Encouraging data points to significant healthcare cost reductions and improved patient outcomes, writes Lasse Rousi, CEO of Medixine.
In the past year, we’ve witnessed an interesting shift in healthcare professionals’ perceptions of remote patient monitoring (RPM). From once being considered a yet-to-be-proven, experimental concept, the technology is now becoming recognised as a ready-to-implement solution to the daily challenges currently crippling the healthcare sector.
Signals from Finland and other European countries indicate that RPM is gradually moving beyond the latest digitalisation trend and towards more mainstream adaptation. The direction is particularly strong in the management of chronic diseases, such as heart conditions, respiratory illnesses, cancer, and diabetes.
There’s a good reason for this development: clinicians are beginning to see the proven value RPM can bring. Furthermore, these observations are supported by clinical studies’ indication that RPM programs can significantly reduce care costs compared to traditional physical follow-up and treatment pathways while maintaining the same quality of care.
The growing need for RPM
Chronic diseases like heart conditions, diabetes, and respiratory illnesses are on the rise globally and are a tremendous burden to patients and healthcare systems alike. The World Health Organisation (WHO) estimated chronic diseases account for 85% of total deaths in the UK. In 2019, the UK spent £ 50.5 billion treating chronic conditions, which is next to roughly 700 billion euros spent at the European level, making chronic diseases one of the major socio-economic challenges of our time. Alarmingly, the cost of chronic disease worldwide is estimated to reach $47 trillion by 2030.
These conditions require continuous management, which traditionally involves frequent hospital visits, regular check-ups, and constant monitoring by healthcare professionals. This is time-consuming for the patients and will also swallow up money as, in some areas, the distances between homes and hospitals can be substantial. This is not only highly inconvenient for patients, but can also impact the quality of healthcare services available to them.
At the same time, the global healthcare workforce is facing significant shortages, and the traditional model driven by face-to-face care is becoming unsustainable. In the UK, the workforce crisis is at a tipping point already impacting healthcare delivery and patient care quality. Unless changes are effectively ushered in, the longer-term outlook appears bleak, with a significant staffing shortfall predicted by 2036. Already, emergency departments are consistently overwhelmed, and healthcare providers are stretched more thinly than ever, trying to meet the needs of patients who could receive the care and medical advice they need through other channels.
This is where remote patient monitoring steps in.
The case for cost reduction in CHF
Congestive heart failure (CHF) offers an enlightening case study of the impact that RPM can have on costs and patient outcomes, simply by prioritising in-person consultations to the situations where they are most needed, while also reducing the frequency of sudden hospital admissions.
Patients with CHF often experience sudden deteriorations in their condition, leading to emergency hospital visits. These can be caused by, for example, fluid buildup in the lungs and tissues making it difficult to breathe, or heart rhythm abnormalities, such as atrial fibrillation, which can precipitate sudden heart failure symptoms or lead to dangerous drops in blood pressure. Traditional in-person monitoring may not catch early signs of deterioration in such cases.
However, it is possible to significantly decrease or even avoid unplanned hospital visits by proactively monitoring the patient’s condition in the comfort of their home. This way, any signs of the patient’s condition worsening can be identified early, and clinicians can adjust the medication or call the patient in for a visit before there is an acute need for hospital care. By addressing these issues early, healthcare providers can decrease hospitalisation rates, leading to significant cost savings and better patient outcomes.
And it’s no hypothetical story. A recent study in Finland involving over 100,000 heart failure patients found that nearly half had been admitted to the hospital at least once due to exacerbations of their condition. In many of these cases, early intervention via RPM could have identified worsening symptoms, such as fluid retention or weight gain, and allowed for timely adjustments to medication or lifestyle recommendations, preventing the need for hospitalisation altogether.
The study also highlighted that RPM could reduce inpatient days by 50% and cut healthcare costs by up to 36%, all while maintaining the same quality of care.
Enhancing patient empowerment and engagement
Looking beyond the financial benefits, RPM’s potential to change lives by increasing patient comfort and convenience is another key factor in its continued prevalence. Additionally, patients with chronic diseases often feel a sense of security knowing that their health is being monitored continuously by experts familiar with their medical history. This reassurance can improve their overall well-being and quality of life, as they are no longer confined to the rigid schedules of in-person appointments. Studies have shown this not only increases self-reported patient satisfaction but can also lead to improved health-related outcomes.
With access to RPM, they have the flexibility to manage their health on their own terms, with the support of their healthcare providers just a click away. With access to their health data, patients can also take a more active role in managing their conditions. They can monitor trends in their health metrics, receive alerts when something is amiss, and then, with the interpretation of their healthcare provider, the data can be used to inform adjustments to their lifestyle or medication. This level of engagement brings a sense of responsibility and control, often lacking in traditional healthcare models.
Challenges in adopting new technology
As is to be expected in any significant shift in the way care is delivered, RPM comes with hurdles that must be cleared if we are to maximise its potential, despite the clear benefits. One of the primary obstacles impacting the speed of RPM adoption at present concerns the funding models that underpin healthcare systems and the overall complex way healthcare is managed and monetized.
In countries with public healthcare, such as Finland, budgets are tightly controlled, and making room for innovation can be challenging. In contrast, more market-driven systems like the United States tend to adopt new technologies more rapidly, as providers are incentivised to find cost-effective solutions to improve patient care.
But there is hope on the horizon. Recent reforms in many European countries have started to bridge the gap between primary and specialist care, ensuring that the organisations that pay for healthcare also benefit from cost-saving innovations like RPM.
Another challenge is the perception that news technologies will require a long-winded adaptation process for clinicians. While many healthcare organisations recognise the potential of RPM, their conservative attitudes and reluctance to roll out new technologies into established workflows has meant that adoption has been slower than anticipated.
To address this, it is critical for RPM providers to make their solutions as seamless and user-friendly as possible. In fact, the best RPM systems become “invisible” over time. When they work well, clinicians don’t even notice the technology. It seamlessly integrates into their day-to-day work, giving them the data they need to make informed decisions without adding to their workload.
For example, healthcare providers are already juggling multiple IT systems, and asking them to learn and implement another platform may be seen by some organisations as an added burden. In fact, the opposite is actually true. Most RPM solutions integrate directly with existing electronic health records and other hospital systems, so one major advantage is that clinicians don’t need to learn multiple separate systems.
From management to prevention – expanding the scope of RPM
While RPM is currently most effective for managing chronic diseases, its potential extends far beyond this. As technology continues to evolve, there is the possibility of integrating RPM into preventive healthcare. Imagine a world where individuals can continuously monitor their health metrics, allowing for early detection of potential health issues before they become serious. This proactive approach would shift the focus from treatment to prevention.
For example, for patients with a history of heart disease, monitoring metrics like heart rate variability, respiratory rate, and oxygen saturation could reveal subtle patterns indicating early stages of heart dysfunction, even before other symptoms arise. With this early detection, preventive steps like lifestyle changes or adjustments to medications could be implemented, delaying or even preventing the onset of CHF.
However, this vision of the future comes with its own set of challenges. For example, costs and savings do not always occur in the same place. While the primary healthcare sector is responsible for preventive care, the savings resulting from preventive actions are realised in the secondary care sector. For RPM to be effective in preventive care, there needs to be a clear framework for who will bear the costs. Currently, healthcare systems, especially in Europe, are already burdened with high expenses. While RPM offers long-term savings, the initial investment can be substantial, which may be a barrier to adoption for many, and this in turn, overshadows long-term savings.
To overcome these challenges, a collaborative approach involving governments, healthcare providers, and technology companies could be key. By developing public-private partnerships, the financial burden can be shared, making RPM more accessible and scalable. Incentivising the adoption of RPM through subsidies, tax breaks, or insurance coverage could help offset initial costs, encouraging wider implementation.
A global perspective on RPM
The primary reasons driving the adoption of RPM vary across different regions. In the Nordic countries, for instance, where public healthcare is dominant, RPM is being integrated into public healthcare systems to manage the growing burden of chronic diseases exacerbated by a rapidly aging population.
By contrast, in countries like the United States, RPM is often driven by private healthcare providers who see the value in offering patients a more convenient and cost-effective way to manage their health. But since the overall clinical situation remains fairly consistent globally, there’s no reason why RPM shouldn’t be considered as a solution that can be adopted for the wholesale benefits and nuanced to more precisely fit the needs of a host of different specific use cases, many of which have fundamental similarities. It’s an example of a single solution that can be used in many different ways, with the benefits amplified by developers listening to the customers’ needs to tailor the solution to the challenges.
As RPM continues to gain traction globally, it is essential for healthcare providers to collaborate and share best practices. The challenges faced by one region could offer valuable lessons for another. By working together, healthcare providers can overcome the barriers to RPM adoption and unlock its full potential.
In fact, for healthcare providers still on the fence about adopting RPM, my advice is this: you simply have to take the leap to reap the rewards. The investment required to implement RPM is relatively low, and the benefits can be seen almost immediately. If overhauling the operations of an entire healthcare center feels too daunting, begin with a pilot.
Yes, there may be challenges, but the technology is now proven, and any process hurdles are part and parcel of any change for the better.
Lasse Rousi joined Medixine in November 2019. Previously he worked at IT and business consulting group CGI, as director of the company’s welfare and healthcare business.
