Telemonitoring - Transforming Healthcare, Episode 6
September 19, 2022

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We’re back with another new technology that we believe will transform healthcare. Telemonitoring… Here’s what you need to know in a nutshell!

Hosts: Em Tombash, MD, Todd Ponsky, MD

Telemonitoring is the use of information technology to monitor patients at a distance. This monitoring involves recording vital signs, for example, blood pressure and pulse, and transmitting this information electronically which allows the patient's medical team to track and monitor a patient's vitals on a regular basis, then use this data to identify signs of deterioration, intervene promptly and prevent admission to hospital. With COVID-19, healthcare systems had to rethink the optimal delivery of healthcare services and this has increased the demand for general medicine providers like internal medicine, family medicine, and emergency medicine. https://journals.lww.com/journalpatientsafety/Fulltext/2021/12000/Inpatient_Respiratory_Arrest_Associated_With.5.aspx

Before the pandemic, data suggested that routinely monitoring hospitalized patients with continuous pulse oximetry and heart rate devices was associated with reduced mortality. In this study, which involved more than a hundred thousand patient discharges, early recognition of hypoxemia and respiratory depression were largely responsible for the observed decrease in mortality. https://bmcprimcare.biomedcentral.com/articles/10.1186/s12875-018-0814-6

Here is another article where, “The focus group included 181 patients and telemonitoring was valued by those who found it empowering and convenient. This, combined with initial professional concern that increased surveillance may create dependency led to the development of a more patient-led service.” https://pubmed.ncbi.nlm.nih.gov/34586072/

Home telemonitoring has emerged as a potential solution to reduce these costs, but the evidence is mixed. According to this meta-analysis, “Health care costs showed ambiguous results, with 3 studies reporting an increase in health care costs, 3 studies reporting a reduction, and 4 studies reporting no significant differences. Health care cost reductions were realized through a reduction in hospitalizations, whereas increases were caused by the high costs of the telemonitoring program or increased health care utilization.” https://pubmed.ncbi.nlm.nih.gov/31282755/

Although we see telemonitoring mostly in cardiology or internal medicine, it’s not limited by them. In this article, they used telemonitoring for hypertensive disease in pregnancy. And according to them, “Telemonitoring of hypertension in pregnancy is likely to become commonplace in the next five to ten years and research now must be directed to ensure it is used most safely before its general introduction into daily clinical practice can be recommended. Raising women's awareness of their health condition could improve both pregnancy and long-term health outcomes.”

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