian et al. (2012) postulate that the future of RPM is wireless technologies that abolish the need for bedside transmitters. This will include the use of mobile apps, which do not need patients to carry around devices and can do their daily activities seamlessly. Besides, these mobile apps will provide more data compared to the existing monitoring devices. Today, decisions about the management of patients can be made while at their homes. For instance, a diabetic patient can be instructed to reduce the dose of their insulin based on evaluation of their blood sugars by the doctor without visiting the hospital.
References
Gheorghiu, B., & Ratchford, F. (2015). Scaling up the use of remote patient monitoring in Canada. Stud Health Technol Inform, 209, 23-26.
Magsi, H., Sodhro, A. H., Chachar, F. A., Abro, S. A. K., Sodhro, G. H., & Pirbhulal, S. (2018, March). Evolution of 5G on the Internet of medical things. In 2018 international conference on computing, mathematics and engineering technologies (iCoMET) (pp. 1-7). IEEE. Mittal, S., Movsowitz, C., & Varma, N. (2014). The modern EP practice: EHR and remote monitoring. Cardiology clinics, 32(2), 239-252.
Ong, M. K., Romano, P. S., Edgington, S., Aronow, H. U., Auerbach, A. D., Black, J. T., … & Ganiats, T. G. (2016). Effectiveness of remote patient monitoring after the discharge of hospitalized patients with heart failure: the better effectiveness after transition–heart failure (BEAT-HF) randomized clinical trial. JAMA internal medicine, 176(3), 310-318.
Sebastian, S., Jacob, N. R., Manmadhan, Y., Anand, V. R., & Jayashree, M. J. (2012). Remote patient monitoring system. International Journal of Distributed and Parallel Systems, 3(5), 99.