Remote Patient Monitoring for Cardiology
Kencor’s Remote Patient Management is targeted to cardiology patients who have been identified as candidates for Chronic Care Management (CCM) services. In addition to access to Sami, Kencor provides each patient with a kit that includes a wireless transmission enabled weight scale, blood pressure cuff, and pulse oximeter.
Kencor’s Remote Patient Monitoring (RPM) can empower patients to better manage their health and participate in their health care. When used by clinicians, RPM can provide a more holistic view of a patient’s health over time, increase visibility into a patient’s adherence to a treatment, and enable timely intervention before a costly care episode. Clinicians can strengthen their relationships with, and improve the experience of, their patients by using the data sent to them via RPM to develop a personalized care plan and to engage in joint decision-making to foster better outcomes.
The cost of traditional healthcare has soared to untenable heights. In the United States, federal healthcare spending is rapidly approach 20% of GDP. Furthermore, chronic disease is highly prevalent, accounting for nearly 90% of all healthcare spending in the United States. Additionally, it costs 3.5 times more to treat chronic diseases than it does other conditions, and they account for 80% of all hospital admissions. In recent years, rapid advancements in healthcare delivery models and low-cost wireless communication have spurred optimism in finding cost-effective, value-enhancing solutions to these issues. Notably, the integration of mobile communications with wearable sensors has facilitated the shift of healthcare services from clinic-centric to patient-centric delivery models such as remote patient monitoring.
With Kencor SAMi™ integrated directly into Remote Patient Monitoring services, each healthcare provider, medical professional, or doctor will receive a personalized user login that will allow them to view and analyze patient-generated health data that is transmitted via the devices or manually entered. The healthcare professional can interact with the patient in the following ways:
- Monitoring of vital signs
- Communicating with patients/caregivers
- Making changes to a patient’s Care Plan based on analysis of data
- Generating assessment questions and follow-up activities
Kencor’s overall goal is to facilitate engagement between patients and their providers to reduce unnecessary hospital readmissions, reduce the overall cost of care, and improve patient outcomes.
Effects of RPM and Cardiovascular Disease
The potential for RPM to reduce the burden of CVD has led to a burgeoning volume of research aimed at evaluating its clinical and economic effectiveness.
Hypertension is a major risk factor for CVD. The age-adjusted prevalence of hypertension in US adults is nearly 35%, which equates to approximately 85 million. By 2035, projections show that over 42% of US adults will be hypertensive, an additional 27 million from current projections.3 Cost projections for hypertension are similarly daunting, with 2015 figures tallying nearly $70 billion and those for 2035 soaring to over $150 billion. RPM may serve as a vital conduit for improving hypertension control and reducing the economic burden that stems from the costly hospital stays that result from acute events related to hypertension.
Research has shown RPM can reduce systolic blood pressure (SBP) and diastolic blood pressure (DBP) significantly compared to usual care and self-monitoring alone. When compared directly to usual care, RPM on the average reduced SBP and DBP. In three-way comparisons, though self-monitoring alone may have a positive impact on blood pressure control compared to usual care, the inclusion of RPM can have a more substantive impact on SBP and DBP than does self- monitoring. Additional studies have shown that RPM’s positive impact on SBP can increase if the intervention is long-term, and if the intervention includes multiple behavior change techniques. However, the results of this research have been largely heterogenous, leading to inconclusive results on the degree to which RPM can positively impact blood pressure control.
Heart Failure Heart failure (HF) is a chronic and life-threatening condition that places a substantial burden on health care systems worldwide with high rates of hospitalizations, readmissions, and outpatient visits. In the US, it is estimated that nearly 6 million adults currently have HF, a number that is expected to increase by 40% by 2035. Limited research has been published on the potential for RPM to improve clinical outcomes for heart failure patients, and the results have been mixed.
Although recent systematic reviews and meta analyses have shown a positive effect on HF-related admissions and mortality rates and all-cause mortality rates, the bulk of the literature consists of low-quality and inconsistent evidence about the beneficial effects of RPM. More specifically, though better evidence from randomized control trials has been unfavorable, it still stands in contrast to the favorable evidence gained from non-randomized trials. For example, while RPM has been shown to lower the risk of all-cause and HF mortality, and all-cause and HF hospital admissions in cohort analyses and non-randomized trials, results from larger-scale, randomized control trials have been inconsistent with some showing no or negative effects, and others showing decreases in HF-related admissions, emergency department visits. Future research should focus on understanding the process by which RPM works in terms of improving HF-related outcomes, identify optimal strategies and the duration of follow-up for which it confers benefits, and further investigate whether there is differential effectiveness between chronic HF patient groups and types of RPM technologies.
Usability and Patient Experience
Remote Patient Monitoring is highly dependent on its design and usability as it often involves the interaction between multiple user groups through a digital system, or with healthcare professional or doctor at their office. Communication in these use scenarios is usually multimodal, which makes it crucial to know between whom, how and when the information transmission and personal communication occur.
In device development, a user-centered design approach involves end-users in all the stages and helps to understand users’ needs and the context of use, which are key elements for the construction of a system framed within a clinical workflow. RPM that does not include a user-centered design can lead to low uptake and adherence rates. Further, user errors can result from poor usability. Research has shown that a user-centered design appeals to a wide variance of ages and health and digital literacy levels, and increases patient satisfaction. Thus, because ensuring adequate usability is of the essence for the individual patient, effective RPM requires a detailed analysis of end-users’ needs to inform system designers.
Data Privacy and Patient Confidence
All of Kencor’s systems are HIPAA Compliant, and keeping your data private is a top priority. The quality of healthcare data impacts every decision made along the patient care lifecycle. Using RPM to make healthcare decisions necessitates the need for RPM technologies to produce accurate data and information integrity. Data accuracy helps in evaluating health, assess effectiveness of interventions, monitor trends, inform health policy and set priorities. Lack of data accuracy and can cause serious harm to patients and limit the benefits of RPM.
Additionally, intentional and unintentional wrong data entry and the speed at which data is collected can be misleading. Misleading data results in misallocating resources or interventions when needed for the patients. Inaccurate readings, insufficient amount of data, movement and physical activities also contribute to inaccurate data provided through the mHealth devices. Concerns associated with data accuracy and integrity are persistent and can become a risk to patients’ safety.