Disappointing Evidence Mounts For Remote Patient Monitoring Technology


For years, entrepreneurs and investors have been developing new digital health tools and sensors under the untested assumption that once these solutions were put in the hands of patients and health systems, outcomes would improve and readmissions would drop. The premise is sound. Patients discharged from the hospital are generally not yet fully recovered, and with the help of technology, the remainder of a patient’s recovery can be remotely monitored while they are at home. Many extend this concept beyond the recovery period, suggesting that chronically ill patients would benefit from prolonged monitoring to support their disease management efforts. The metrics one would want to measure are known. For heart failure patients, a precise daily weight is a valuable metric because it helps clinicians spot fluid retention. For diabetics, blood sugar levels could help clinicians identify patients struggling to manage their condition. Patients with hypertension could benefit from remote monitoring of their blood pressure. Now, thanks to the work of digital health entrepreneurs, the sensors and apps exist to capture all of these metrics in the patient home and share them with local providers. The next step is to field test them and measure the improvement to outcomes, hospitalization rates, and readmission rates.

In 2013, Spyglass Consulting conducted a small survey of health systems, home health agencies, hospices, and government agencies like the VA that were early adopters of remote patient monitoring technology. At the time, more than 50 percent of respondents questioned the clinical efficacy and potential for a return on investment from remote patient monitoring solutions. Fast forward two years, and researchers from Cedars-Sinai Medical Center and UCLA presented similar findings at the American Heart Association’s 2015 Scientific Summit. In this more recent study, researchers focused on heart failure patients, conducting a randomized control trial to measure changes to readmission rates and mortality rates when supplemental remote patient monitoring solutions were used. The study concluded that no meaningful improvements were made to either the 30-day readmission rates or six-month mortality rates of heart failure patients who were enrolled in the remote patient monitoring program.

Now, further evidence is casting a doubtful light on the potential of remote patient monitoring. Scripps Translational Science Institute has just published results from the largest study on remote patient monitoring to date. Launched in August 2013, the two-year study was designed to measure “whether the integration of wireless technologies, online social networks, and medicine can have a direct effect on health care spending.” For its study, 200 participants with either diabetes, hypertension, or heart arrhythmias that had also generated high healthcare costs in the year preceding the study were enrolled. These patients were given iPhones and smartphone-connected wireless blood pressure cuffs, blood glucose meters, or mobile ECG sensors. Data from the devices was pushed to an online health management system where patients and providers could trend the results over time. The control group for this study received only standard care to manage their disease. The results of the study were disappointing for digital health workers. There were no differences in health care costs between the two groups, nor was there a difference in the average amount of healthcare services utilized or clinical outcomes, leading investigators to conclude that there is no “large short-term increases or decreases in health care costs or utilization associated with monitoring chronic health conditions using mobile health or digital medicine technologies.”

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