Remote patient monitoring moving into the mainstream

The Covid-19 pandemic has accelerated the shift toward RPM, and provided companies an unprecedented chance to prove their devices can make care more convenient, cheaper, and more effective. It has also opened the door for RPM to play a new and more pivotal role in clinical trials, as researchers look to keep virtual tabs on patients’ symptoms or progress.

More medical care is being delivered virtually than ever before – and remote patient monitoring is making it possible.

Thanks to rapid advances in technology and significant investment, the field of remote patient monitoring, or RPM, has expanded dramatically in recent years.

Medical device stalwarts, healthcare startups, and tech giants alike have moved into the space, armed with everything from smart watches that can detect heart problems to connected inhalers that forecast the chance of an asthma flare-up.

The Covid-19 pandemic has accelerated the shift toward RPM, and provided companies an unprecedented chance to prove their devices can make care more convenient, cheaper, and more effective. It has also opened the door for RPM to play a new and more pivotal role in clinical trials, as researchers look to keep virtual tabs on patients’ symptoms or progress.

As the sector continues to grow, companies working in remote patient monitoring will face several key tests. Can their technologies improve patient outcomes, or meet the same standards as traditional care at a lower cost? And how will they earn the trust – and backing – of payers, regulators, and patients?

According to the statistics, RPM technology was a concept that was foreign to the majority of people before 2020 but is now slowly gaining a foothold among providers as they have started adopting this service and often prescribe it to their patients.

The RPM system is a vast and expanding field with USD 32 billion valuations reported in 2021. It is expected to reach USD 117.1 billion by 2025 at a CAGR of 38.2 percent, thus showing the enormous potential a remote patient monitoring system might hold in the next few years.

Currently, the providers integrating RPM-enabled home health monitoring systems in their providing services are already witnessing reduced hospital readmission penalties.

Especially popular among senior patients, RPM technology is gaining positive ROI, largely due to the cohort’s high incidence of multiple chronic diseases.

Another significant trend emerging in RPM technology is the miniaturization, a process whereby devices makers are making their solutions smaller and less invasive, while partnering with new companies expand their market share and grow the technology. As RPM continues to advance, it stands to have a positive effect on both patients and the healthcare providers treating them.

Non-traditional players are entering the market. RPM has seen exponential growth in recent years, boosted further by the widespread adoption of consumer wellbeing monitoring and, more recently, its subsequent convergence with long-term healthcare monitoring in the home and other non-clinical environments. With changes in the reimbursement environment and mounting evidence pointing to the as-yet-untapped potential of telehealth in many countries, non-traditional medical devices manufacturers are increasingly eager to enter and disrupt the healthcare market.

Apple was the first to enter the space this way, publishing a large and entirely virtual clinical study of its Apple watch and embedded electrocardiogram, or EKG, which records the heart’s electrical signal. The study, which Apple brought to the Food and Drug Administration as part of its work to get the watch cleared as a medical device, showed the device could spot the heart condition atrial fibrillation, or A-fib. Fitbit, which was acquired by Google last year, is following the same path. The company launched a similar virtual study of its wearable in A-fib in May and plans to present the data to the FDA.

Even Facebook, which has yet to make its own wellness wearable, appears to be edging toward the heart-monitoring space. In May, the social media giant formed a new team dedicated to health technology under the leadership of Yale cardiologist Freddy Abnousi and posted job ads for positions that include an expert in photoplethysmography, the same type of technology that Apple and Fitbit use for heart monitoring, and an expert skilled at interfacing with regulators like the FDA.

The tech- and consumer-driven shake-ups are already creating ripple effects throughout the healthcare system. Clinicians, for example, are increasingly being asked to interpret the results of Apple watch EKGs in patients who are hesitant to come in for a visit during the pandemic.

Still, by focusing on building out device capabilities – instead of creating comprehensive virtual health platforms that pair with devices – tech giants have created a new set of challenges. Without being connected to any sort of system, it remains unclear how, exactly, the devices will ultimately fit into a user’s care continuum.

If Apple, Fitbit, and other big tech companies intend for their tools to remain relevant to users’ health for the long term, they will need to start integrating them with platforms that can help guide their care.

Amazon’s new wearable, called Halo, may be a first step in this direction. Although the device does not currently have any medical diagnostic capabilities, it lets users share their body fat percentages with clinicians through an integration partnership with electronic medical record vendor Cerner.

Virtual care businesses, in contrast to tech giants, are jumping into the health-tracking space with a platform-centric strategy. Companies, including Omada as well as Alphabet subsidiaries Onduo and Verily, offer care-delivery programs that harness remote-monitoring hardware made by other companies, and use fleets of faraway health coaches to help patients interpret and understand their data.

Those devices – which include Bluetooth-enabled weight scales, blood pressure cuffs, and glucose meters – are connected to the company’s platform, where clinicians and coaches take a patient’s data, contextualize it, and use it to offer advice or guide a person’s care. Unlike tech giants and medical device makers, who acquire customers by selling devices, these companies acquire patients by way of partnerships with employers, insurers, and health plans.

But virtual-care companies’ business models often rely on reimbursement or buy-in from health insurers or employers, meaning their success depends on being able to consistently demonstrate their effectiveness with research. And while many of these companies have published small-and short-term studies, academics and researchers say larger and more comprehensive research is needed.

The rise of the patient-consumer is also placing new pressures on more traditional healthcare players, including established medical device makers. Industry stalwarts like Philips and General Electric, for example, are being forced to consider fundamental changes to their business structure aimed at better serving the patient-consumer instead of the hospital or clinic.

Regulators have begun to respond to these changes in recent months with a mix of temporary and permanent policies geared at making remote monitoring tools more widely accessible. For example, the FDA introduced a series of pandemic-era authorizations that increase patients’ ability to use remote health-tracking tools at home, including the EKG-containing Apple watch and Livongo’s glucose meters.

And starting last year, the Centers for Medicare and Medicaid Services began reimbursing providers, who use remote monitoring tools, with new billing codes explicitly focused on remote health tracking, including codes that focus on weight and blood pressure.

If those changes are to have real sticking power, however, companies, including tech giants and health tech providers, will need to figure out how to make their devices an established, long-term component of the existing healthcare system, rather than simply a temporary or one-off solution.

With the benefits of RPM, it is pretty simple to say why it is burgeoning. Even after the health crisis is over, digital healthcare demand is here to stay for years. McKinsey & Co. estimates that the current healthcare spending of about USD 250 million can be virtualized to save costs. That said, the pandemic has certainly banished various traditional practices in healthcare and has strived hard to move with the growing trend. In the coming years, the popularity and increasing availability of health devices and patients’ willingness to capture and share the information will significantly raise RPM. It helps the health providers to deal with the hassle of outpatient visits.

With over 3.2 billion mobile users and 1.35 billion tablet users, it comes as no surprise how mobile apps will benefit the patients and healthcare providers. The deployment of mobile apps and boost in mHealth has made remote mentoring even easier.

Hence, the remote care of the patients should be pivotal for every healthcare organization.