Table of Contents
Abstract
The concept of remote patient monitoring is getting more popularity in the United States of America. The shortage of manpower in the healthcare sector and the rapid improvements and advancements in technology are some of the factors which motivate the government to develop and implement such programs on a consistent basis. There are many instances in which patients get admissions in hospitals even for minor problems. This is happening because of the difficulties of the patients in assessing their present situation while staying at their homes. Remote patient monitors are capable of providing valuable insights or data about the present conditions of a patient to his/her care managers instantly. After the analysis of the data, care managers can decide whether the patient requires hospitalization or not. In short, remote patient monitoring can avoid time delay in providing necessary care to the patients. At the same time, there are many arguments against the implementation of remote patient monitoring programs. It is not necessary that the remote patient monitors may work properly all the time. Such monitors have limitations in communicating with the care managers in certain conditions. Moreover, the affordability and cost effectiveness of such monitors are questionable. This paper briefly analyses the pros and cons of remote patient monitoring programs in the USA.
Pros and cons of remote patient monitoring
Manpower shortage is one of the major problems in the United States of America. Virtually all critical employment sectors in America face the problems related to the shortage of skilled manpower. Healthcare is one sector in which America uses the services of foreigners or expatriates extensively to overcome the manpower shortage problem. Many of the doctors, nurses and other professionals working in this industry are foreigners. When the number of inpatients increases, hospitals may struggle to provide adequate care to each patient because of the shortage of caregivers or care managers. There are many instances in which patients visit hospitals and get admitted there without genuine reasons. In other words, unnecessary emergency department visits and hospitalizations increase the workloads of the care managers. The concept of remote patient monitoring came into existence under the above circumstances. Remote patient monitoring is a process in which a health care professional reviews the health conditions of a patient with the help of a coordinated system that makes use of home-based mobile monitoring devices that are capable of transmitting information regarding the health conditions of a patient (GAO reports, 2017)
According to Jacobi (2017), care managers will be able to provide better care to patients using remote patient monitoring program. He has pointed out that earlier interventions can be made and unnecessary emergency department visits and hospitalizations can be prevented while care managers effectively incorporate timely biometric data into existing case and disease management programs. The absence of earlier intervention is one of the major causes of death of several patients. With the help of remote patient monitoring programs, care managers will be able to assess the conditions of the patients quickly and provide instructions about what to do when emergency occurs. Improper interventions before the hospitalization can cause death. Moreover, the delay in hospitalization can also lead towards death. All these problems can be addressed properly while using remote patient monitoring programs.
At the same time, there are many arguments against the remote patient monitoring practices. Scholars such as Steinberg and Mittal (2013) mentioned that remote patient monitoring programs may increase the capital expenditure as more healthcare professionals may be required to review and interpret the enormous amount of incoming data from various parts of the country. It is a fact that the services of skilled data analysts are necessary for the care managers in order to implement the remote patient monitoring programs successfully. However, these programs are capable of avoiding unnecessary hospitalizations and thereby reduce the administrative and capital expenses.
Remote patient monitoring is extremely useful in mental health or m-health. With the help of modern technologies such as Wireless Body Area Networks (WBANs), it is possible for care managers to monitor the activities of the mental health patients. WBANs consist of a subset of wireless sensor networks (WSNs) which help care managers in tracking the movements and activities of the patients. At the same time, it should not be forgotten that WSNs have many limitations with respect to communication bandwidth, reliability, and power consumption (Esfahani et al., 2016). In other words, it will be difficult for care managers to monitor the activities of m-patients if the patients were located at a distant place. Moreover, the batteries used in the WSNs need frequent charging and recharging.
Cardiac patients can also be benefitted immensely from remote patient monitoring programs. According to Ricci et al. (2014), cardiac implantable electronic devices can help care managers to monitor the progress of the cardiac patients remotely. They have conducted a study in Berlin, Germany to know the effectiveness of home monitoring with the help of the cardiac implantable electronic devices. Their study involved 1650 cardiac patients from different parts of Germany. They found that the services of a reference nurse (RN) for ordinary management, and a responsible physician (RP) for medical decisions are enough for providing adequate care to cardiac patients who were using the cardiac implantable electronic devices. Another finding of this study was that remote patient monitoring programs are capable of detecting the majority of actionable events among cardiac patients with limited administrative workload (Ricci et al. 2014). It should be noted that majority of the cardiac patients have the habit of seeking medical help immediately whenever they feel some discomfort. They may pretend that the discomfort is caused by their cardiac problem. In reality it may be caused by some other problems. It is possible for the care managers to identify whether the discomfort is caused by the cardiac problem or not if the patients possess the cardiac implantable electronic devices. The care managers can advise the patient whether to visit the hospital or not after assessing the conditions of the patient with the help of the cardiac implantable electronic devices.
As mentioned by Steinberg and Mittal (2013), the cost of remote patient monitoring is slightly on the higher side at present. However, it is not unaffordable to the ordinary patients. Because of the rapid advancements in technology, the cost of the equipment necessary for the remote patient monitoring is getting lowered every day. Today, many companies are engaged in the business of manufacturing medical equipment and developing software that are required for the success of remote patient monitoring programs. As a result of that, the competition in this industry is increasing every day. It should be noted that increased competition in the market would force companies to lower the prices and improve the quality of their products and services. Thus, the remote patient monitors are becoming more reliable and affordable nowadays. The increased reliability of these monitors would help care managers to provide adequate care to patients even without hospital admission.
Conclusions
Remote patient monitoring programs have many benefits as well as drawbacks. These programs are capable of improving the quality of healthcare delivery. They are capable of evaluating the conditions of a patient remotely and take necessary actions to protect the life of the patient. Patients can avoid unnecessary hospital visits and the hospitals can reduce the capital and administrative costs while implementing such programs. At the same time, these programs are slightly expensive at present. The equipment required for the implementation of these programs is unaffordable to ordinary people. However, it is expected that they may become affordable in near future as the competition increases in this sector.
- Esfahani, A. Mantas, G. Silva, H. Rodriguez, J. and Neves, J. (2016). An efficient MAC-based scheme against pollution attacks in XOR network coding-enabled WBANs for remote patient monitoring systems. EURASIP Journal on Wireless Communications & Networking, 2016 (1), 1-10.
- GAO reports. (2017). Medicare Valuation of Remote Patient Monitoring. GAO Reports, April 14, 2017.
- Jacobi, K. (2017). Remote Patient Monitoring Works for Health Plan Members and Care Managers.
- Ricci, R. P. Morichelli, L. D’onofrio, A. et al. (2014). Manpower and Outpatient Clinic Workload for Remote Monitoring of Patients with Cardiac Implantable Electronic Devices: Data from the Home Guide Registry. Journal of Cardiovascular Electrophysiology, 25(11), 1216-1223.
- Steinberg, J.S. and Mittal, S. (2013). Remote Patient Monitoring in Cardiology. Demos Medical Publishing, LLC.