According to a report by the Australian Institute of Health and Welfare (AIHW)1, in 2016-2017 alone there were 715,000 potentially preventable hospitalisations in Australia.
Almost half of these hospitalisations (47%) were due to chronic conditions. Since the 1980s, the number of people in Australia with multiple coexisting chronic conditions, known as multi-morbidity, has increased four-fold.2 Current estimates suggest that 40% of Australian adults have three or more chronic conditions.3
While older patients are more likely to have multiple chronic conditions, they’re also generally considered more likely to struggle with adopting new technology. This perception, as well as other barriers such as cost and inferior or cumbersome technology, has resulted in the reluctance of clinicians to think patients can manage with the use of technology to monitor their own health. Recent research on tech adoption in older adults in the US by the Pew Research Center4 found that while many seniors remain digitally disconnected, two-thirds of those aged 65 and older go online and 42% now own smartphones (up from just 18% in 2013).
How remote patient monitoring can help
Remote Patient Monitoring (RPM) can help to reduce unnecessary hospital admissions whilst empowering patients with chronic conditions to be more proactive in managing their health.
Research by the CSIRO5 has shown that RPM provides cost savings for the healthcare system and improves patients’ quality of life and understanding of their own medical conditions. It enables patients to stay connected with health professionals outside of formal care delivery settings (such as hospitals and GP clinics) and can allow older patients to receive care in their own homes for longer.
With remote monitoring, deterioration in a patient’s health status can be brought to a provider’s attention early enough to allow for proactive intervention to help avoid hospitalisation. It also involves patients more in the management of their own care; for example, by teaching them how and when to integrate taking medication into their daily activities. Hospitals that manage patients with RPM can experience efficiency gains with better patient flow and reduced emergency room admissions.
Assessing patients for RPM
Research literature identifies a wide range of conditions that are known to benefit from vital sign monitoring and routine collection of health survey data including (but not limited to) asthma, diabetes, chronic obstructive pulmonary disease (COPD), heart failure, coronary artery disease, cardiac arrhythmias, mental health, and wound care.6
RPM is best deployed in populations where the goal is to improve health literacy and self-management, support patients with unstable and poorly controlled chronic conditions, and help people stay at home and out of hospital where that might be appropriate.
Factors to consider
When contemplating who could benefit from the use of RPM, health professionals should consider the patient’s type of health condition, personal attributes and technological capability.
- Technical literacy: It’s important that a patient has the ability to use the technology required to facilitate RPM. However, a recent study7 of telemonitoring older patients with multi-morbidity found that their belief in their own ability to use technology was not linked to prior experience. This suggests it’s important that appropriate on boarding processes are followed so a patient’s confidence in RPM is established early.
- Health literacy: RPM may aid improving health literacy which is important as low health literacy is associated with poor health outcomes and reduced effectiveness of chronic disease management programs in general. This is because health literacy impacts on the ability of people to understand the advice and recommendations from healthcare providers.
- Readiness to engage: An individual’s adherence to prescribed medicine regimens and lifestyle changes have been shown to impact on the effectiveness of health interventions. Self-motivation to participate in an RPM program is in itself a good indicator of patient suitability.
Removing barriers to technology adoption
A 2017 review9 of the factors influencing patients’ acceptance of smartphone health technology for chronic disease management showed that perceived ease of use was affected by patients’ smartphone usage experience, their relationship with their doctor, the perceived health threat, and self-efficacy. When people use their own mobile device, they are more likely to add an application for a specific use than if they are required to use new and unfamiliar devices in their home.
Improving care through technology
MyCareManager is a software solution from Telstra Health that helps healthcare professionals monitor, connect with, and guide multiple patients remotely, using a comprehensive dashboard that provides at-a-glance visibility of any matters requiring attention. Clinicians can also use the built-in video conferencing feature to contact their patients both for assessment and support and if they identify clinical issues.
The solution actively involves patients in their health and wellbeing. Using the MyCareManager Client App, patients build a healthcare plan, including a list of daily tasks to action, and receive scheduled reminders, notifications and appropriate monitoring from their clinician.
The team at MyCareManager have the technical and clinical expertise to work with clinicians to define patient eligibility based on their medical needs, technological compatibility and user competency. This includes providing an assessment tool that helps clinicians determine a patient’s mobile device competency level, and therefore their individual suitability to this solution.
