The Covid crisis highlighted four essential challenges facing healthcare services today. 1. Increase the volume of care; 2. Improve care outcomes for patients; 3. Protect the health of medical and care providers; 4. Improve the overall quality of care.
Each challenge points to a requirement to improve the efficiency of healthcare, a requirement that is being met through the increasing use of remote care and technology.
The Need to Reduce Hospitalisation
The benefits of remote patient monitoring (RPM) can be broadly divided into two categories: patient benefits and provider benefits. Patient benefits are largely psychological, eg reassurance and engagement, while the benefits to care providers concern process efficiency and efficacy. Both contribute to one overriding benefit, which lies at the root of healthcare efficiency: a lower number of hospitalised patients.
The estimated cost of a hospital stay in the UK is £400 per day. The longer a patient stays in hospital, the more vulnerable they are to further infections and loss of physical condition. There are also many more emergency readmissions than necessary, due to discharged patients not adhering to their prescribed course of treatment. The quality of healthcare will improve if patients can receive healthcare at home until hospitalisation is really necessary.
RPM tackles these challenges by greatly improving the quality of care that can be given to patients at home.
Increasing Patient Accountability
The risk for patients requiring ongoing outpatient care, including those with chronic ailments such as diabetes and cardiac conditions, is that they lose interest and fall behind with their treatment. In some cases, this loss of interest is actually an aversion, either caused by fear or a dislike of the clinical environment.
Patients who have been equipped with RPM report feeling much more comfortable and familiar interacting with their care giver via their own enabled device in their own home, and thus become more engaged. They also find it reassuring that their clinical team are ‘with them’ once they leave hospital, and the regular interaction encourages them to be more accountable for their own health. This reduces non-adherence and thus the likelihood of hospitalisation.
In one study of chronic patients using RPM in the US, the re-hospitalisation rate was reduced by two thirds. A similar reduction in unscheduled attendances was recorded in a program of remote monitoring for patients with cardiac rhythm management devices in Dublin.
The regular monitoring and feedback that RPM affords also helps to reduce missed appointments, which represent a severe drain on healthcare budgets. In the UK, the cost of missed appointments amounts to around £1billion per year.
Raising Care Providers’ Capacity
While the comfort and convenience afforded by RPM have proven benefits on patient engagement, the technical attributes yield major efficiencies for care providers.
Patient feedback, coupled with monitoring of vital signs using RPM connected wearables, provides a wealth of data that helps care managers to prioritise patients accurately and thus manage their case load more efficiently. In some cases, care managers have achieved a 15-fold increase in their case load without any additional demand on their working hours.
As the technology develops, artificial intelligence and machine learning will be able to take care of much of the day-to-day care, looking for patterns in the data and raising the alarm when it detects abnormalities. It will be able to generate automated messages to patients to remind them to take their medication, report how they’re feeling, do their exercises etc, and simply maintain that regular contact that patients find so reassuring.
The data collected from each patient will help care providers to deliver a better quality of care individually, but there is also a wider benefit when the data from all patients is aggregated. Care outcomes can be analysed to assess which treatments are more effective than others and the lessons gleaned can be applied to improve the efficiency and quality of care.
In summary, remote care technology is changing the way outpatient cases are managed from an outbound process, where care managers have to chase patients to check on their progress, to an inbound model, where patients take more interest in and responsibility for their own care and send their feedback to the system.
This reduces the burden on healthcare providers, reducing the physical and mental impact on staff, saving costs and enabling a better outcome for patients all round. And as AI comes increasingly into play, those efficiencies will only increase.