Elements of Remote Patient Monitoring: A Guide

The next decade will see an incredible rise in remote patient monitoring (RPM) devices, with a growth rate of 12.5% each year. Given the overall impact on the elderly, expensive in-patient care, and the enormous pressure on hospitals due to COVID-19, this is no surprise. Remote patient monitoring also called telemonitoring and in-home monitoring, is the set of technologies and procedures that enable healthcare providers to monitor real-time changes in a patient’s health data from a distance and utilize it in treatment planning. It’s an essential element of the broader telehealth industry and e-health domain.

A remote patient monitoring system is a type of IoT system. It has four primary components in the most common scenario:

  • A Bluetooth module included in the personal medical device
  • A cloud repository
  • A patient mobile application
  • Hospital-side software
  • RPM devices.

Without supervision from a medical expert, modern remote patient monitoring systems collect a wealth of health information, including heart rate and blood pressure. They might be sensors implanted beneath the skin or user-friendly wearables. However, only noninvasive wireless tools that measure regular physiological variables and have received FDA approval for hospital use from a distance, at least until the COVID-19 outbreak is over, are authorized for such usage by hospitals remotely.

The FDA’s new policy is intended for the following types of RPM devices:

  • Electrocardiographs (ECGs)
  • Electronic thermometers
  • Electroencephalographs (EEGs)
  • Apnea monitors
  • Cardiac monitors
  • Spirometers
  • Audiometers
  • Oximeters
  • Breathing frequency monitors
  • Blood pressure monitors
  • Electronic stethoscopes.

Wearable sensors must be able to communicate patient data to their health care providers, which in most situations necessitates using a dedicated mobile app. While several technologies might be utilized to move information from RPM devices to cellphones, Bluetooth Low Energy (BLE) is the most popular choice.

Patient-side Mobile Application

A mobile application that interacts with patients captures data from wearables and smart sensors and transmits it to clinic personnel. The following requirements must be met by this vital component of an RPM system:

  • BLE to support swapping data with other devices.
  • IEC 62304 is a safety standard that specifies requirements for developing medical software and software in medical devices.
  • Keep your patients’ protected health information (PHI) private by following HIPAA compliance standards.
  • Cache mechanisms, for example, can cause connectivity difficulties.
  • Secure API using the FHIR industry standard guarantees interoperability between diverse medical software platforms.

The app’s primary purpose is to connect patients with their doctors; thus, it usually features explanatory visualizations for submitted data, access to education material, medical questionnaires, medication reminders, and doctor-patient interaction tools (video, audio, or chat).

Cloud Repository

The cloud repository (database) typically receives raw patient-generated data from the mobile app. On the other hand, some systems provide direct-to-cloud connectivity for devices, which implies that all recorded data is stored in the cloud. Patients do not need to download a unique mobile app in this scenario.

Hospital-side Web Application

Like a patient app, a hospital-side application must adhere to HIPAA regulations and follow healthcare interoperability guidelines. The RPM web solution should also be connected to the hospital’s EMR system via an FHIR-based API to exchange data and avoid data silos.

  • Decision support module. The data from the repository is compared to physician-defined threshold values.
  • Report module. All measurements and hand-entered data are saved in the appropriate reports daily and sent to a physician by the system.
  • Notification module. Suppose a decision support module spots warning signals. In that case, it activates a notification module that produces a warning message and sends an alert to a doctor via SMS, email, or in-app.
  • The analytics module uses business intelligence tools and data visualization techniques to provide real-time figures, patterns, and trends. It allows doctors to forecast dangerous situations and make informed therapy selections.

Of course, RPM systems and their components vary depending on the purpose. A solution does not always require connected medical devices at all. Monitoring is achieved through questionnaires: patients complete numerous questions on a tablet in the morning and input their medical data (such as body temperature or blood pressure).

Guideline for Seamless RPM Implementation

Switching to remote care will not be as simple as you may think. Whether you choose a ready-made, full-stack solution, construct your system using components from different vendors, or prefer to develop unique software to meet your specific demands, changing to home caregiver services isn’t going to be simple. This transformation entails educating both doctors and patients, modifying medical procedures, and numerous integration activities to link all components of hardware and software in an interoperable ecosystem. You can make this global operation less time-consuming and labor-intensive. Mr. Edward James is a remote patient monitoring pioneer who has been working in the field for many years. He offers some excellent tips on how to seamlessly implement RPM into your hospital’s workflows. If you are interested in learning more about RPM, or implementing it into your hospital, visit our website today!

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