Hospitals everywhere are being exhorted to cut costs and improve outcomes. There is actually a way to square that circle: remote patient monitoring (RPM). Studies show that monitoring patients at home with biometric technology reduces hospital readmissions dramatically. Equally remarkable is that patient satisfaction with RPM is extremely high. In this Q&A with Dave Wattling (pictured), VP of enterprise solutions at Telus Health, we discuss the projects Telus has underway, and the key trends shaping RPM evolution.
Q: What kind of projects is Telus conducting in RPM?
A: We were involved in supplying the technology for an OTN (Ontario Telemedicine Network) project four years ago that covered over 6,000 patients that were hospitalized for either heart failure or COPD. More recently, we’re involved in a similar project with the Ministry of Health in British Columbia, but this time with a five-year time horizon for provincial rollout across the various health authorities.
Q: Were health outcomes improved in these RPM projects?
A: The results of the OTN project are actually quite stunning. We saw a 76% reduction in hospital admission and 70% reduction in ER visits. In B.C., we saw a 60% reduction in ER visits and 80% reduction in patient stays, and we were actually able to discharge patients sooner. The technology is used to monitor on an ongoing basis instead of waiting for a healthcare provider to collect readings, so we’re able to catch things earlier. We get better outcomes because we avoid readmission or a trip to the expensive hospital. In B.C., we saw a per-client cost reduction of between $4000 – $12,500 per patient. But the most impressive thing in my opinion is nearly 100% patient satisfaction with the programs. Patients get a sense of comfort knowing that they’re being monitored on an ongoing basis, as do the family members of elderly or chronically ill patients.
Q: Does RPM improve the healthcare provider’s productivity?
A: Yes, we saw a dramatic rise in nurses’ productivity. They can go from monitoring about 20 patients at a time to monitoring 50 or even more, in some cases. They’re able to manage a much greater panel of patients because the dashboards prioritize the patients who require attention. The software is intelligent and issues alerts when needed.
Q: Has RPM technology grown simpler for patients to use?
A: Absolutely. The initial versions of the technology were wired. As technology moves on, those devices are becoming wireless and more affordable. In the earlier generations, there were also a lot of finicky buttons to turn on and off. Elderly people had trouble with them, so we fixed all these ergonomic issues. We’ve also worked on the user interface. The buttons are bigger, and the way you take readings and submit data is more intuitive. And we’re no longer reliant on Wi-Fi connections – we now do it through our cellular network because it’s pervasive and available everywhere.
Q: Has the range of equipment and the conditions that can be monitored increased?
A: This is one of the fastest growing areas globally. Wireless biometric devices are now available at a much more attractive price point. They used to cost five times more than a wired device. Now we’re seeing them sold as consumer grade devices in drug stores: pedometers, diabetes monitors, and so on. The number of conditions that can be tracked is also increasing. Heart failure was the first one, COPD and asthma came next, and now we can add diabetes, which is simpler to do than the others.
Q: In what ways is RPM technology evolving?
A: As we evolve technologies, the commodity pricing is coming down, and we’re able to then reduce our price to our customers, which expands the number of customers we’re able to service. We’re also evolving the business model. Historically, a health authority or a government would buy a license for the RPM technology and they buy these kits as they roll it out to patients. We’re evolving that to be more of a Software-as-a-Service solution, where we’ll use a subscription-style pricing, which makes it more accessible.
Q: What are future directions for Telus in the RPM market?
A: We see being able to create solutions that are more aimed at prevention, or ‘soft monitoring,’ if you will. Our solutions today are based on the period of time that follows an acute event. Someone has a heart problem, so we continue to monitor them for six months after their hospital stay. When that period is up, many people still want to be monitored. They become comfortable with their technology, they like the security blanket of it. People want to continue the monitoring solution even when the government is not providing the solution to them. We’re looking at evolving our solutions so that they’re even more consumer grade. That, we think, is the next revolution that will drive greater adoption of RPM.