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Physicians at UPMC Medical Center in Pittsburgh are using remote monitoring platforms to more easily interact with heart failure patients, other providers, insurers and additional stakeholders.
Remote monitoring is a form of telemedicine, explains Andrew Watson, MD, a practicing physician and a vice president at UPMC. Telemedicine involves the use of images or video to communicate with others.
Remote monitoring involves using technology that patients, insurers and other entities already have, such as a smartphone, tablet computer or desktop computer. Each participant is using their own devices to fill out survey questions or asking a patient questions and getting back answers.
Remote monitoring at UPMC is growing quickly, with about 200,000 encounters expected this year, Watson estimates. He has worked with remote patient monitoring vendor Vivify for several years, and UPMC has invested in the company.
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Watson views remote patient monitoring as a more humane way to practice medicine and reduce burdens on patients, because they can stay home and communicate in real time with no need to travel to a doctor’s office.
Vulnerable patients are provided with medical devices that they use during a remote medical encounter—these devices can include bio-sensors, blood pressure cuffs, heart rate and pulse rate monitors, glucometers and even Apple smartwatches.
Remote monitoring can be used across various patient populations, but it’s particularly helpful for physicians treating elderly patients, according to Watson. In the UPMC program, the average age of a patient is 72, and they typically have congestive heart failure. Some 96 percent of these patients recommend the in-home program to others.
When the monitoring program was started, there was concern about whether the elderly would be the right patients to target with all the gadgets being used, but that worry quickly dispelled.
“Age bias is something we learned about,” Watson acknowledges. “Just because someone is older doesn’t means they can’t do it.”
Now, results from the program show a significant reduction in heart failure mortality at 90 days with patients who have congestive heart failure.
Still, the program had hiccups that compelled stopping and rebooting certain parts. For instance, the organization found that integration of remote patient data being put in the electronic health record and other information systems took more time than anticipated, and a lot of time was spent understanding how to best integrate front-end care systems.
Once everything was in place, however, UPMC quickly found that remote monitoring also could be used for a range of other maladies, such as postpartum hypertension, pain management, behavioral health, and a range of additional disease states and illnesses.
Once it’s set up, it is easy to scale up,” Watson advises. “You can move from well care to other care types.”
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