Study finds limited evidence that remote patient monitoring improves outcomes
- Despite growing enthusiasm for remote patient monitoring devices, there is little evidence to support claims they improve health outcomes, a new study in the journal Digital Medicine concludes.
- A meta-analysis of randomized controlled trials from January 2000 to October 2016 found RPM had no statistically significant impact on six reported outcomes: body mass index, weight, waist circumference, body fat percentage, systolic blood pressure and diastolic blood pressure.
- RPM was more beneficial when tied to health behavior models and personalized coaching. Still, providers should consider the gaps in the evidence base before using RPM in the clinical setting, the study says.
Wearable biosensors that track, store and transmit health-related data have been touted for their potential to improve patient outcomes, reduce utilization, lower healthcare costs and increase efficiencies in the provider workplace. The Cleveland Clinic included RPM in its list of top 10 medical innovations to watch in 2018.
With the shift to value-based reimbursement, payers will continue to push payment models that encourage patients to seek care in cost-effective settings. “Bundled payments hold great potential to become the driver of innovations that leverage the explosion of wearables, remote monitoring and greater patient engagement,” Steve Wiggins, founder and chairman of Remedy Partners, told Healthcare Dive in December.
However, questions about their ability to impact patient outcomes remain.
Using trackers to improve outcomes for patents with select conditions like hypertension, Parkinson’s disease and low back pain showed some promise, while goals such as increased physical activity and weight loss yielded mixed results, the study says.
Similarly, automated text messages and cash incentives had little effect on outcomes, while care pathways and other behavior modification models were likely to trigger change. But even there, some populations benefited more than others, the authors note, citing a hypertension study where only adults 55 and older improved with RPM.
Future studies should look at the varying effectiveness of RPM in different subpopulations, as well as how both patients and providers view benefits, the study says.
“For RPM interventions to impact healthcare, they will need to impact outcomes that matter to patients. Examples include patient-reported health related quality of life (HRQOL), symptom severity, satisfaction with care, resource utilization, hospitalizations, readmissions, and survival,” the authors write. “There is little data investigating the impact of RPM on these outcome measures.”
There is some evidence that using trackers could help to reduce readmissions. In a study of 71 patients with appendiceal cancer, those with higher daily step counts on their Fitbit device during recovery from surgery had lower 30-day and 60-day readmissions.