By Maria Palombini, Healthcare and Life Sciences Practice Leader, Director, IEEE Standards Association (IEEE SA)
In the last two decades, wearable medical and fitness devices – such as activity trackers, blood sugar monitors, blood pressure cuffs, and heart rate monitors – became popular through physician adoption but also with the introduction of many well-known, heavily marketed off-the-shelf solutions such as Fitbit and Apple watches. You can’t go to the gym, a store, or your doctor’s office without seeing someone using a wearable medical device, and that doesn’t include the ones concealed under clothing. As of January 2020, the Pew Research Center reported that one in five Americans are wearing a smart watch or fitness tracker and that figure has expectedly grown since then. While we’ve seen significant advances in wearable technology, there remain notable improvements beyond just wearables yet to come.
What is remote patient monitoring (RPM)?
Remote patient monitoring (RPM) is a technology to enable monitoring of patients outside of conventional clinical settings, such as in the home or in a remote area, which may increase access to care and decrease healthcare delivery costs. RPM refers to the specific technology used to electronically transmit information between patients and physicians, and it is just one delivery system within the broader telemedicine industry.
Remote Patient Monitoring (RPM) as a Patient-Centered Healthcare System
Healthcare providers understand the potential of RPM as a key component in the evolution towards more proactive, continuous models of care. By 2025, one report estimates that the number of U.S. remote patient monitoring users will almost double to 70.6 million – more than one-quarter of the population. This growth will be facilitated by the continued push to move patient care into patients’ daily lives, rather than being relegated to the four walls of the doctor’s office or healthcare facility.
But as new devices are being developed, one questions needs to be top of mind – who are we designing these products for?
Evolving the Designs of RPM Devices
While we can appreciate the advances in technologies that influence the evolution of RPM devices, we cannot lose sight of designing with the patient in mind. Some of the considerations and issues affecting the evolution of RPM devices include:
- Lack of infrastructure. Device manufacturers need to remember that not every patient owns a mobile phone let alone have Wi-Fi in the home. In the United States, nearly 30 million residents cannot fully benefit from the digital age. About seven out of ten rural Americans (72%) say they have broadband internet at home, a 9 percentage point rise in home broadband adoption since 2016, according to a Pew Research Center survey taken in 2021. While 97 percent of urban Americans have access to a high-speed, fixed service, only 65 percent of residents in rural areas have this access, according to the Federal Communications Commission. In tribal lands, only 60 percent.
- Real-time monitoring and lag. For some types of monitoring, lag can have serious implications. As we see the build-out of 5G networks, this technology could help solve this problem.
- Patients’ physical and mental capabilities. Mobility is the most common disability among older Americans. According to the Centers for Disease Control and Prevention, there are 61 million adults living with a disability in the U.S. of which 13.7% have mobility disability with serious difficulty walking or climbing stairs. An estimated 1.2 million people aged 18 years and older are diagnosed annually with adult onset brain disease/disorders in the United States. RPM designers need to fully consider these factors when designing in terms of size, device programming, and ease of use and wear, particularly in consideration of an increasing population of elder adults.
- Ease of use. According to the National Library of Medicine, nearly 9 out of 10 adults struggle with health literacy. Patients with high literacy skills may have lower health literacy skills in certain situations, such as a very stressful healthcare issue that could even be further compounded by medications.
- Battery life. Just as mobile phone manufacturers have strived to improve battery life in their devices, the same holds true for wearable medical devices. This issue transitions to the trust issue – a patient must trust that a device, such as one that delivers insulin, won’t fail.
- Affordability. As companies innovate, recovery of R&D costs translates to higher device costs, which are often only available to those with higher levels of insurance or their ability to pay out-of-pocket costs. As a consequence, not everyone has equal access to the latest, more “user friendly” devices. Thus the challenge when the patient sees a device they want, ask the doctor for it, and find they simply cannot afford it.
- Patient privacy and security. This might be one of the greatest concerns of patients – what happens to the data? Is it being sold and, if so, to whom? Is there a possibility that my personal identity can be stolen? The issue here again is trust. While the RPM device might be ideal for the patient’s care, security fears can be the barrier for patient adoption.
Success stories – the future of RPM
Despite the many challenges with RPM design, we can celebrate tremendous innovation. In February, the IEEE Standards Association recognized nine trailblazing and innovativefinalists who competed in the IEEE SA Telehealth Virtual Pitch Competition hosted by IEEE SA Healthcare and Life Sciences Practice and the IEEE SA Transforming the Telehealth Paradigm Industry Connections Program. The competition officially launched the last week of November 2021 and within two short months, more than 30 submissions were received from a well-balanced mix of tech entrepreneurs, academia and commercial entities from across the globe innovating the future of RPM. The IEEE SA Telehealth Virtual Pitch Competition is designed to showcase not only the innovation but also solutions to ongoing challenges of accessibility, feasibility, inclusivity, adaptability, security, and privacy to transform RPM into a patient-centered healthcare system. It placed an impetus on meeting a robust set of criteria, challenging entrants to think beyond the device and position the patient at the center of the process.
I encourage you to read about these amazing innovators, which not only should be recognized for their ingenuity but also for encouraging the advancement of RPM technologies and systems to improve healthcare delivery for all patients.
Maria Palombini currently leads the IEEE SA Healthcare & Life Sciences Practice working with a global community of stakeholder volunteers who are committed to establishing trust and validation in tools and technologies that will change the approach to discover therapies, deliver care, and ultimately enable a sustainable and universal quality of care for all. She holds a B.S. and B.A. from Rutgers College and an M.B.A. from Rutgers Graduate School of Business at Rutgers University.
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