Remote patient monitoring (RPM) has the potential to address healthcare challenges in rural areas. It enables chronic patients, older individuals, and those recovering from surgeries to monitor their health from home and access virtual care. RPM adoption is driven by the need for improved accessibility, cost savings, better patient care, and addressing nursing shortages. Rural hospitals and health systems should embrace RPM’s capabilities, customize programs as needed, and understand its positive impact on patient adherence and readmission rates.
Remote patient monitoring (RPM) has the potential to address numerous challenges faced by both patients and healthcare providers in rural areas. Studies conducted by the Mayo Clinic have shown impressive results, indicating that 72.5% of patients using RPM comply with their care plans, including medication adherence and vital sign monitoring. Furthermore, the readmission rate within 30 days for RPM users was only 9.4%, compared to 20% for non-users.
Rural communities across the United States are grappling with a healthcare crisis due to shortages in healthcare providers and facilities. The scarcity of nurses, in particular, exacerbates the problem. However, telemedicine and remote patient monitoring offer a convenient and cost-effective solution for individuals in these underserved areas.
Telemedicine enables chronic patients residing in rural areas to access specialized medical expertise without having to travel long distances. It also allows healthcare providers to identify specific social determinants of health, such as food insecurity.
We interviewed Kimberly O’Loughlin, CEO of Health Recovery Solutions, a leading remote patient monitoring company, to discuss the current state of RPM in rural America, the trends driving its adoption, the motivations behind rural hospitals and health systems pursuing RPM, and crucial considerations for CIOs and health IT leaders before implementing RPM.
Q. What is the current state of remote patient monitoring in rural settings? Is there significant activity in this area? What does the typical patient profile look like?
A. Although the need for remote patient monitoring in rural settings is evident due to limited resources and restricted access to medical facilities, the actual utilization of RPM remains low. Factors such as staffing shortages, budget cuts, and reduced patient volumes following the pandemic have forced many rural hospitals to shut down, with 19 closures recorded in 2020 alone.
While the closure of hospitals continues to impact rural areas, there is an expectation that RPM implementation will increase in these regions. However, there is still a long way to go before the full potential of RPM is realized in rural communities.
Hesitancy toward adopting RPM in rural settings stems from various reasons, including unreliable internet connectivity, lack of proper credentials and licenses for nurses, and reimbursement challenges.
Currently, RPM services are predominantly utilized by older patients managing chronic conditions or recovering from surgeries or procedures. These patients require close monitoring, support, and easy access to healthcare. As their health becomes more fragile, they may face difficulties traveling to appointments, especially when healthcare facilities are located far away. This situation places a burden on family members or caregivers, who must transport them to and from appointments or may even require doctors to travel to their homes.
This is where RPM plays a crucial role. Through RPM, elderly patients can monitor their health from the comfort of their homes using user-friendly communication tools and medical devices. They can schedule appointments with their doctors and seek medical advice without the need for office visits.
Additionally, RPM solutions offer hospice and palliative care, enabling patients to have a dignified end-of-life experience.
Apart from elderly patients, RPM is highly valuable for individuals managing chronic conditions or recovering from surgeries. RPM provides tools such as scales, blood pressure cuffs, blood oxygen monitors, educational content, and surveys, allowing patients with conditions like diabetes, hypertension, and COPD to monitor and manage their health effectively.
Continuous monitoring enables healthcare providers to intervene when necessary, reducing the likelihood of hospital admissions or readmissions and improving adherence to care plans. Patients can also gain a better understanding of their diseases through educational content and consult with specialists virtually, even if they are located hundreds of miles away.
Q. What are the current trends in rural healthcare that are driving the adoption of RPM?
A. Telehealth experienced a significant surge nationwide during the pandemic, as lockdowns confined people to their homes. Even
as restrictions eased, many individuals, particularly those in rural areas with limited access to healthcare, continued to opt for virtual appointments to receive medical care.
RPM was one of the solutions that experienced substantial growth during the pandemic. Although the public health emergency has ended, recent reports indicate that patients in rural areas will still have access to telehealth and RPM tools. This reaffirms the positive impact of RPM on rural communities and suggests that the adoption of these tools will continue to grow.
With the assurance of continued access to RPM tools for rural populations, the momentum for implementing these solutions has been reignited. The benefits that RPM offers are driving strong desire and advocacy for its adoption.
Easy and timely access to care is crucial, particularly when healthcare organizations serve a radius of approximately 300 miles, forcing patients to travel several hours to see a provider. This not only consumes a significant amount of time but also incurs costly travel expenses. RPM eliminates these barriers by allowing patients to receive care virtually, saving time and money.
Another common challenge faced by patients, especially in rural areas where face-to-face interactions with providers are infrequent, is understanding their medical condition and treatment regimen. Lack of comprehension can lead to non-adherence to care plans, resulting in adverse effects.
RPM addresses this issue by providing automated reminders, educational materials, and patient engagement capabilities, thereby increasing adherence to care plans and enabling patients to better manage their medications, diets, and exercise routines. These tools have received positive feedback from users and have proven effective in addressing critical social determinants of health issues.
Furthermore, the ongoing shortage of nursing and clinical providers is driving the adoption of RPM. Many hospitals and clinics operate with understaffed teams, and some have been forced to close due to the scarcity of nurses and physicians.
RPM helps alleviate this pressing issue by enabling nurses to monitor and care for patients more efficiently. The time saved can be utilized to see more patients during shifts, while also avoiding overtime and scheduling conflicts.
Lastly, RPM enables providers to identify and address key social determinants of health that impact access to care, such as language barriers, limited health literacy, and transportation challenges. Virtual visits facilitated by RPM help patients and providers overcome these obstacles.
The benefits that nurses and physicians witness daily are driving the urgency for RPM adoption, particularly in rural and underserved communities.
Q. From your experience, what motivates rural hospitals, health system CIOs, and clinical teams to pursue RPM?
A. The primary driver pushing rural hospitals and health systems to pursue RPM is the improved accessibility it offers to the communities they serve. Access to healthcare is essential, but in rural communities, finding an appointment or physically reaching a hospital or clinic can be challenging.
When patients are unable to care for themselves or access healthcare services, they may delay seeking care until their condition becomes critical, resulting in emergency room visits and hospital admissions. As the public health emergency subsides, many patients are overdue for care. RPM can empower patients to better manage their health and wellness between visits, ensuring timely care when needed.
Cost is another motivator for RPM adoption, as critical care is more expensive than routine or preventive care. Historically, the cost has been a barrier to the implementation of virtual care in health systems due to expenses associated with training, implementation, product costs, and change management. However, government-sponsored grants and loan programs can help organizations embrace the adoption of virtual technologies.
Delivering improved patient care is a significant driver as well. When patients can monitor and manage their health from home, they can identify issues earlier, adhere better to care plans and stay connected to clinicians and caregivers, reducing the need for emergency room visits and hospital stays.
From the provider’s perspective, having a better understanding of a patient’s health between visits enables timely interventions and appropriate care. Moreover, medication reminders
provided through RPM increase the likelihood of patients adhering to their prescribed medications and effectively managing their conditions.
Automated reminders also free up nursing time, allowing them to spend less time on check-ins and more time caring for additional patients. The positive impact of RPM on readmission rates and outcomes has been demonstrated. In one rural health system using RPM, the readmission rate averaged just 6.6% over 30 days.
Q. What should rural provider organizations’ CIOs and health IT leaders know about RPM before implementing it?
A. They should be willing to learn about and embrace the full capabilities of RPM and recognize the potential for scalability. Some RPM technologies offer customizable program features that can be leveraged as an organization’s needs evolve. Understanding how to implement remote care delivery can adapt based on the population of patients served.
For instance, a rural clinic might initially focus on high-risk maternity cases and then expand to cover all maternity cases due to a high prevalence of diabetes and related social issues that impact outcomes. RPM programs are not one-size-fits-all and should evolve and expand to maximize benefits and impact.
Most RPM companies provide support for evolving needs, assisting patients in setting up the technology and training them on its usage. This relieves the burden of logistics and training from the provider.
Evidence shows that patient engagement with RPM programs is high, and users can diligently follow their care plans virtually. Mayo Clinic studies reveal that more than 72.5% of over 7,000 participating patients complied with their care plan tasks, including medication adherence and regular health monitoring.
Furthermore, the readmission rate within 30 days of enrollment or discharge for RPM users was only 9.4%, compared to nearly 20% for non-users.
Ultimately, RPM can reduce barriers to care for rural populations, providing timely and consistent access for patients, saving staff time, and enabling organizations to optimize care models with both in-person and virtual approaches, resulting in cost savings. RPM platforms also streamline the recording, storage, and access to patient information, alleviating the paperwork burden on physicians and enhancing the overall care experience for both providers and patients.
